MANAGEMENT THESIS ON
A study on the promotional strategies used by medical representative with respect to Cipla
A report submitted in partial fulfillment of the requirements of
THE MBA PROGRAM (The Class of 2009)
ICFAI NATIONAL COLLEGE
Submitted to Mrs Malleshwari(faculty guide)
Submitted by Mukesh Kumar
Roll no 7NBBPO19
1 | P a g e
TABLE OF Contents
MAIN HEADINGS
PAGENO
(1)ACKNOWLEDGEMENThelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip3
(2)CERTIFICATEhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip4
(3)INTRODUCTIONhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip hellip5
31OBJECTIVE OF STUDYhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip5
32 LIMITATIONhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip5
(4)INDUSTRY PROFILEhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip6-23
(5)COMPANY PROFILEhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip24-33
51SWOT ANALYSIShelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip31-32
52VISION AND MISSIONhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip33
(6)ANALYSIShelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip34-51
(8)FINDINGShelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip52
(9)CONCLUSIONhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip53
(10)ANNEXUREhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip54
101QUESTIONNNAIREhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip54
(11)REFERENCEShelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip55
2 | P a g e
ACKNOWLEDGEMENTS
We cannot achieve anything worthwhile in the field of technical education unless or until the
theoretical education acquired in the classroom is effectively wedded to its practical approach
that is taking place in the modern industries and research institutes It gives me a great pleasure
to have an opportunity to acknowledge and to express gratitude to those who were associated
with my Project Constraints are the best source of inspiration and opportunity to explore us
This project is synergistic product of many minds The inspiration is drawn from the working of
team members and their experiences Communication is the key towards all the responsibilities
and demands of time travel work in competitive work It is plus to have effective secures
communication Project team is grateful to all personalities for stimulating and thought
provoking during the entire project For the successful completion of this project team members
feel deep senses of gratitude to Mrs Malleshwari faculty ICFAIJP Nagar for motivating and
inspiring to achieve the best and providing opportunity to explore ourselves
Last but not the least I would again like to express my sincere thanks to medical representatives
of Cipla for their constant friendly guidance during the entire stretch of this report Every new
step I took was due to their persistent enthusiastic backing amp I acknowledge that with a deep
sense of gratitude
MUKESH KUMAR
ICFAI-JP NAGAR
4th SEMESTER
Date
Place Bangalore
3 | P a g e
CERTIFICATE
This is to certify that management thesis titled ldquoA study on the promotional strategies used by medical representative with respect to Ciplardquo submitted by Mukesh Kumar Enrollment no7NBBP019 during the semester 4 of the MBA program(The class of 2009) embodies original work done by him
Signature of the faculty supervisor
Name Mrs Malleshwari
Designation Faculty for Quantitative methods
Campus ICFAI (JP NAGAR)
INTRODUCTION
4 | P a g e
Management thesis is a part of our MBA program and gives us the opportunity to keep foreword
our views on business It is a component that provides an opportunity to the student to undertake
research into ideas and express our opinions after research Summer internship program is a
extensive opportunity which is really helpful to design the MT Financial sector is the one of the
fastest growing which is helping the Indian economy to increase the pace of the GDP Hence
working with the brokerage firm a NBFC really helped me to construct the management thesis
The report will really help to understand the Indian equity market and how does it works Report
will be also helpful to understand the how the brokerage firm works and the different services
provided by them The study was conducted through the primary and secondary data
Respondents were basically from Bangalore and the customers of Religare who invest in the
Indian equity market in the various form of their investment
Objective OF THE STUDY
To find out the promotional strategies used by medical representative with respect to Cipla
To find out various promotional strategies used by Cipla to acquire the market share
To find out the importance of medical representative in the pharma sector
To find out various roles played by medical representative to enhance the sales
To find out product which are doing well in the market of Cipla
LIMITATION
Major of the study is supported by secondary data
No specific data for bribing with respect to the industry
Bias on the part of respondents will be a major drawback
Analysis of the primary data cant be done by implementing of test
Industry profile
5 | P a g e
The Indian Pharmaceutical Industry today is in the front rank of Indiarsquos science-based
industries with wide ranging capabilities in the complex field of drug manufacture and
technology A highly organized sector the Indian Pharma Industry is estimated to be worth $ 45
billion growing at about 8 to 9 percent annually It ranks very high in the third world in terms of
technology quality and range of medicines manufactured From simple headache pills to
sophisticated antibiotics and complex cardiac compounds almost every type of medicine is now
made indigenously Playing a key role in promoting and sustaining development in the vital field
of medicines Indian Pharma Industry boasts of quality producers and many units approved by
regulatory authorities in USA and UK International companies associated with this sector have
stimulated assisted and spearheaded this dynamic development in the past 53 years and helped
to put India on the pharmaceutical map of the world
The Indian Pharmaceutical sector is highly fragmented with more than 20000 registered units It
has expanded drastically in the last two decades The leading 250 pharmaceutical companies
control 70 of the market with market leader holding nearly 7 of the market share It is an
extremely fragmented market with severe price competition and government price control
The pharmaceutical industry in India meets around 70 of the countrys demand for bulk drugs
drug intermediates pharmaceutical formulations chemicals tablets capsules orals and
injectibles There are about 250 large units and about 8000 Small Scale Units which form the
core of the pharmaceutical industry in India (including 5 Central Public Sector Units) These
units produce the complete range of pharmaceutical formulations ie medicines ready for
consumption by patients and about 350 bulk drugs ie chemicals having therapeutic value and
used for production of pharmaceutical formulations
Over 20000 registered pharmaceutical manufacturers exist in the country The domestic
pharmaceuticals industry output is expected to exceed Rs260 billion in the financial year 2002
which accounts for merely 13 of the global pharmaceutical sector Of this bulk drugs will
account for Rs 54 bn (21) and formulations the remaining Rs 210 bn (79) In financial year
2001 imports were Rs 20 bn while exports were Rs87 bn
6 | P a g e
Indian companies need to attain the right product-mix for sustained future growth Core
competencies will play an important role in determining the future of many Indian
pharmaceutical companies in the post product-patent regime after 2005 Indian companies in an
effort to consolidate their position will have to increasingly look at merger and acquisition
options of either companies or products This would help them to offset loss of new product
options improve their RampD efforts and improve distribution to penetrate markets
The first Indian pharmaceutical company Bengal Chemicals and Pharmaceutical Works which
still exists today as one of 5 government-owned drug manufacturers appeared in Calcutta in
1930 For the next 60 years most of the drugs in India were imported by multinationals either in
fully-formulated or bulk form The government started to encourage the growth of drug
manufacturing by Indian companies in the early 1960s and with the Patents Act in 1970 enabled
the industry to become what it is today This patent act removed composition patents from food
and drugs and though it kept process patents these were shortened to a period of five to seven
years The lack of patent protection made the Indian market undesirable to the multinational
companies that had dominated the market and while they streamed out Indian companies started
to take their places They carved a niche in both the Indian and world markets with their
expertise in reverse-engineering new processes for manufacturing drugs at low costs Although
some of the larger companies have taken baby steps towards drug innovation the industry as a
whole has been following this business model until the present
Products and business description
This sector profile covers pharmaceutical end products only These can be divided intothree
categories
1048707 Prescription drugs based on chemical compounds and prescribed or administered by
healthcare professionals
1048707 Over the counter (OTC) drugs based on chemical compounds and freely sold
1048707 Vaccines based on bacteria and viruses
The distinction between branded and generic products is also important A branded product is the
original version produced by the innovative company that developed the product A generic
product is a copy of the original by another company Many innovative companies have 7 | P a g e
divisions that pro RampD for new drugs requires high investments After the discovery of new
chemical compounds with a therapeutic effect a patent is filed This protects the potential new
drug against generic competition usually for 20 years The drug then still has to be tested in
several phases of clinical trials The total development process costs several hundred million
dollars and takes over 10years If the new drug is finally proven safe and effective it is approved
by a regulatory authority As long as a branded product is protected by a patent companies
charge high prices to recover RampD investments and make high profits After patent expiry
competition from cheap generics usually causes a large
drop in prices duce generics as well
RampD investments for vaccines are comparable to those for drugs However the production
process of vaccines is more complicated and their delivery requires an advanced infrastructure
(lsquocold chainrsquo) Furthermore the new vaccines currently used in high income countries are of a
different type than those recommended for poor countries They are much more expensive but
are preferred due to the lower risk of adverse reactions The largest pharmaceutical markets are
the US Europe and Japan Together these account for 84 of the $460 billion of global drug
and vaccine sales in 2003 Cardiovascular and central nervous system (CNS) medicines are the
largest selling therapeutic classes
Companies and business strategies
Over the last years there have been many large mergers and acquisitions in the sector while
many companies have divested non-core activities Although RampD investment has strongly
increased over the past decade many large companies do not have promising RampD pipelines and
increasingly pursue growth through enhanced marketing Outsourcing of production and
alliances for RampD distribution or marketing are common business strategies
Within this part of the sector it important to recognize the distinction between branded and
generic producers
8 | P a g e
bull Branded companies are the innovative companies that carry out the Research and
Development (RampD) of new drugs (or contract this process) Initially their products are
protected by patents The clinical test data used for the approval of the drugs is usually
protected as well
bull Generic companies produce drugs that they have not developed themselves Normally these
drugs are not protected by patents anymore
This report focuses mainly on the branded industry However many branded companies have
divisions or subsidiaries that produce generics as well With regard to the products of these
companies three categories of drugs are commonly distinguished
bull Prescription drugs These have to be prescribed or administered by healthcare professionals
bullOver the counter (OTC) drugs also called self-medication drugs These can be purchased
without a prescription
bull Vaccines These are usually regarded as a separate category next to pharmaceuticals5 In
contrast to pharmaceuticals vaccines are not based on chemical compounds but on live bacteria
and viruses The production process of vaccines is therefore quite different and far more
complicated
The business of drug development
Branded companies make high investments in RampD to discover new drugs It is estimated that
the development of a major drug costs up to US$ 400 million and requires as long as 10 years to
be introduced into the market The development of new drugs usually starts with the discovery of
new chemical compounds with a therapeutic effect This is the first research phase Once the
basic compounds have been identified pharmaceutical companies obtain patent protection for
their potential use in new drugs These patents grant the exclusive right to sell and market a
specific drug for a specified time period usually twenty years After the discovery of a new
compound follows the further development into an effective and safe treatment and the testing of
the new drug candidate in subsequent phases of clinical trials Finally a new drug has to be
approved by a regulatory authority like the Food and Drug Administration (FDA) in the case of
the US Drug approval may take 1ndash15 year The estimated duration cost and rate of success for
the various development stages of an average drug are provided in the table below A short
description of the testing phases is given as well
9 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
TABLE OF Contents
MAIN HEADINGS
PAGENO
(1)ACKNOWLEDGEMENThelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip3
(2)CERTIFICATEhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip4
(3)INTRODUCTIONhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip hellip5
31OBJECTIVE OF STUDYhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip5
32 LIMITATIONhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip5
(4)INDUSTRY PROFILEhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip6-23
(5)COMPANY PROFILEhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip24-33
51SWOT ANALYSIShelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip31-32
52VISION AND MISSIONhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip33
(6)ANALYSIShelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip34-51
(8)FINDINGShelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip52
(9)CONCLUSIONhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip53
(10)ANNEXUREhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip54
101QUESTIONNNAIREhelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip54
(11)REFERENCEShelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip55
2 | P a g e
ACKNOWLEDGEMENTS
We cannot achieve anything worthwhile in the field of technical education unless or until the
theoretical education acquired in the classroom is effectively wedded to its practical approach
that is taking place in the modern industries and research institutes It gives me a great pleasure
to have an opportunity to acknowledge and to express gratitude to those who were associated
with my Project Constraints are the best source of inspiration and opportunity to explore us
This project is synergistic product of many minds The inspiration is drawn from the working of
team members and their experiences Communication is the key towards all the responsibilities
and demands of time travel work in competitive work It is plus to have effective secures
communication Project team is grateful to all personalities for stimulating and thought
provoking during the entire project For the successful completion of this project team members
feel deep senses of gratitude to Mrs Malleshwari faculty ICFAIJP Nagar for motivating and
inspiring to achieve the best and providing opportunity to explore ourselves
Last but not the least I would again like to express my sincere thanks to medical representatives
of Cipla for their constant friendly guidance during the entire stretch of this report Every new
step I took was due to their persistent enthusiastic backing amp I acknowledge that with a deep
sense of gratitude
MUKESH KUMAR
ICFAI-JP NAGAR
4th SEMESTER
Date
Place Bangalore
3 | P a g e
CERTIFICATE
This is to certify that management thesis titled ldquoA study on the promotional strategies used by medical representative with respect to Ciplardquo submitted by Mukesh Kumar Enrollment no7NBBP019 during the semester 4 of the MBA program(The class of 2009) embodies original work done by him
Signature of the faculty supervisor
Name Mrs Malleshwari
Designation Faculty for Quantitative methods
Campus ICFAI (JP NAGAR)
INTRODUCTION
4 | P a g e
Management thesis is a part of our MBA program and gives us the opportunity to keep foreword
our views on business It is a component that provides an opportunity to the student to undertake
research into ideas and express our opinions after research Summer internship program is a
extensive opportunity which is really helpful to design the MT Financial sector is the one of the
fastest growing which is helping the Indian economy to increase the pace of the GDP Hence
working with the brokerage firm a NBFC really helped me to construct the management thesis
The report will really help to understand the Indian equity market and how does it works Report
will be also helpful to understand the how the brokerage firm works and the different services
provided by them The study was conducted through the primary and secondary data
Respondents were basically from Bangalore and the customers of Religare who invest in the
Indian equity market in the various form of their investment
Objective OF THE STUDY
To find out the promotional strategies used by medical representative with respect to Cipla
To find out various promotional strategies used by Cipla to acquire the market share
To find out the importance of medical representative in the pharma sector
To find out various roles played by medical representative to enhance the sales
To find out product which are doing well in the market of Cipla
LIMITATION
Major of the study is supported by secondary data
No specific data for bribing with respect to the industry
Bias on the part of respondents will be a major drawback
Analysis of the primary data cant be done by implementing of test
Industry profile
5 | P a g e
The Indian Pharmaceutical Industry today is in the front rank of Indiarsquos science-based
industries with wide ranging capabilities in the complex field of drug manufacture and
technology A highly organized sector the Indian Pharma Industry is estimated to be worth $ 45
billion growing at about 8 to 9 percent annually It ranks very high in the third world in terms of
technology quality and range of medicines manufactured From simple headache pills to
sophisticated antibiotics and complex cardiac compounds almost every type of medicine is now
made indigenously Playing a key role in promoting and sustaining development in the vital field
of medicines Indian Pharma Industry boasts of quality producers and many units approved by
regulatory authorities in USA and UK International companies associated with this sector have
stimulated assisted and spearheaded this dynamic development in the past 53 years and helped
to put India on the pharmaceutical map of the world
The Indian Pharmaceutical sector is highly fragmented with more than 20000 registered units It
has expanded drastically in the last two decades The leading 250 pharmaceutical companies
control 70 of the market with market leader holding nearly 7 of the market share It is an
extremely fragmented market with severe price competition and government price control
The pharmaceutical industry in India meets around 70 of the countrys demand for bulk drugs
drug intermediates pharmaceutical formulations chemicals tablets capsules orals and
injectibles There are about 250 large units and about 8000 Small Scale Units which form the
core of the pharmaceutical industry in India (including 5 Central Public Sector Units) These
units produce the complete range of pharmaceutical formulations ie medicines ready for
consumption by patients and about 350 bulk drugs ie chemicals having therapeutic value and
used for production of pharmaceutical formulations
Over 20000 registered pharmaceutical manufacturers exist in the country The domestic
pharmaceuticals industry output is expected to exceed Rs260 billion in the financial year 2002
which accounts for merely 13 of the global pharmaceutical sector Of this bulk drugs will
account for Rs 54 bn (21) and formulations the remaining Rs 210 bn (79) In financial year
2001 imports were Rs 20 bn while exports were Rs87 bn
6 | P a g e
Indian companies need to attain the right product-mix for sustained future growth Core
competencies will play an important role in determining the future of many Indian
pharmaceutical companies in the post product-patent regime after 2005 Indian companies in an
effort to consolidate their position will have to increasingly look at merger and acquisition
options of either companies or products This would help them to offset loss of new product
options improve their RampD efforts and improve distribution to penetrate markets
The first Indian pharmaceutical company Bengal Chemicals and Pharmaceutical Works which
still exists today as one of 5 government-owned drug manufacturers appeared in Calcutta in
1930 For the next 60 years most of the drugs in India were imported by multinationals either in
fully-formulated or bulk form The government started to encourage the growth of drug
manufacturing by Indian companies in the early 1960s and with the Patents Act in 1970 enabled
the industry to become what it is today This patent act removed composition patents from food
and drugs and though it kept process patents these were shortened to a period of five to seven
years The lack of patent protection made the Indian market undesirable to the multinational
companies that had dominated the market and while they streamed out Indian companies started
to take their places They carved a niche in both the Indian and world markets with their
expertise in reverse-engineering new processes for manufacturing drugs at low costs Although
some of the larger companies have taken baby steps towards drug innovation the industry as a
whole has been following this business model until the present
Products and business description
This sector profile covers pharmaceutical end products only These can be divided intothree
categories
1048707 Prescription drugs based on chemical compounds and prescribed or administered by
healthcare professionals
1048707 Over the counter (OTC) drugs based on chemical compounds and freely sold
1048707 Vaccines based on bacteria and viruses
The distinction between branded and generic products is also important A branded product is the
original version produced by the innovative company that developed the product A generic
product is a copy of the original by another company Many innovative companies have 7 | P a g e
divisions that pro RampD for new drugs requires high investments After the discovery of new
chemical compounds with a therapeutic effect a patent is filed This protects the potential new
drug against generic competition usually for 20 years The drug then still has to be tested in
several phases of clinical trials The total development process costs several hundred million
dollars and takes over 10years If the new drug is finally proven safe and effective it is approved
by a regulatory authority As long as a branded product is protected by a patent companies
charge high prices to recover RampD investments and make high profits After patent expiry
competition from cheap generics usually causes a large
drop in prices duce generics as well
RampD investments for vaccines are comparable to those for drugs However the production
process of vaccines is more complicated and their delivery requires an advanced infrastructure
(lsquocold chainrsquo) Furthermore the new vaccines currently used in high income countries are of a
different type than those recommended for poor countries They are much more expensive but
are preferred due to the lower risk of adverse reactions The largest pharmaceutical markets are
the US Europe and Japan Together these account for 84 of the $460 billion of global drug
and vaccine sales in 2003 Cardiovascular and central nervous system (CNS) medicines are the
largest selling therapeutic classes
Companies and business strategies
Over the last years there have been many large mergers and acquisitions in the sector while
many companies have divested non-core activities Although RampD investment has strongly
increased over the past decade many large companies do not have promising RampD pipelines and
increasingly pursue growth through enhanced marketing Outsourcing of production and
alliances for RampD distribution or marketing are common business strategies
Within this part of the sector it important to recognize the distinction between branded and
generic producers
8 | P a g e
bull Branded companies are the innovative companies that carry out the Research and
Development (RampD) of new drugs (or contract this process) Initially their products are
protected by patents The clinical test data used for the approval of the drugs is usually
protected as well
bull Generic companies produce drugs that they have not developed themselves Normally these
drugs are not protected by patents anymore
This report focuses mainly on the branded industry However many branded companies have
divisions or subsidiaries that produce generics as well With regard to the products of these
companies three categories of drugs are commonly distinguished
bull Prescription drugs These have to be prescribed or administered by healthcare professionals
bullOver the counter (OTC) drugs also called self-medication drugs These can be purchased
without a prescription
bull Vaccines These are usually regarded as a separate category next to pharmaceuticals5 In
contrast to pharmaceuticals vaccines are not based on chemical compounds but on live bacteria
and viruses The production process of vaccines is therefore quite different and far more
complicated
The business of drug development
Branded companies make high investments in RampD to discover new drugs It is estimated that
the development of a major drug costs up to US$ 400 million and requires as long as 10 years to
be introduced into the market The development of new drugs usually starts with the discovery of
new chemical compounds with a therapeutic effect This is the first research phase Once the
basic compounds have been identified pharmaceutical companies obtain patent protection for
their potential use in new drugs These patents grant the exclusive right to sell and market a
specific drug for a specified time period usually twenty years After the discovery of a new
compound follows the further development into an effective and safe treatment and the testing of
the new drug candidate in subsequent phases of clinical trials Finally a new drug has to be
approved by a regulatory authority like the Food and Drug Administration (FDA) in the case of
the US Drug approval may take 1ndash15 year The estimated duration cost and rate of success for
the various development stages of an average drug are provided in the table below A short
description of the testing phases is given as well
9 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
ACKNOWLEDGEMENTS
We cannot achieve anything worthwhile in the field of technical education unless or until the
theoretical education acquired in the classroom is effectively wedded to its practical approach
that is taking place in the modern industries and research institutes It gives me a great pleasure
to have an opportunity to acknowledge and to express gratitude to those who were associated
with my Project Constraints are the best source of inspiration and opportunity to explore us
This project is synergistic product of many minds The inspiration is drawn from the working of
team members and their experiences Communication is the key towards all the responsibilities
and demands of time travel work in competitive work It is plus to have effective secures
communication Project team is grateful to all personalities for stimulating and thought
provoking during the entire project For the successful completion of this project team members
feel deep senses of gratitude to Mrs Malleshwari faculty ICFAIJP Nagar for motivating and
inspiring to achieve the best and providing opportunity to explore ourselves
Last but not the least I would again like to express my sincere thanks to medical representatives
of Cipla for their constant friendly guidance during the entire stretch of this report Every new
step I took was due to their persistent enthusiastic backing amp I acknowledge that with a deep
sense of gratitude
MUKESH KUMAR
ICFAI-JP NAGAR
4th SEMESTER
Date
Place Bangalore
3 | P a g e
CERTIFICATE
This is to certify that management thesis titled ldquoA study on the promotional strategies used by medical representative with respect to Ciplardquo submitted by Mukesh Kumar Enrollment no7NBBP019 during the semester 4 of the MBA program(The class of 2009) embodies original work done by him
Signature of the faculty supervisor
Name Mrs Malleshwari
Designation Faculty for Quantitative methods
Campus ICFAI (JP NAGAR)
INTRODUCTION
4 | P a g e
Management thesis is a part of our MBA program and gives us the opportunity to keep foreword
our views on business It is a component that provides an opportunity to the student to undertake
research into ideas and express our opinions after research Summer internship program is a
extensive opportunity which is really helpful to design the MT Financial sector is the one of the
fastest growing which is helping the Indian economy to increase the pace of the GDP Hence
working with the brokerage firm a NBFC really helped me to construct the management thesis
The report will really help to understand the Indian equity market and how does it works Report
will be also helpful to understand the how the brokerage firm works and the different services
provided by them The study was conducted through the primary and secondary data
Respondents were basically from Bangalore and the customers of Religare who invest in the
Indian equity market in the various form of their investment
Objective OF THE STUDY
To find out the promotional strategies used by medical representative with respect to Cipla
To find out various promotional strategies used by Cipla to acquire the market share
To find out the importance of medical representative in the pharma sector
To find out various roles played by medical representative to enhance the sales
To find out product which are doing well in the market of Cipla
LIMITATION
Major of the study is supported by secondary data
No specific data for bribing with respect to the industry
Bias on the part of respondents will be a major drawback
Analysis of the primary data cant be done by implementing of test
Industry profile
5 | P a g e
The Indian Pharmaceutical Industry today is in the front rank of Indiarsquos science-based
industries with wide ranging capabilities in the complex field of drug manufacture and
technology A highly organized sector the Indian Pharma Industry is estimated to be worth $ 45
billion growing at about 8 to 9 percent annually It ranks very high in the third world in terms of
technology quality and range of medicines manufactured From simple headache pills to
sophisticated antibiotics and complex cardiac compounds almost every type of medicine is now
made indigenously Playing a key role in promoting and sustaining development in the vital field
of medicines Indian Pharma Industry boasts of quality producers and many units approved by
regulatory authorities in USA and UK International companies associated with this sector have
stimulated assisted and spearheaded this dynamic development in the past 53 years and helped
to put India on the pharmaceutical map of the world
The Indian Pharmaceutical sector is highly fragmented with more than 20000 registered units It
has expanded drastically in the last two decades The leading 250 pharmaceutical companies
control 70 of the market with market leader holding nearly 7 of the market share It is an
extremely fragmented market with severe price competition and government price control
The pharmaceutical industry in India meets around 70 of the countrys demand for bulk drugs
drug intermediates pharmaceutical formulations chemicals tablets capsules orals and
injectibles There are about 250 large units and about 8000 Small Scale Units which form the
core of the pharmaceutical industry in India (including 5 Central Public Sector Units) These
units produce the complete range of pharmaceutical formulations ie medicines ready for
consumption by patients and about 350 bulk drugs ie chemicals having therapeutic value and
used for production of pharmaceutical formulations
Over 20000 registered pharmaceutical manufacturers exist in the country The domestic
pharmaceuticals industry output is expected to exceed Rs260 billion in the financial year 2002
which accounts for merely 13 of the global pharmaceutical sector Of this bulk drugs will
account for Rs 54 bn (21) and formulations the remaining Rs 210 bn (79) In financial year
2001 imports were Rs 20 bn while exports were Rs87 bn
6 | P a g e
Indian companies need to attain the right product-mix for sustained future growth Core
competencies will play an important role in determining the future of many Indian
pharmaceutical companies in the post product-patent regime after 2005 Indian companies in an
effort to consolidate their position will have to increasingly look at merger and acquisition
options of either companies or products This would help them to offset loss of new product
options improve their RampD efforts and improve distribution to penetrate markets
The first Indian pharmaceutical company Bengal Chemicals and Pharmaceutical Works which
still exists today as one of 5 government-owned drug manufacturers appeared in Calcutta in
1930 For the next 60 years most of the drugs in India were imported by multinationals either in
fully-formulated or bulk form The government started to encourage the growth of drug
manufacturing by Indian companies in the early 1960s and with the Patents Act in 1970 enabled
the industry to become what it is today This patent act removed composition patents from food
and drugs and though it kept process patents these were shortened to a period of five to seven
years The lack of patent protection made the Indian market undesirable to the multinational
companies that had dominated the market and while they streamed out Indian companies started
to take their places They carved a niche in both the Indian and world markets with their
expertise in reverse-engineering new processes for manufacturing drugs at low costs Although
some of the larger companies have taken baby steps towards drug innovation the industry as a
whole has been following this business model until the present
Products and business description
This sector profile covers pharmaceutical end products only These can be divided intothree
categories
1048707 Prescription drugs based on chemical compounds and prescribed or administered by
healthcare professionals
1048707 Over the counter (OTC) drugs based on chemical compounds and freely sold
1048707 Vaccines based on bacteria and viruses
The distinction between branded and generic products is also important A branded product is the
original version produced by the innovative company that developed the product A generic
product is a copy of the original by another company Many innovative companies have 7 | P a g e
divisions that pro RampD for new drugs requires high investments After the discovery of new
chemical compounds with a therapeutic effect a patent is filed This protects the potential new
drug against generic competition usually for 20 years The drug then still has to be tested in
several phases of clinical trials The total development process costs several hundred million
dollars and takes over 10years If the new drug is finally proven safe and effective it is approved
by a regulatory authority As long as a branded product is protected by a patent companies
charge high prices to recover RampD investments and make high profits After patent expiry
competition from cheap generics usually causes a large
drop in prices duce generics as well
RampD investments for vaccines are comparable to those for drugs However the production
process of vaccines is more complicated and their delivery requires an advanced infrastructure
(lsquocold chainrsquo) Furthermore the new vaccines currently used in high income countries are of a
different type than those recommended for poor countries They are much more expensive but
are preferred due to the lower risk of adverse reactions The largest pharmaceutical markets are
the US Europe and Japan Together these account for 84 of the $460 billion of global drug
and vaccine sales in 2003 Cardiovascular and central nervous system (CNS) medicines are the
largest selling therapeutic classes
Companies and business strategies
Over the last years there have been many large mergers and acquisitions in the sector while
many companies have divested non-core activities Although RampD investment has strongly
increased over the past decade many large companies do not have promising RampD pipelines and
increasingly pursue growth through enhanced marketing Outsourcing of production and
alliances for RampD distribution or marketing are common business strategies
Within this part of the sector it important to recognize the distinction between branded and
generic producers
8 | P a g e
bull Branded companies are the innovative companies that carry out the Research and
Development (RampD) of new drugs (or contract this process) Initially their products are
protected by patents The clinical test data used for the approval of the drugs is usually
protected as well
bull Generic companies produce drugs that they have not developed themselves Normally these
drugs are not protected by patents anymore
This report focuses mainly on the branded industry However many branded companies have
divisions or subsidiaries that produce generics as well With regard to the products of these
companies three categories of drugs are commonly distinguished
bull Prescription drugs These have to be prescribed or administered by healthcare professionals
bullOver the counter (OTC) drugs also called self-medication drugs These can be purchased
without a prescription
bull Vaccines These are usually regarded as a separate category next to pharmaceuticals5 In
contrast to pharmaceuticals vaccines are not based on chemical compounds but on live bacteria
and viruses The production process of vaccines is therefore quite different and far more
complicated
The business of drug development
Branded companies make high investments in RampD to discover new drugs It is estimated that
the development of a major drug costs up to US$ 400 million and requires as long as 10 years to
be introduced into the market The development of new drugs usually starts with the discovery of
new chemical compounds with a therapeutic effect This is the first research phase Once the
basic compounds have been identified pharmaceutical companies obtain patent protection for
their potential use in new drugs These patents grant the exclusive right to sell and market a
specific drug for a specified time period usually twenty years After the discovery of a new
compound follows the further development into an effective and safe treatment and the testing of
the new drug candidate in subsequent phases of clinical trials Finally a new drug has to be
approved by a regulatory authority like the Food and Drug Administration (FDA) in the case of
the US Drug approval may take 1ndash15 year The estimated duration cost and rate of success for
the various development stages of an average drug are provided in the table below A short
description of the testing phases is given as well
9 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
CERTIFICATE
This is to certify that management thesis titled ldquoA study on the promotional strategies used by medical representative with respect to Ciplardquo submitted by Mukesh Kumar Enrollment no7NBBP019 during the semester 4 of the MBA program(The class of 2009) embodies original work done by him
Signature of the faculty supervisor
Name Mrs Malleshwari
Designation Faculty for Quantitative methods
Campus ICFAI (JP NAGAR)
INTRODUCTION
4 | P a g e
Management thesis is a part of our MBA program and gives us the opportunity to keep foreword
our views on business It is a component that provides an opportunity to the student to undertake
research into ideas and express our opinions after research Summer internship program is a
extensive opportunity which is really helpful to design the MT Financial sector is the one of the
fastest growing which is helping the Indian economy to increase the pace of the GDP Hence
working with the brokerage firm a NBFC really helped me to construct the management thesis
The report will really help to understand the Indian equity market and how does it works Report
will be also helpful to understand the how the brokerage firm works and the different services
provided by them The study was conducted through the primary and secondary data
Respondents were basically from Bangalore and the customers of Religare who invest in the
Indian equity market in the various form of their investment
Objective OF THE STUDY
To find out the promotional strategies used by medical representative with respect to Cipla
To find out various promotional strategies used by Cipla to acquire the market share
To find out the importance of medical representative in the pharma sector
To find out various roles played by medical representative to enhance the sales
To find out product which are doing well in the market of Cipla
LIMITATION
Major of the study is supported by secondary data
No specific data for bribing with respect to the industry
Bias on the part of respondents will be a major drawback
Analysis of the primary data cant be done by implementing of test
Industry profile
5 | P a g e
The Indian Pharmaceutical Industry today is in the front rank of Indiarsquos science-based
industries with wide ranging capabilities in the complex field of drug manufacture and
technology A highly organized sector the Indian Pharma Industry is estimated to be worth $ 45
billion growing at about 8 to 9 percent annually It ranks very high in the third world in terms of
technology quality and range of medicines manufactured From simple headache pills to
sophisticated antibiotics and complex cardiac compounds almost every type of medicine is now
made indigenously Playing a key role in promoting and sustaining development in the vital field
of medicines Indian Pharma Industry boasts of quality producers and many units approved by
regulatory authorities in USA and UK International companies associated with this sector have
stimulated assisted and spearheaded this dynamic development in the past 53 years and helped
to put India on the pharmaceutical map of the world
The Indian Pharmaceutical sector is highly fragmented with more than 20000 registered units It
has expanded drastically in the last two decades The leading 250 pharmaceutical companies
control 70 of the market with market leader holding nearly 7 of the market share It is an
extremely fragmented market with severe price competition and government price control
The pharmaceutical industry in India meets around 70 of the countrys demand for bulk drugs
drug intermediates pharmaceutical formulations chemicals tablets capsules orals and
injectibles There are about 250 large units and about 8000 Small Scale Units which form the
core of the pharmaceutical industry in India (including 5 Central Public Sector Units) These
units produce the complete range of pharmaceutical formulations ie medicines ready for
consumption by patients and about 350 bulk drugs ie chemicals having therapeutic value and
used for production of pharmaceutical formulations
Over 20000 registered pharmaceutical manufacturers exist in the country The domestic
pharmaceuticals industry output is expected to exceed Rs260 billion in the financial year 2002
which accounts for merely 13 of the global pharmaceutical sector Of this bulk drugs will
account for Rs 54 bn (21) and formulations the remaining Rs 210 bn (79) In financial year
2001 imports were Rs 20 bn while exports were Rs87 bn
6 | P a g e
Indian companies need to attain the right product-mix for sustained future growth Core
competencies will play an important role in determining the future of many Indian
pharmaceutical companies in the post product-patent regime after 2005 Indian companies in an
effort to consolidate their position will have to increasingly look at merger and acquisition
options of either companies or products This would help them to offset loss of new product
options improve their RampD efforts and improve distribution to penetrate markets
The first Indian pharmaceutical company Bengal Chemicals and Pharmaceutical Works which
still exists today as one of 5 government-owned drug manufacturers appeared in Calcutta in
1930 For the next 60 years most of the drugs in India were imported by multinationals either in
fully-formulated or bulk form The government started to encourage the growth of drug
manufacturing by Indian companies in the early 1960s and with the Patents Act in 1970 enabled
the industry to become what it is today This patent act removed composition patents from food
and drugs and though it kept process patents these were shortened to a period of five to seven
years The lack of patent protection made the Indian market undesirable to the multinational
companies that had dominated the market and while they streamed out Indian companies started
to take their places They carved a niche in both the Indian and world markets with their
expertise in reverse-engineering new processes for manufacturing drugs at low costs Although
some of the larger companies have taken baby steps towards drug innovation the industry as a
whole has been following this business model until the present
Products and business description
This sector profile covers pharmaceutical end products only These can be divided intothree
categories
1048707 Prescription drugs based on chemical compounds and prescribed or administered by
healthcare professionals
1048707 Over the counter (OTC) drugs based on chemical compounds and freely sold
1048707 Vaccines based on bacteria and viruses
The distinction between branded and generic products is also important A branded product is the
original version produced by the innovative company that developed the product A generic
product is a copy of the original by another company Many innovative companies have 7 | P a g e
divisions that pro RampD for new drugs requires high investments After the discovery of new
chemical compounds with a therapeutic effect a patent is filed This protects the potential new
drug against generic competition usually for 20 years The drug then still has to be tested in
several phases of clinical trials The total development process costs several hundred million
dollars and takes over 10years If the new drug is finally proven safe and effective it is approved
by a regulatory authority As long as a branded product is protected by a patent companies
charge high prices to recover RampD investments and make high profits After patent expiry
competition from cheap generics usually causes a large
drop in prices duce generics as well
RampD investments for vaccines are comparable to those for drugs However the production
process of vaccines is more complicated and their delivery requires an advanced infrastructure
(lsquocold chainrsquo) Furthermore the new vaccines currently used in high income countries are of a
different type than those recommended for poor countries They are much more expensive but
are preferred due to the lower risk of adverse reactions The largest pharmaceutical markets are
the US Europe and Japan Together these account for 84 of the $460 billion of global drug
and vaccine sales in 2003 Cardiovascular and central nervous system (CNS) medicines are the
largest selling therapeutic classes
Companies and business strategies
Over the last years there have been many large mergers and acquisitions in the sector while
many companies have divested non-core activities Although RampD investment has strongly
increased over the past decade many large companies do not have promising RampD pipelines and
increasingly pursue growth through enhanced marketing Outsourcing of production and
alliances for RampD distribution or marketing are common business strategies
Within this part of the sector it important to recognize the distinction between branded and
generic producers
8 | P a g e
bull Branded companies are the innovative companies that carry out the Research and
Development (RampD) of new drugs (or contract this process) Initially their products are
protected by patents The clinical test data used for the approval of the drugs is usually
protected as well
bull Generic companies produce drugs that they have not developed themselves Normally these
drugs are not protected by patents anymore
This report focuses mainly on the branded industry However many branded companies have
divisions or subsidiaries that produce generics as well With regard to the products of these
companies three categories of drugs are commonly distinguished
bull Prescription drugs These have to be prescribed or administered by healthcare professionals
bullOver the counter (OTC) drugs also called self-medication drugs These can be purchased
without a prescription
bull Vaccines These are usually regarded as a separate category next to pharmaceuticals5 In
contrast to pharmaceuticals vaccines are not based on chemical compounds but on live bacteria
and viruses The production process of vaccines is therefore quite different and far more
complicated
The business of drug development
Branded companies make high investments in RampD to discover new drugs It is estimated that
the development of a major drug costs up to US$ 400 million and requires as long as 10 years to
be introduced into the market The development of new drugs usually starts with the discovery of
new chemical compounds with a therapeutic effect This is the first research phase Once the
basic compounds have been identified pharmaceutical companies obtain patent protection for
their potential use in new drugs These patents grant the exclusive right to sell and market a
specific drug for a specified time period usually twenty years After the discovery of a new
compound follows the further development into an effective and safe treatment and the testing of
the new drug candidate in subsequent phases of clinical trials Finally a new drug has to be
approved by a regulatory authority like the Food and Drug Administration (FDA) in the case of
the US Drug approval may take 1ndash15 year The estimated duration cost and rate of success for
the various development stages of an average drug are provided in the table below A short
description of the testing phases is given as well
9 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Management thesis is a part of our MBA program and gives us the opportunity to keep foreword
our views on business It is a component that provides an opportunity to the student to undertake
research into ideas and express our opinions after research Summer internship program is a
extensive opportunity which is really helpful to design the MT Financial sector is the one of the
fastest growing which is helping the Indian economy to increase the pace of the GDP Hence
working with the brokerage firm a NBFC really helped me to construct the management thesis
The report will really help to understand the Indian equity market and how does it works Report
will be also helpful to understand the how the brokerage firm works and the different services
provided by them The study was conducted through the primary and secondary data
Respondents were basically from Bangalore and the customers of Religare who invest in the
Indian equity market in the various form of their investment
Objective OF THE STUDY
To find out the promotional strategies used by medical representative with respect to Cipla
To find out various promotional strategies used by Cipla to acquire the market share
To find out the importance of medical representative in the pharma sector
To find out various roles played by medical representative to enhance the sales
To find out product which are doing well in the market of Cipla
LIMITATION
Major of the study is supported by secondary data
No specific data for bribing with respect to the industry
Bias on the part of respondents will be a major drawback
Analysis of the primary data cant be done by implementing of test
Industry profile
5 | P a g e
The Indian Pharmaceutical Industry today is in the front rank of Indiarsquos science-based
industries with wide ranging capabilities in the complex field of drug manufacture and
technology A highly organized sector the Indian Pharma Industry is estimated to be worth $ 45
billion growing at about 8 to 9 percent annually It ranks very high in the third world in terms of
technology quality and range of medicines manufactured From simple headache pills to
sophisticated antibiotics and complex cardiac compounds almost every type of medicine is now
made indigenously Playing a key role in promoting and sustaining development in the vital field
of medicines Indian Pharma Industry boasts of quality producers and many units approved by
regulatory authorities in USA and UK International companies associated with this sector have
stimulated assisted and spearheaded this dynamic development in the past 53 years and helped
to put India on the pharmaceutical map of the world
The Indian Pharmaceutical sector is highly fragmented with more than 20000 registered units It
has expanded drastically in the last two decades The leading 250 pharmaceutical companies
control 70 of the market with market leader holding nearly 7 of the market share It is an
extremely fragmented market with severe price competition and government price control
The pharmaceutical industry in India meets around 70 of the countrys demand for bulk drugs
drug intermediates pharmaceutical formulations chemicals tablets capsules orals and
injectibles There are about 250 large units and about 8000 Small Scale Units which form the
core of the pharmaceutical industry in India (including 5 Central Public Sector Units) These
units produce the complete range of pharmaceutical formulations ie medicines ready for
consumption by patients and about 350 bulk drugs ie chemicals having therapeutic value and
used for production of pharmaceutical formulations
Over 20000 registered pharmaceutical manufacturers exist in the country The domestic
pharmaceuticals industry output is expected to exceed Rs260 billion in the financial year 2002
which accounts for merely 13 of the global pharmaceutical sector Of this bulk drugs will
account for Rs 54 bn (21) and formulations the remaining Rs 210 bn (79) In financial year
2001 imports were Rs 20 bn while exports were Rs87 bn
6 | P a g e
Indian companies need to attain the right product-mix for sustained future growth Core
competencies will play an important role in determining the future of many Indian
pharmaceutical companies in the post product-patent regime after 2005 Indian companies in an
effort to consolidate their position will have to increasingly look at merger and acquisition
options of either companies or products This would help them to offset loss of new product
options improve their RampD efforts and improve distribution to penetrate markets
The first Indian pharmaceutical company Bengal Chemicals and Pharmaceutical Works which
still exists today as one of 5 government-owned drug manufacturers appeared in Calcutta in
1930 For the next 60 years most of the drugs in India were imported by multinationals either in
fully-formulated or bulk form The government started to encourage the growth of drug
manufacturing by Indian companies in the early 1960s and with the Patents Act in 1970 enabled
the industry to become what it is today This patent act removed composition patents from food
and drugs and though it kept process patents these were shortened to a period of five to seven
years The lack of patent protection made the Indian market undesirable to the multinational
companies that had dominated the market and while they streamed out Indian companies started
to take their places They carved a niche in both the Indian and world markets with their
expertise in reverse-engineering new processes for manufacturing drugs at low costs Although
some of the larger companies have taken baby steps towards drug innovation the industry as a
whole has been following this business model until the present
Products and business description
This sector profile covers pharmaceutical end products only These can be divided intothree
categories
1048707 Prescription drugs based on chemical compounds and prescribed or administered by
healthcare professionals
1048707 Over the counter (OTC) drugs based on chemical compounds and freely sold
1048707 Vaccines based on bacteria and viruses
The distinction between branded and generic products is also important A branded product is the
original version produced by the innovative company that developed the product A generic
product is a copy of the original by another company Many innovative companies have 7 | P a g e
divisions that pro RampD for new drugs requires high investments After the discovery of new
chemical compounds with a therapeutic effect a patent is filed This protects the potential new
drug against generic competition usually for 20 years The drug then still has to be tested in
several phases of clinical trials The total development process costs several hundred million
dollars and takes over 10years If the new drug is finally proven safe and effective it is approved
by a regulatory authority As long as a branded product is protected by a patent companies
charge high prices to recover RampD investments and make high profits After patent expiry
competition from cheap generics usually causes a large
drop in prices duce generics as well
RampD investments for vaccines are comparable to those for drugs However the production
process of vaccines is more complicated and their delivery requires an advanced infrastructure
(lsquocold chainrsquo) Furthermore the new vaccines currently used in high income countries are of a
different type than those recommended for poor countries They are much more expensive but
are preferred due to the lower risk of adverse reactions The largest pharmaceutical markets are
the US Europe and Japan Together these account for 84 of the $460 billion of global drug
and vaccine sales in 2003 Cardiovascular and central nervous system (CNS) medicines are the
largest selling therapeutic classes
Companies and business strategies
Over the last years there have been many large mergers and acquisitions in the sector while
many companies have divested non-core activities Although RampD investment has strongly
increased over the past decade many large companies do not have promising RampD pipelines and
increasingly pursue growth through enhanced marketing Outsourcing of production and
alliances for RampD distribution or marketing are common business strategies
Within this part of the sector it important to recognize the distinction between branded and
generic producers
8 | P a g e
bull Branded companies are the innovative companies that carry out the Research and
Development (RampD) of new drugs (or contract this process) Initially their products are
protected by patents The clinical test data used for the approval of the drugs is usually
protected as well
bull Generic companies produce drugs that they have not developed themselves Normally these
drugs are not protected by patents anymore
This report focuses mainly on the branded industry However many branded companies have
divisions or subsidiaries that produce generics as well With regard to the products of these
companies three categories of drugs are commonly distinguished
bull Prescription drugs These have to be prescribed or administered by healthcare professionals
bullOver the counter (OTC) drugs also called self-medication drugs These can be purchased
without a prescription
bull Vaccines These are usually regarded as a separate category next to pharmaceuticals5 In
contrast to pharmaceuticals vaccines are not based on chemical compounds but on live bacteria
and viruses The production process of vaccines is therefore quite different and far more
complicated
The business of drug development
Branded companies make high investments in RampD to discover new drugs It is estimated that
the development of a major drug costs up to US$ 400 million and requires as long as 10 years to
be introduced into the market The development of new drugs usually starts with the discovery of
new chemical compounds with a therapeutic effect This is the first research phase Once the
basic compounds have been identified pharmaceutical companies obtain patent protection for
their potential use in new drugs These patents grant the exclusive right to sell and market a
specific drug for a specified time period usually twenty years After the discovery of a new
compound follows the further development into an effective and safe treatment and the testing of
the new drug candidate in subsequent phases of clinical trials Finally a new drug has to be
approved by a regulatory authority like the Food and Drug Administration (FDA) in the case of
the US Drug approval may take 1ndash15 year The estimated duration cost and rate of success for
the various development stages of an average drug are provided in the table below A short
description of the testing phases is given as well
9 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
The Indian Pharmaceutical Industry today is in the front rank of Indiarsquos science-based
industries with wide ranging capabilities in the complex field of drug manufacture and
technology A highly organized sector the Indian Pharma Industry is estimated to be worth $ 45
billion growing at about 8 to 9 percent annually It ranks very high in the third world in terms of
technology quality and range of medicines manufactured From simple headache pills to
sophisticated antibiotics and complex cardiac compounds almost every type of medicine is now
made indigenously Playing a key role in promoting and sustaining development in the vital field
of medicines Indian Pharma Industry boasts of quality producers and many units approved by
regulatory authorities in USA and UK International companies associated with this sector have
stimulated assisted and spearheaded this dynamic development in the past 53 years and helped
to put India on the pharmaceutical map of the world
The Indian Pharmaceutical sector is highly fragmented with more than 20000 registered units It
has expanded drastically in the last two decades The leading 250 pharmaceutical companies
control 70 of the market with market leader holding nearly 7 of the market share It is an
extremely fragmented market with severe price competition and government price control
The pharmaceutical industry in India meets around 70 of the countrys demand for bulk drugs
drug intermediates pharmaceutical formulations chemicals tablets capsules orals and
injectibles There are about 250 large units and about 8000 Small Scale Units which form the
core of the pharmaceutical industry in India (including 5 Central Public Sector Units) These
units produce the complete range of pharmaceutical formulations ie medicines ready for
consumption by patients and about 350 bulk drugs ie chemicals having therapeutic value and
used for production of pharmaceutical formulations
Over 20000 registered pharmaceutical manufacturers exist in the country The domestic
pharmaceuticals industry output is expected to exceed Rs260 billion in the financial year 2002
which accounts for merely 13 of the global pharmaceutical sector Of this bulk drugs will
account for Rs 54 bn (21) and formulations the remaining Rs 210 bn (79) In financial year
2001 imports were Rs 20 bn while exports were Rs87 bn
6 | P a g e
Indian companies need to attain the right product-mix for sustained future growth Core
competencies will play an important role in determining the future of many Indian
pharmaceutical companies in the post product-patent regime after 2005 Indian companies in an
effort to consolidate their position will have to increasingly look at merger and acquisition
options of either companies or products This would help them to offset loss of new product
options improve their RampD efforts and improve distribution to penetrate markets
The first Indian pharmaceutical company Bengal Chemicals and Pharmaceutical Works which
still exists today as one of 5 government-owned drug manufacturers appeared in Calcutta in
1930 For the next 60 years most of the drugs in India were imported by multinationals either in
fully-formulated or bulk form The government started to encourage the growth of drug
manufacturing by Indian companies in the early 1960s and with the Patents Act in 1970 enabled
the industry to become what it is today This patent act removed composition patents from food
and drugs and though it kept process patents these were shortened to a period of five to seven
years The lack of patent protection made the Indian market undesirable to the multinational
companies that had dominated the market and while they streamed out Indian companies started
to take their places They carved a niche in both the Indian and world markets with their
expertise in reverse-engineering new processes for manufacturing drugs at low costs Although
some of the larger companies have taken baby steps towards drug innovation the industry as a
whole has been following this business model until the present
Products and business description
This sector profile covers pharmaceutical end products only These can be divided intothree
categories
1048707 Prescription drugs based on chemical compounds and prescribed or administered by
healthcare professionals
1048707 Over the counter (OTC) drugs based on chemical compounds and freely sold
1048707 Vaccines based on bacteria and viruses
The distinction between branded and generic products is also important A branded product is the
original version produced by the innovative company that developed the product A generic
product is a copy of the original by another company Many innovative companies have 7 | P a g e
divisions that pro RampD for new drugs requires high investments After the discovery of new
chemical compounds with a therapeutic effect a patent is filed This protects the potential new
drug against generic competition usually for 20 years The drug then still has to be tested in
several phases of clinical trials The total development process costs several hundred million
dollars and takes over 10years If the new drug is finally proven safe and effective it is approved
by a regulatory authority As long as a branded product is protected by a patent companies
charge high prices to recover RampD investments and make high profits After patent expiry
competition from cheap generics usually causes a large
drop in prices duce generics as well
RampD investments for vaccines are comparable to those for drugs However the production
process of vaccines is more complicated and their delivery requires an advanced infrastructure
(lsquocold chainrsquo) Furthermore the new vaccines currently used in high income countries are of a
different type than those recommended for poor countries They are much more expensive but
are preferred due to the lower risk of adverse reactions The largest pharmaceutical markets are
the US Europe and Japan Together these account for 84 of the $460 billion of global drug
and vaccine sales in 2003 Cardiovascular and central nervous system (CNS) medicines are the
largest selling therapeutic classes
Companies and business strategies
Over the last years there have been many large mergers and acquisitions in the sector while
many companies have divested non-core activities Although RampD investment has strongly
increased over the past decade many large companies do not have promising RampD pipelines and
increasingly pursue growth through enhanced marketing Outsourcing of production and
alliances for RampD distribution or marketing are common business strategies
Within this part of the sector it important to recognize the distinction between branded and
generic producers
8 | P a g e
bull Branded companies are the innovative companies that carry out the Research and
Development (RampD) of new drugs (or contract this process) Initially their products are
protected by patents The clinical test data used for the approval of the drugs is usually
protected as well
bull Generic companies produce drugs that they have not developed themselves Normally these
drugs are not protected by patents anymore
This report focuses mainly on the branded industry However many branded companies have
divisions or subsidiaries that produce generics as well With regard to the products of these
companies three categories of drugs are commonly distinguished
bull Prescription drugs These have to be prescribed or administered by healthcare professionals
bullOver the counter (OTC) drugs also called self-medication drugs These can be purchased
without a prescription
bull Vaccines These are usually regarded as a separate category next to pharmaceuticals5 In
contrast to pharmaceuticals vaccines are not based on chemical compounds but on live bacteria
and viruses The production process of vaccines is therefore quite different and far more
complicated
The business of drug development
Branded companies make high investments in RampD to discover new drugs It is estimated that
the development of a major drug costs up to US$ 400 million and requires as long as 10 years to
be introduced into the market The development of new drugs usually starts with the discovery of
new chemical compounds with a therapeutic effect This is the first research phase Once the
basic compounds have been identified pharmaceutical companies obtain patent protection for
their potential use in new drugs These patents grant the exclusive right to sell and market a
specific drug for a specified time period usually twenty years After the discovery of a new
compound follows the further development into an effective and safe treatment and the testing of
the new drug candidate in subsequent phases of clinical trials Finally a new drug has to be
approved by a regulatory authority like the Food and Drug Administration (FDA) in the case of
the US Drug approval may take 1ndash15 year The estimated duration cost and rate of success for
the various development stages of an average drug are provided in the table below A short
description of the testing phases is given as well
9 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Indian companies need to attain the right product-mix for sustained future growth Core
competencies will play an important role in determining the future of many Indian
pharmaceutical companies in the post product-patent regime after 2005 Indian companies in an
effort to consolidate their position will have to increasingly look at merger and acquisition
options of either companies or products This would help them to offset loss of new product
options improve their RampD efforts and improve distribution to penetrate markets
The first Indian pharmaceutical company Bengal Chemicals and Pharmaceutical Works which
still exists today as one of 5 government-owned drug manufacturers appeared in Calcutta in
1930 For the next 60 years most of the drugs in India were imported by multinationals either in
fully-formulated or bulk form The government started to encourage the growth of drug
manufacturing by Indian companies in the early 1960s and with the Patents Act in 1970 enabled
the industry to become what it is today This patent act removed composition patents from food
and drugs and though it kept process patents these were shortened to a period of five to seven
years The lack of patent protection made the Indian market undesirable to the multinational
companies that had dominated the market and while they streamed out Indian companies started
to take their places They carved a niche in both the Indian and world markets with their
expertise in reverse-engineering new processes for manufacturing drugs at low costs Although
some of the larger companies have taken baby steps towards drug innovation the industry as a
whole has been following this business model until the present
Products and business description
This sector profile covers pharmaceutical end products only These can be divided intothree
categories
1048707 Prescription drugs based on chemical compounds and prescribed or administered by
healthcare professionals
1048707 Over the counter (OTC) drugs based on chemical compounds and freely sold
1048707 Vaccines based on bacteria and viruses
The distinction between branded and generic products is also important A branded product is the
original version produced by the innovative company that developed the product A generic
product is a copy of the original by another company Many innovative companies have 7 | P a g e
divisions that pro RampD for new drugs requires high investments After the discovery of new
chemical compounds with a therapeutic effect a patent is filed This protects the potential new
drug against generic competition usually for 20 years The drug then still has to be tested in
several phases of clinical trials The total development process costs several hundred million
dollars and takes over 10years If the new drug is finally proven safe and effective it is approved
by a regulatory authority As long as a branded product is protected by a patent companies
charge high prices to recover RampD investments and make high profits After patent expiry
competition from cheap generics usually causes a large
drop in prices duce generics as well
RampD investments for vaccines are comparable to those for drugs However the production
process of vaccines is more complicated and their delivery requires an advanced infrastructure
(lsquocold chainrsquo) Furthermore the new vaccines currently used in high income countries are of a
different type than those recommended for poor countries They are much more expensive but
are preferred due to the lower risk of adverse reactions The largest pharmaceutical markets are
the US Europe and Japan Together these account for 84 of the $460 billion of global drug
and vaccine sales in 2003 Cardiovascular and central nervous system (CNS) medicines are the
largest selling therapeutic classes
Companies and business strategies
Over the last years there have been many large mergers and acquisitions in the sector while
many companies have divested non-core activities Although RampD investment has strongly
increased over the past decade many large companies do not have promising RampD pipelines and
increasingly pursue growth through enhanced marketing Outsourcing of production and
alliances for RampD distribution or marketing are common business strategies
Within this part of the sector it important to recognize the distinction between branded and
generic producers
8 | P a g e
bull Branded companies are the innovative companies that carry out the Research and
Development (RampD) of new drugs (or contract this process) Initially their products are
protected by patents The clinical test data used for the approval of the drugs is usually
protected as well
bull Generic companies produce drugs that they have not developed themselves Normally these
drugs are not protected by patents anymore
This report focuses mainly on the branded industry However many branded companies have
divisions or subsidiaries that produce generics as well With regard to the products of these
companies three categories of drugs are commonly distinguished
bull Prescription drugs These have to be prescribed or administered by healthcare professionals
bullOver the counter (OTC) drugs also called self-medication drugs These can be purchased
without a prescription
bull Vaccines These are usually regarded as a separate category next to pharmaceuticals5 In
contrast to pharmaceuticals vaccines are not based on chemical compounds but on live bacteria
and viruses The production process of vaccines is therefore quite different and far more
complicated
The business of drug development
Branded companies make high investments in RampD to discover new drugs It is estimated that
the development of a major drug costs up to US$ 400 million and requires as long as 10 years to
be introduced into the market The development of new drugs usually starts with the discovery of
new chemical compounds with a therapeutic effect This is the first research phase Once the
basic compounds have been identified pharmaceutical companies obtain patent protection for
their potential use in new drugs These patents grant the exclusive right to sell and market a
specific drug for a specified time period usually twenty years After the discovery of a new
compound follows the further development into an effective and safe treatment and the testing of
the new drug candidate in subsequent phases of clinical trials Finally a new drug has to be
approved by a regulatory authority like the Food and Drug Administration (FDA) in the case of
the US Drug approval may take 1ndash15 year The estimated duration cost and rate of success for
the various development stages of an average drug are provided in the table below A short
description of the testing phases is given as well
9 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
divisions that pro RampD for new drugs requires high investments After the discovery of new
chemical compounds with a therapeutic effect a patent is filed This protects the potential new
drug against generic competition usually for 20 years The drug then still has to be tested in
several phases of clinical trials The total development process costs several hundred million
dollars and takes over 10years If the new drug is finally proven safe and effective it is approved
by a regulatory authority As long as a branded product is protected by a patent companies
charge high prices to recover RampD investments and make high profits After patent expiry
competition from cheap generics usually causes a large
drop in prices duce generics as well
RampD investments for vaccines are comparable to those for drugs However the production
process of vaccines is more complicated and their delivery requires an advanced infrastructure
(lsquocold chainrsquo) Furthermore the new vaccines currently used in high income countries are of a
different type than those recommended for poor countries They are much more expensive but
are preferred due to the lower risk of adverse reactions The largest pharmaceutical markets are
the US Europe and Japan Together these account for 84 of the $460 billion of global drug
and vaccine sales in 2003 Cardiovascular and central nervous system (CNS) medicines are the
largest selling therapeutic classes
Companies and business strategies
Over the last years there have been many large mergers and acquisitions in the sector while
many companies have divested non-core activities Although RampD investment has strongly
increased over the past decade many large companies do not have promising RampD pipelines and
increasingly pursue growth through enhanced marketing Outsourcing of production and
alliances for RampD distribution or marketing are common business strategies
Within this part of the sector it important to recognize the distinction between branded and
generic producers
8 | P a g e
bull Branded companies are the innovative companies that carry out the Research and
Development (RampD) of new drugs (or contract this process) Initially their products are
protected by patents The clinical test data used for the approval of the drugs is usually
protected as well
bull Generic companies produce drugs that they have not developed themselves Normally these
drugs are not protected by patents anymore
This report focuses mainly on the branded industry However many branded companies have
divisions or subsidiaries that produce generics as well With regard to the products of these
companies three categories of drugs are commonly distinguished
bull Prescription drugs These have to be prescribed or administered by healthcare professionals
bullOver the counter (OTC) drugs also called self-medication drugs These can be purchased
without a prescription
bull Vaccines These are usually regarded as a separate category next to pharmaceuticals5 In
contrast to pharmaceuticals vaccines are not based on chemical compounds but on live bacteria
and viruses The production process of vaccines is therefore quite different and far more
complicated
The business of drug development
Branded companies make high investments in RampD to discover new drugs It is estimated that
the development of a major drug costs up to US$ 400 million and requires as long as 10 years to
be introduced into the market The development of new drugs usually starts with the discovery of
new chemical compounds with a therapeutic effect This is the first research phase Once the
basic compounds have been identified pharmaceutical companies obtain patent protection for
their potential use in new drugs These patents grant the exclusive right to sell and market a
specific drug for a specified time period usually twenty years After the discovery of a new
compound follows the further development into an effective and safe treatment and the testing of
the new drug candidate in subsequent phases of clinical trials Finally a new drug has to be
approved by a regulatory authority like the Food and Drug Administration (FDA) in the case of
the US Drug approval may take 1ndash15 year The estimated duration cost and rate of success for
the various development stages of an average drug are provided in the table below A short
description of the testing phases is given as well
9 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
bull Branded companies are the innovative companies that carry out the Research and
Development (RampD) of new drugs (or contract this process) Initially their products are
protected by patents The clinical test data used for the approval of the drugs is usually
protected as well
bull Generic companies produce drugs that they have not developed themselves Normally these
drugs are not protected by patents anymore
This report focuses mainly on the branded industry However many branded companies have
divisions or subsidiaries that produce generics as well With regard to the products of these
companies three categories of drugs are commonly distinguished
bull Prescription drugs These have to be prescribed or administered by healthcare professionals
bullOver the counter (OTC) drugs also called self-medication drugs These can be purchased
without a prescription
bull Vaccines These are usually regarded as a separate category next to pharmaceuticals5 In
contrast to pharmaceuticals vaccines are not based on chemical compounds but on live bacteria
and viruses The production process of vaccines is therefore quite different and far more
complicated
The business of drug development
Branded companies make high investments in RampD to discover new drugs It is estimated that
the development of a major drug costs up to US$ 400 million and requires as long as 10 years to
be introduced into the market The development of new drugs usually starts with the discovery of
new chemical compounds with a therapeutic effect This is the first research phase Once the
basic compounds have been identified pharmaceutical companies obtain patent protection for
their potential use in new drugs These patents grant the exclusive right to sell and market a
specific drug for a specified time period usually twenty years After the discovery of a new
compound follows the further development into an effective and safe treatment and the testing of
the new drug candidate in subsequent phases of clinical trials Finally a new drug has to be
approved by a regulatory authority like the Food and Drug Administration (FDA) in the case of
the US Drug approval may take 1ndash15 year The estimated duration cost and rate of success for
the various development stages of an average drug are provided in the table below A short
description of the testing phases is given as well
9 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Thus when a pharmaceutical company launches a new drug on the market it has only a limited
period of time of considerably less than twenty years in which it has exclusive marketing rights
During this period companies charge high prices for the drugs to recover their RampD investments
and make high profits The production costs of drugs are never disclosed but they are only a
fraction of the exclusive marketing price of a drug It is estimated that average manufacturing
cost are usually in the order of 5 of this price
Marginal production costs are still considerably lower due to economies of scale6 Apart from
patent protection there is usually a period of data exclusivity that protects the clinical testing
data of pharmaceutical companies This period starts at the moment a product is approved and
may have a duration of five years or more During the data exclusivity period other companies
cannot rely on the data of the company that developed the drug for the approval of a generic
version After the expiry of patent protection on a pharmaceutical product other companies may
legally copy the drug and sell a generic version For the approval of a generic a company has to
proof that its drug is a biological equivalent of the original This allows a company to rely on the
clinical testing data of the branded company provided that these are not protected by data
exclusivity anymore Generic producers therefore do not have to make high RampD investments
and generic competition usually causes a large fall in prices In the US drugs face fierce
competition right after the expiration of a patent In Europe generics are generally introduced
slowly and at higher prices7 A successful drug can generate enormous revenues for a
pharmaceutical company Some drugs the so-called blockbusters have sales of well over US$ 1
billion per year Yet after the expiration of a patent revenues can quickly diminish and
companies may be forced to lower their profit margins because of generic competition For
example in 2003 the quarterly sales revenue of its three medicines Glucophage IR Taxol and
Serzone of Bristol- Meyers Squibb dropped by 90 after patent protection expired8
13 Market structure and trends
The largest pharmaceutical markets are the USA Europe and Japan The total world market for
pharmaceuticals (sales of pharmaceutical products) displayed strong growth over the past years
and increased by almost 9 in 2003 Due to the ageing populations in the major markets drug
use will probably continue to grow Market size estimates of regional pharmaceutical markets
and of the largest selling therapeutic areas are provided in the tables below
10 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
The vaccines marketThe market for vaccines is somewhat different from that of other therapeutic classes Like
pharmaceuticals the development of new vaccine products usually takes 7-12 years an costs
several hundred million dollars The development of new vaccines also requires the construction
of new facilities The strict government regulations that are imposed have profound implications
for the vaccine industry and vaccine producers have to continue to invest in production facilities
in order to meet production standards In addition vaccines have to be kept at the right
temperature during distribution and therefore the delivery of vaccines requires an advanced
infrastructure (lsquocold chainrsquo) and active support of the producer
A large majority of vaccines is procured at the national level by public health sector
organizations Large market segments may be served by a single company Merck is the sole
supplier of measles-mumps-rubella vaccines in the US for example Yet the demand for
vaccines is difficult to forecast and may change during the actual production cycle which is
considerably longer than for pharmaceuticals Demand for vaccines changes according to for
example the severity of diseases production lead times regulations and actions of competitors
The vaccines currently used in the US and other high income countries are often of a different
type than those used in developing countries For example the US use the a celullar pertussis
type and Measles-mumps-rubella (MMR) combination whereas developing countries use whole
cell pertussis vaccines and measles alone instead of MMR The Netherlands has recently decided
to start administrating the whole cell pertussis vaccine instead of the a cellular type This is
because of the higher risk of adverse reactions associated with the older vaccine types
Furthermore high income countries use Inactivated Polio Vaccine (IPV) for routine
immunization programmes whereas developing countries use Oral Polio Vaccine (OPV)12
OPV is easier to administrate and much cheaper It is also the preferred vaccine when a polio
outbreak needs to be contained because it causes higher immunity in the intestinal tract and is
therefore more effective to interrupt the circulation of the polio virus However in extremely rare
cases (less than 1 in a million doses) the live attenuated virus in OPV can cause vaccine-
associated polio For this reason high income countries prefer IPV for regular immunization The
newer vaccines used in high income countries are much more expensive In some cases they
cost over a hundred times more A diphteria-tetanus-whole cell pertussis (DTwP) vaccine for
11 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
example costs US$ 007 only By contrast the diphteria-tetanus-acellular pertussis (DTaP)
vaccine that is used in high income countries in combination with for example IPV or hepatitis
B costs over $10 Similarly a single measles vaccine costs $014d
RampD pipelines
In principle the quality and the marketing potential of the products in the RampD pipeline of a
company determine its potential for future growth At present the largest 20 pharmaceutical
companies have almost 700 new drugs in development20 Over the past decade RampD
investments of the pharmaceutical industry have grown faster in the US than in Europe In
Europe 2002 investments were Euro 20 billion compared to 8 billion in 1990 whereas RampD
investments in the US were at 28 billion in 2002 down from 5 billion in 1990 As companies are
investing more heavily in the US analysts perceive that the European pharmaceutical industry is
in not in a favourable competitive position21 Yet the increase in investment has not been
matched by a comparable increase in new drug approvals hence the RampD results of most
companies are declining22 The complexity of the investigated treatments has increased and it
has become more difficult to obtain approval for new drugs due to the stricter application of
existing regulations in the US by the FDA The most common reasons for not approving a drug
are negative by-effects of the drug that were identified in clinical trials and the limited added
value over existing drugs23 Worldwide drug approvals hit an all time low in 200324 The
largest pharmaceutical companies which have grown fastly during the 1990s do not promising
RampD pipelines while patents on successful drugs are expiring For the period 2002-2007 the
drugs on which patent protection expires in these years generate combined sales of about US$ 40
billion25
23 Protection against generic competition and growth through marketing
Pharmaceutical companies have several strategies to reduce or prevent competition form generic
producers which often greatly reduces the renevues from a drug One strategy is to obtain
additional patents to extend the period of patent protection if possible Another strategy is to
fight the approval of generic drugs and charge generic producers of infringing patents or data
exclusivity For example in 2003 Mylan Watson and Ranbaxy Laborories two generic
producers from the US and one India resectively sought FDA approval to produce generic
12 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
versions of Actos Actos is a blockbuster diabetes drug of Takeda Japans largest
pharmaceuticals
Another strategy to protect a drug from competition is to launch a slightly improved version or
more convenient formulation of the same drug A new patent can be obtained for this improved
drug The company then tries to persuade doctors and patients to use this improved version The
effectiveness of this strategy depends to a large extent on the marketing of the new drug
Examples of attempts to curb generic competition in this way include AstraZenecarsquos marketing
of Nexium a slightly improved version of its out-of-patent ulcer drug Prilosec27 and the release
of Wellbutrin XR by GlaxoSmithKline a sustained release version of its antidepressant
Welbutrin that now faces generic competition28 In the US the growth of the industry over the
last ten years has been partly based on such slightly improved new drugs backed by massive
sales and marketing operations and TV advertisement 29 Because of the disappointing results of
their RampD pipelines pharmaceutical companies increasingly pursue growth through enhanced
marketing of their drugs Especially the large pharmaceutical companies have developed into
marketing specialists that are very good at putting products into the market The focus on growth
through marketing is reflected by the high marketing expenses compared to RampD investment
The Swiss company Roche for instance spends 31 of its turnover on marketing against 16
for RampD30 Corporate philanthropy and corporate responsibility programmes help to enhance a
companyrsquos identity and hence such initiatives might support marketing efforts Marketing is also
a stategy to reduce generic competition in itself By promoting the propietary brand names of
patented drugs pharmaceutical companies may be able to sustain drug sales even if these are no
longer protected by patents
Restructuring and outsourcing
Several companies are restructuring their businesses to cut costs Among these are Merck which
eliminated 4400 jobs worldwide and Organ on the human health division of Akzo Nobel
which cut 800 jobs in the US The contracting of drug manufacturing to low cost producers is a
common business practice in the pharmaceutical industry These are usually located in lower cost
countries such as India China or South Africa It is not unusual that the production is contracted
to a company that produces generics too Hence although the development of the generic drug
13 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
industry in low cost countries may lead to increased competition for branded pharmaceutical
companies it also creates opportunities for cost-saving through outsourcing of production There
is a trend towards the outsourcing of RampD towards countries with lower wages too For example
Novartis established its new RampD facility the Novartis Institute on Tropical Diseases (NITD) in
Singapore GlaxoSmithKline linked up with the Ranbaxy an Indian producer of competing
generic drugs for early-stage research of new drugs31 GlaxoSmithKline is also carrying out
trials for its Rotavirus vaccine in Latin America among other reasons because trials are
considerably cheaper there whereas reasonable infrastructure is readily available
25 Consolidation and specialization
Over the last years many pharmaceutical companies have been involved in large-scale margers
and acquisitions and there is a trend towards further consolidation and concentration in the
sector Recent large mergers and acquisitions include the following
bull In 2004 UCB is to take over Celltech for US$ 27 billion creating the fifth largest
biotechnology company in the world
bull In 2004 Sanofi-Syntheacutelabo has taken over Aventis for Euro 55 billion
bull In 2003 Pfizer acquired Pharmacia for US$ 56 billion32
bull In 2002 Amgen acquired Immunex for US$ 16 billion
bull In 2001 Johnson amp Johnson acquired Alza for US$ 12 billion
bull In 2001 Broistol-Myers Squibb acquired DuPont Pharmaceuticals for US$ 8 billion
bull In 2000 Glaxo Wellcome and SmithKline Beecham merged to from
GlaxoSmithKline33
bull In 2000 Pfizer and Warner-Lambert merged to form the new Pfizer
bull In 1999 Rhocircne-Poulenc and Hoechst merged to form Aventis34
At the same time there is a trend towards concentration on pharmaceutical core-business and the
divestment of non-core activities Recent major divestments include the following
bull In 2003 Merck divested Medco Health a provider healthcare services
bull In 2002 Aventis sold its agrochemical business to Bayer and its animal health division to CVC
Capital Partners
bull In 2002 Novartis divested its agrochemical business to form Syngenta
14 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
The consolidation leads to increased concentration of drug portfolios For example when Rhocircne-
Poulenc and Hoechst merged in 1999 their combined portfolio included three fo the four
medicines against sleeping sickness The present merger between Sanofi-Syntheacutelabo and Aventis
could also lead to serious competition concerns and in an effort to head these off Sanofi-
Syntheacutelabo has already agreed to sell two heart disease drugs and a manufacturing plant to
GlaxoSmithKline35 Because of the far more complicated production process and a series of
litigation lawsuits in the 1980s the number of industrialized country vaccine manufacturers has
decreased over the past decades and they have consolidated into five major corporations These
are Merck amp Co GlaxoSmithKline Aventis Wyeth and Chiron For some vaccines the number
of producers is even lower Yellow fever vaccines for example are produced exclusively
byAventis GlaxoSmithKline and UCB (formerly Celltech)
Strategic alliances
Strategic alliances are also common in the industry mainly for combining the strengths of
companies in different areas such as distriubution and marketing manufacturing and RampD For
example distribution or marketing agreements provide smaller companies especially
biotechnology companies with access to large sales infrastructures However the number of
alliances between biotechnology companies themselves has also been increasing suggesting that
they are becoming less dependent on large pharmaceutical companies for the marketing of their
products37 On the other hand biotechnology companies continue to offer interesting
opportunities for large companeis to improve their RampD pipelines Pfizer recently announced a
new strategy to buy biotech companies for example38
27 Expansion towards generic drugs
In the first section of this report it was already mentioned that many branded companies have
divisions or subsidiaries that produce generics as well Of the twenty largest pharmaceutical
companies listed in this report only Teva Pharmaceuticals has the production of generic drugs as
its main activity However some of the other companies are important generic producers too
15 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
CSR issues on access to medicines for developing countries
31 Recent developments on TRIPS
The protection of intellectual property is an important aspect of access to medicines As decribed
above patents and other forms of intellectual property rights protect a innovative drugs against
generic competition The pharmaceutical industry itself stresses that access to medicines depends
on many more factors than patents including the infrastucture for the distribution of medicines
The potential effects of generic competition on drug prices in developing countries will be
illustrated with a common example of anti-retroviral (ARV) therapy Before 2001 ARV
treatment would cost more or less the same in Africa as in the US and Europe about $10000 a
year Only a relatively small number of countries had negotiated prices in the range of $1000 a
year after lengthy negotiations with the patent holders who sometimes required them to keep
the lower prices a secret In february 2001 prices suddenly dropped when the Indian generics
manufacturer Cipla offered ARV therapy for US$ 350 a year India recognizes patents on drug-
making processes not on products so Cipla can legally produce generics as long as it uses a
slightly different process40 In August 2003 Aspen Pharmacare launched the first domestically
produced generic in South Africa a copy of Bristol-Myers Squibbrsquos Zerit 41 An important
international framework for the protection of intellectual property is the World Trade
Organization (WTO) agreement on Trade-Related aspects of Intellectual Property Rights
(TRIPS) This agreement was concluded in the Uruguay round of WTO negotiations that ended
in 1994 The TRIPS agreement requires all WTO members (currently 147 countries) to pass
legislation that protects intellectual property such as patent protection It also states that
signatories must protect patent holdersrsquo data from lsquounfair commercial usersquo but it does explicitly
not oblige data exclusivity periods Least developed countries were given until 2006 to comply
with these requirements The articles 6 30 and 31 of the agreement are of special relevance for
access to medicines in developing countries
bull Article 6 specifies that countries can decide whether or not to allow international exhaustion of
patents This is also called parallel importing and means that patented products may be imported
from foreign markets at a lower price
bull Article 30 allows countries to provide exceptions to the exclusive rights conferred by a patent
provided that they do not unreasonably conflict with a normal exploitation of the patent
16 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Industry lobbying for intellectual property protection
Pharmaceutical companies have been accused of agressively lobbying against the weakening of
international patent protection during TRIPS negotiations47 A large part of the industry lobby is
carried out by the Pharmaceutical Research and Manufacturers of America (PhRMA) It is
therefore difficult to determine the lobby positions of individual pharmaceutical companies The
PhRMA is a US-based organization that represents the countrys leading research-based
pharmaceutical and biotechnology companies48 Its members include all major pharmaceutical
companies in the world not just those based in the US
The PhRMA pursues a TRIPS-plus agenda that is provisions on intellectual property protection
that go beyond the requirements of TRIPS agreement The main issues of this agenda are the
following 49
bull Limitations to compulsory licensing
bull The protection of test data by data exclusivity periods
bull No approval of generic drugs until the patent on a drug has expired also called linkage of
regulatory approval with patent status This delays the launch of generic drugs beyond patent
expiry as generic producers typically obtain approval well in advance to prepare the launch of
the generic product
bull No exhaustion of patent rights and no export of generics This means that patented or generic
products cannot be purchased in foreign markets at lower prices Recently the focus of the
industry lobby has shifted towards the establishment and extension of data exclusivity periods
As explained before this effectively prevents generic competition by not allowing other
producers to rely on the clinical test data of the patent holder for approval of the drug This may
delay the launch of generic medicines beyond patent expiry In line with these industry interests
the European Commission proposed in 2003 an extension of the data exclusivity period which
could threaten access to cheap generic medicines in accession countries50
Pricing of medicines
Pricing is one of the areas where pharmaceutical companies can make a major contribution to
enhance access to medicines in developing countries Lower medicine prices can considerably
increase their availability to poor populations regardless from other problems such as the weak
infrastructure for the delivery of medicines in developing countries Sales in poor countries
17 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
especially least developed countries typically generate a very small proportion of the total sales
of a pharmaceutical company Companies could therefore supply medicines too these countries
at differential strongly reduced prices without a substantial loss of profits This brings two
potential risks for pharmaceutical companies Firstly the supply of cheaper medicines in
developing countries can result in parallel imports of these medicines into high income markets
where they can be sold by others for a much higher price Such product diversion means that the
medicines will not reach the target population and that the company will suffer reduced sales in
high income countries Most industrialized countries prohibit parallel imports without the
permission of the patent holder Some companies have taken additional steps to prevent
preferentially priced medicines from being illegally re-sold at higher prices Preferentially priced
products from GlaxoSmithKline for example have different colours and come in different
packages sothey can be easily recognized
Secondly the preferential prices may be used as a reference by healthcare providers in high
income countries for negotiating lower prices This is called reference pricing Companies
sometimes set preferential drug prices for least developed countries at production cost which is
normally kept secret because it is higly sensitive commercial information The prevention of
reference pricing requires political commitment from developed countries The Accelerating
Access Initiative (AAI) a partnership that searches to enhance access to ARVs has
demonstrated that this problem can be overcome From a public health point of view there are
several concerns about the preferential pricing offers of pharmaceutical companies In the past
most pharmaceutical companies used to negotiate preferential prices on a case-by-case basis with
individual countries Such negotiations are a lengthy process often yield sub-optimal outcomes
for developing countries Individual negotiations also limit the transparency and reliability of
preferential prices Furthermore governments may be required to offer advantages to the
company inexchange such as refraining from resorting to generic drugs or to keep medicine
prices secret This type of negotiations for ARV prices under the AAI have caused the
partnership to be heavily criticized Furthermore price reduction have often been limited to
small numbers of products Development organizations therefore stress the need of a generalized
global system of differential prices which covers a broad range of a companyrsquos medicines and
bases eligibility on objective indicators60 Several companies have recently adopted preferential
18 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
pricing schemes for ARVs that meet the criteria of fixed prices for groups of countries objectve
eligibility criteria and transparent offers Yet in some cases negotiations still take place on a
country basis especially with middle income countries
RampD for developing countriesrsquo diseases
The majority of RampD expenditures is aimed at treatments for diseases that are mainly prevalent
in high income countries It is estimated that only 10 of RampD investment goes to diseases of
developing countries whereas these diseases account for 90 of the global disease death burden
Many poor people suffer or die from diseases that are treatable or curable but for which little
research is being performed These include sleeping sickness (African Trypanosomiasis)
diarrhoeal diseases schistosomiasis chagas disease and leprosy Compared to for example
HIVAIDS research RampD investment for leishmaniasis tuberculosis (TB) and malaria is also
relatively low61 The reason for this discrepancy is that there are only lsquosmall marketsrsquo for these
medicines which means there is little profit to be made except for HIVAIDS treatments They
will therefore not yield an adequate return on RampD investments This contrasts with treatments
against diseases and disorders such as hypertension elevated cholesterol levels depression
arthritis allergy and schizophrenia These treatments fall in the therapeutic areas that generate
the largest sales worldwide as indicated earlier in this report
Drugs donations
Many pharmaceutical companies make drug donations to developing countries Although these
may help to improve access to medicines there are some important concerns about drug
donations
bull Donations may have an undue influence on the choice of medicines that are used in a recipient
country If one drug is available for free and other drugs are not the first drug might be used
even though it is not the prefered treatment
bull Various types of restrictions may apply such as geographic quantitative indication and time
restrictions
bull Sometimes donations require the implementation of a separate donations programme and are
accompanied by high administrative costs for the recipient country
19 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
bull Recipient countries may become dependent on medicine donations
bull Donations may be more costly for donor governments than the procurement of preferentially
priced or generic drugs because of tax breaks that are under certain conditions granted to the
donating companies especially in the US Not all donation programmes qualify for tax breaks
though
bull Donations may have a negative impact on the development of the generic drugs industry and
therefore cause unfair competition
bull Assuming that tax breaks are not a substantial compensation for donating companies it is
generally considered that offering preferentially priced medicines at production cost is more
sustainable than medicine donations because it enables companies to recover their expenses In
addition the decision to donate a certain medicine involves setting priorities for the use of
resources available to enhance healthcare in developing countries If companies offer preferential
prices for a wide range of drugs instead this would allow developing countries more autonomy
to set their own priorities
bull In the past there have been several cases of medicine donations that were inappropriate and
sometimes even useless for the recipients For example donated medicines were not requested
and could not be used they could not be identified due to inappropriate labelling or they had a
remaining shelf-life too short to be used in time
bull Donations may be a disguised form of medicine promotion In one case for example the Swiss
company Novartis announced free supplies of its cancer drug Glivec to people around the world
that could not afford its costs of US$ 27000 per year Some estimated that this number of
patients would be as high as 600000 However in the end only 1500 patients outside the US
benefited from these donations of which just 11 in least developed countries It became clear
that Novartis had used Glivec as part of a marketing strategy and even encouraged patients
benefiting from the donations to press public health systems to pay high prices for the drug
In 1999 the WHO adopted a set of guidelines for drug donations These guidelines deal mainly
with the last issue inappropriate donations due to the quality of donations The guidelines
include the following standards
bull No donations should be made without consent of the recipient
20 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
bull There should be no double standards in quality For instance the donation of drugs that were
returned to pharmacies are not allowed
bull After delivery the donated drugs should have a remaining shelf-life of at least half
a year
bull The declared value of a drug should be based upon the wholesale price of it generic equivalent
to decrease the burden of customs clearance and import duties High standards of medical
donations are promoted by the Partnership for Quality Medical Donations (PQMD) This is an
alliance of private voluntary organizations that develops and promotes sound donation practices
represents the interests of its members and encourages the study of health and socioeconomic
impacts of donations It identified 7 key components in the comprehensive management of drug
donations including needs assessment appropriateness of the donation quality standards and
impact evaluation
These are consistent with the WHO guidelines but address a broader range of issues Some
pharmaceutical companies have been addressing various types of concerns about medicine
donations on an individual basis For example companies commit themselves to donate a drug
for as long as it is needed and seek to integrate drug donation programmes into existing
healthcare infrastructures
36 Global Public-Private Initiatives
Global Public-Private Initiatives (GPPIs) for health are partnerships of public and private actors
that work together to achieve health outcomes Although this type of collaborations is not new
they are increasingly regarded as one of the most appropriate ways to improve access to
medicines in developing countries In the past 10 years many new GPPIs have been established
There are at present some 80 GPPIs for health The Initiative on Public- Private Partnerships for
Health (IPPPH) registers some (but not all) of these partnerships and maintains a public database
with information about the registered partnerships67 The nature of the partnerships is diverse
Often GPPIs have one or more of the following goals
bull Support or accellerate RampD for major diseases in developing countries
bull Deliver medicines to developing countries for free or at preferential prices
bull Strengthen the health care infrastructure in developing countries
bull Coordinate the efforts of various individual partners or other partnerships
21 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
GPPIs serve to bring together the expertise of different partners and to bring in additional funds
to improve health in developing countries However there are a number of concerns about
GPPIs68 The inventory below applies mainly to partnerships that seek to improve access to
medicines Some concerns are related to the governance of GPPIs
The recipient countries and populations have sometimes very little influence on the goals and
strategy of a partnership They are often underrepresented in GPPI boards
bull There may be conflicts of interest and undue influence of private sector partners on public
health policies For example the participation of pharmaceutical companies in the management
of GPPIs may enable them to influence public health priorities and technical standards according
to their commercial interests
bull Transparency about the governance of partnerships and the commitments and responsibilities
of various partners is often low
bull It may not be clear to whom the management of a GPPI is accountable
bull The role and responsibilities of the various partners to a GPPI may not be clear In
addition it may not be able to hold them accountable for their commitments to the
partnership
bull The impacts of GPPIs are not always well monitored and evaluated
In 2000 the WHO secretariat adopted internal Guidelines on interaction with commercial
enterprises to achieve health outcomes to deal with potential conflicts of interests They
recommend that the WHO lsquoshould always consider whether a proposed relationship might
involve a real or perceived conflict of interestsrsquo and call for a lsquostep-by-step evaluation of the
commercial enterprisersquo69 However these guidelines were not always followed when new
GPPIs were initiated
Other concerns are related to the strategies and impact of GPPIs
bull GPPIs may create parallel structures in developing countries that are an additional burden on
the health sector in developing countries instead of integrating with local healthcare
infrastructures Coordination between different GPPIs is often lacking too
bull GPPIs may not deliver sustainable results because they do not strengthen the local health
sector and commitments from commercial partners are usually for a maximum period of five
years
22 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
bull GPPIs may not be linked to sector-wide approaches and national poverty reduction strategies
bull GPPIs may have a narrow focus and medicalize health problems An integrated approach
including prevention of a disease may be lacking Furthermore many GPPIs are focused at the
enhanced delivery of medicines but do not address the underlying causes of health problems
such as unsafe drinking water malnutrition and inadequate sanitation
Drug safety
The safety of drugs is heavily regulated and companies have the responsibility to ensure that
healthcare workers understand how their drugs can be safely used Furthermore companies have
to ensure drug quality and traceability of drugs during manufacturing and distribution In the
case of production errors or contamination unsafe production batches have to be withdrawn
from the market 76 For products that are sold in the US market the FDA requires companies to
observe current Good Manufacturing Practices (cGMP) a process standard for drug
manufacturing Sometimes companies have failed to comply with such standards which has
resulted in fines litigation claims lost contracts and the suspension of production
23 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
COMPANY PROFILE
Cipla originally founded as The Chemical Industrial amp Pharmaceutical Laboratories is a
prominent Indian pharmaceutical company best-known outside its home country for producing
low-cost anti-AIDS drugs for HIV-positive patients in developing countries Cipla makes drugs
to treat cardiovascular disease arthritis diabetes weight control depression and many other
health conditions and its products are distributed in more than 180 countries worldwide [1]
Among the hundreds of generic medications it produces for international distribution are
atorvastatin amlodipine fluoxetine venlafaxine hydrochloride and metformin
Khwaja Abdul Hamied the founder of Cipla was born on October 31 1898 The fire of
nationalism was kindled in him when he was 15 as he witnessed a wanton act of colonial
highhandedness The fire was to blaze within him right through his life In college he found
Chemistry fascinating He set sail for Europe in 1924 and got admission in Berlin University as a
research student of The Technology of Barium Compounds He earned his doctorate three
years later In October 1927 during the long voyage from Europe to India he drew up great
plans for the future He wrote No modern industry could have been possible without the help of
such centres of research work where men are engaged in compelling nature to yield her secrets to
the ruthless search of an investigating chemist His plan found many supporters but no
financiers However Dr Hamied was determined to being a small wheel no matter how small
than be a cog in a big wheel
Cipla and the Fight against HIVAIDS in the Developing World
Today (2007) Cipla is the worlds largest manufacturer of antiretroviral drugs (ARVs) to fight
HIVAIDS as measured by units produced and distributed (multinational brand-name drugs are
much more expensive so in money terms Cipla medicines are probably somewhere down the
list) Roughly 40 of HIVAIDS patients undergoing antiretroviral therapy worldwide take
Cipla drugs Ranked third in Generic market share statistics in South African Private
SectorBecause Indian law from 1972 has allowed no (end-product) patents on drugs and
provided for compulsory licensing Cipla was able to manufacture medicines which enjoy patent
24 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
monopoly in certain other countries (particularly those where large multinational pharmaceutical
companies are based) By doing so as well as by making an executive decision not to make
profits on AIDS medication Cipla reduced the cost of providing antiretrovirals to AIDS patients
from $12000 and beyond (monopoly prices charged by international pharma conglomerates)
down to around $300 per year Today they are able to do so for under $150 per patient per year
While this sum remains out of reach for many millions of people in Third World countries
government and charitable sources often are in a position to make up the difference for destitute
patientsThe customary treatment of AIDS consists of a cocktail of three drugs Cipla produces
an all-in-one pill called Triomune which contains all three substances (Lamivudine stavudine
and Nevirapine) something difficult elsewhere because the three patents are held by different
companies One more popular fixed dose combination is there with the name Duovir-N This
contains Lamivudine Zidovudine and Nevirapine
Cipla was officially opened on September 22 1937 when the first products were ready for
the market The Sunday Standard wrote The birth of Cipla which was launched into the
world by Dr K A Hamied will be a red letter day in the annals of Bombay Industries The
first city in India can now boast of a concern which will supersede all existing firms in
the magnitude of its operations India has lagged behind in the march of science but she is
now awakening from her lethargy The new company has mapped out an ambitious
programme and with intelligent direction and skillful production bids fair to establish a
great reputation in the East
1935 Dr K A Hamied sets up The Chemical Industrial and Pharmaceutical Laboratories
Ltd in a rented bungalow at Bombay Central
1941 As the Second World War cuts off drug supplies the company starts producing fine
chemicals dedicating all its facilities for the war effort
1952 Sets up first research division for attaining self-sufficiency in technological
development
1960 Starts operations at second plant at Vikhroli Mumbai producing fine chemicals
with special emphasis on natural products25 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
1968 Cipla manufactures ampicillin for the first time in the country
1972 Starts Agricultural Research Division at Bangalore for scientific cultivation of
medicinal plants
1976Cipla launches medicinal aerosols for asthma
1980 Wins Chemexcil Award for Excellence for exports
1982 Fourth factory begins operations at Patalganga Maharashtra
1984 Develops anti-cancer drugs vinblastine and vincristine in collaboration with the
National Chemical Laboratory Pune Wins Sir P C Ray Award for developing inhouse
technology for indigenous manufacture of a number of basic drugs
1985 Cipla wins National Award for Successful Commercialisation of Publicly Funded
RampD
1991 Lauches etoposide a breakthrough in cancer chemotherapy in association with
Indian Institute of Chemical Technology
The company pioneers the manufacture of the antiretroviral drug zidovudine in
technological collaboration with Indian Institute of Chemical Technology Hyderabad
1994 Ciplas fifth factory begins commercial production at Kurkumbh Maharashtra
1997 Launches transparent Rotahaler the worlds first such dry powder inhaler device
now patented by Cipla in India and abroad The palliative cancer care centre set up by the
Cipla Foundation begins offering free services at Warje near Pune
1998 Launches lamivudine becoming one of the few companies in the world to offer all
three component drugs of retroviral combination therapy (zidovudine and stavudine
already launched
1999 Launches Nevirapine antiretroviral drug used to prevent the transmission of AIDS
from mother to child
26 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
2000Cipla became the first company outside the USA and Europe to launch CFC-free
inhalers ndash ten years before the deadline to phase out use of CFC in medicinal products
2002 Four state-of-the-art manufacturing facilities set up in Goa in a record time of less
than twelve months
2003 Launches TIOVA (Tiotropium bromide) a novel inhaled long-acting
anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for
patients with chronic obstructive pulmonary disease (COPD) Commissioned second
phase of manufacturing operations at Goa
2005 Set-up state-of-the-art facility for manufacture of formulations at Baddi Himachal
Pradesh
BOARD OF DIRECTORS
FOUNDER Dr KA Hamied
(1898-1972)
CHAIRMAN AND MANAGING DIRECTOR Dr YK Hamied
JOINT MANAGING DIRECTORS Mr MK Hamied Mramar lulla
NON EXECUTIVE DIRECTORS
Mr VC Kotwal
Dr HR Manchanda
Mr SAA Pinto
Mr MR Raghavan
Mr Ramesh Shroff
Mr Pankaj Patel
27 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
CODE OF CONDUCT As required under revised Clause 49 of the Listing Agreement the
following code of conduct has been approved by the Board of Directors and is applicable
to the Directors and Senior Management of the Company
ETHICAL CONDUCT All directors and senior management employees shall deal on
behalf of the Company with professionalism honesty integrity as well as high moral and
ethical standards Such conduct shall be fair and transparent and be perceived to be as
such by third parties
CONFLICT OF INTEREST Any director or senior management employee of the
Company shall not engage in any business relationship or activity which might
detrimentally conflict with the interest of the Company
TRANSEPERENCY All directors and senior management employees of the Company
shall ensure that their actions in the conduct of business are totally transparent except
where the needs of business security dictate otherwise Such transparency shall be
brought about through appropriate policies systems and processes
LEGAL COMPLIANCE All directors and senior management employees of the
Company shall at all times ensure compliance with all the relevant laws and regulations
affecting operations of the Company They shall abreast of the affairs of the Company
and be kept informed of the Companys compliance with relevant laws rules and
regulations In the event that the implication of law is not clear the course of action
chosen must be supported by eminent legal counsel whose opinion should be documented
28 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Shareholding PatternThe company has an equity capital base of Rs 602 crore and the number of shares outstanding amount to 602 crore The face value per share is Rs 10 and the current market price is hovering around Rs 1075 The market capitalisation as on May 14 2001 was Rs 646827 crores The promoters are holding 412 stake in the company The free float available in the market is 468
Business Overview
The present businesses of Cipla can be broadly classified into
Domestic branded formulation sales (74 of total sales 19-20 operating profit margin) Domestic unbranded formulation sales (7 of total sales over 10 operating profit margin)
Exports (19 of total sales around 38-40 operating profit margin) Breakup of exports is as follows
o Europe (25)
o US (32)
o Africa (17)
o Middle East (14)
o Asia (7) and
o Australia (5)
Cipla has been relatively low profile on its RampD initiatives compared to the domestic peers all of whom have set their sights on discovering new chemical entities (NCEs) But lately RampD spend of Cipla has increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people In future the RampD expenditure is expected to grow at a faster pace compared to sales and might rise to over 5 of sales The business environment for Cipla has become highly competitive in the last few years The major factors affecting Cipla are as folows
New Drug RampD costs are prohibitive which has made MNCs to spread their RampD costs through
29 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Mergers Acquisitions In Indian Pharmaceutical Sector prices of over 60 of the DrugsFormulations is controlled by the
government through DPCO For Cipla DPCO coverage is around 55
Low entry barriers in the bulk drugs market has led to a situation of over-capacity which has made major domestic players shift their focus towards formulations segment As a result Cipla which is earning nearly 80-85 percent of its sales from formulations is facing increasing competition
With the focus on post 2005 era MNCs are strengthening their position in India through marketing tie-ups with local majors and fully owned subsidiaries This can lead to even higher degree of competition
The management of Cipla has consistently demonstrated its vision in backing the right strategy and consistently de-risking the business This is reflected in the choice of therapeutic groups and the individual products that it has focussed on the marketing route adopted for its export business and the kind of RampD projects taken up by the company All this has translated into superior topline growth higher profit margins and one of the most impressive returns on equity among its peers
Exports will be the key growth driver in the coming years - The exports of the company are expected to move up from 19 of sales in FY00 to 40-50 of sales by FY05
Increase in the RampD efforts - RampD spend of Cipla increased by 25 to Rs 300 mn (4 of sales) and the company has an RampD team of 200 people Going forward the RampD spend will grow at a faster pace compared to sales and rise to over 5 of sales
30 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Swot analysis of cipla
Strengths
1 Low cost of production
2 Large pool of installed capacities
3 Efficient technologies for large number of Generics
4 Large pool of skilled technical manpower
5 Increasing liberalization of government policies
Opportunities
1 Aging of the world population
2 Growing incomes
3 Growing attention for health
4 New diagnoses and new social diseases
5 Spreading prophylactic approaches
6 Saturation point of market is far away
7 New therapy approaches
8 New delivery systems
9 Spreading attitude for soft medication (OTC drugs)
10 Spreading use of Generic Drugs
11 Globalization
12 Easier international trading
13 New markets are opening
Weakness
1 Fragmentation of installed capacities
2 Low technology level of Capital Goods of this section
3 Non-availability of major intermediaries for bulk drugs
31 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
4 Lack of experience to exploit efficiently the new patent regime
5 Very low key RampD
6 Low share of India in World Pharmaceutical Production (12 of world production but having
161 of worlds population)
7 Very low level of Biotechnology in India and also for New Drug Discovery Systems
8 Lack of experience in International Trade
9 Low level of strategic planning for future and also for technology forecasting
Threats
1 Containment of rising health-care cost
2 High Cost of discovering new products and fewer discoveries
3 Stricter registration procedures
4 High entry cost in newer markets
5 High cost of sales and marketing
6 Competition particularly from generic products
7 More potential new drugs and more efficient therapies
8 Switching over form process patent to product patent
32 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
VISION AND MISSION
VISION
To heal India and to become the biggest and the most admired pharmaceutical company in
India
MISSION
Cipla commits itself to endeavour to satisfy our customers needs in every manner possible
through excellent service by developing and marketing an effective reliable and safe
product and by offering our product at a price affordable to all patients
We further commit ourselves to contributing to continued medical education and research
into new drug delivery systems in the belief that this contribution will improve technical
know-how and ultimately benefit all patients in India
We intend to be the employer of choice in the pharmaceutical sector developing our most
valuable asset human capital irrespective of race colour or creed so that they may realise
their full potential and ambitions We pledge personal respect fair compensation and a
clean and safe working environment
It is our wish that we be recognised as innovators in the field of pharmaceutical marketing
rather than just followers be the investors pick and achieve sustainable above average
returns to the investor
It is our dream that through our policy of dedication and commitment we will create an
environment whereby Cipla Medpro will come to be recognised as the preferred partner in
medicine
33 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
ANALYSIS
DIFFERENT PROMOTIONAL TOOLS
Promotional mix
It is helpful to define the five main elements of the promotional mix before considering their
strengths and limitations
Advertising
Advertising is any paid form of non-personal communication of ideas or products in the prime
media ie television newspapers magazines billboard posters radio cinema etc Advertising
is intended to persuade and to inform
The two basic aspects of advertising are the message (what you want your communication to
say) and the medium (how you get your message across)
Direct marketing
Direct marketing creates a direct relationship between the customer and the business on an
individual basis
Personal Selling
Personal selling refers to oral communication with potential buyers of a product with the
intention of making a sale The personal selling may focus initially on developing a relationship
with the potential buyer but will always ultimately end with an attempt to close the sale
Sales Promotion
34 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Sales promotion refers to the provision of incentives to customers or to the distribution channel
to stimulate demand for a product
Public Relations
Public relations is the communication of a product brand or business by placing information
about it in the media without paying for the time or media space directly
Factors that determine the type of promotional tools used
Each of the above components of the promotional mix has strengths and weaknesses There are
several factors that should be taken into account in deciding which and how much of each tool
to use in a promotional marketing campaign
(1) Resource availability and the cost of each promotional tool
Advertising (particularly on television and in the national newspapers can be very expensive)
The overall resource budget for the promotional campaign will often determine which tools the
business can afford to use
(2) Market size and concentration
If a market size is small and the number of potential buyers is small then personal selling may
be the most cost-effective promotional tool
A good example of this would be businesses selling software systems designed for supermarket
retailers On the other hand where markets are geographically disperse or where there are
substantial numbers of potential customers advertising is usually the most effective
(3) Customer information needs
Some potential customers need to be provided with detailed complex information to help them
evaluate a purchase (eg buyers of equipment for nuclear power stations or health service
35 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
managers investing in the latest medical technology) In this situation personal selling is almost
always required - often using selling teams rather than just one individual
THE VALUE OF THE REPRESENTATIVE EMPLOYED BY THE CIPLA TO THE HEALTH CARE PROFESSIONAL
INTRODUCTION
The definition of our customer is changing and it is necessary for the pharmaceutical industry to
refine its vision of the behaviour driving each influencer in the network in which a variety of
stakeholders participate Exclusively targeting only doctors is no longer acceptable and other
health care professionals payers administrators and patients are becoming increasingly
important
THE ROLE OF THE MEDICAL REPRESENTATIVE
Medical representatives perform several valuable services for the health care professional and in
so doing contribute to the success of the health care professional and his or her practice They
ensure that doctors and pharmacists are introduced to new and improved medicines and
reminded of other products available for the treatment of different diseases and conditions The
medical representative provides the health care professional with detailed scientific and clinical
information Services are provided free of charge as part of the value provided by the research
based pharmaceutical industry Other health care professionals eg physiotherapists and nurses
may also be visited in the future as new prescribing requirements of the Medicines Act are
implemented
Medical representatives are well trained and possess adequate medical and technical knowledge
to detail their companyrsquos products in an accurate responsible and ethical manner as prescribed
by individual companyrsquos ethos the Code of Marketing Practices to be published in terms of
Section 18C of the Medicines Act (Act 1011965) and subject to approval of the regulations to
this Act
The pharmaceutical representative channel medical doctorsrsquo evaluation of and enquiries about
the medicines to the manufacturer including any reports of adverse events associated with the
companiesrsquo products
36 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
The medical representative is an important partner in improving the health status of the patient
and the most important objective is to build a relationship of trust between all the health care
stakeholders and the pharmaceutical company
VALUE OF THE MEDICAL REPRESENTATIVE
Marketing of pharmaceuticals serves an essential function in the health care delivery system
Many doctors pharmacists and other health care professionals learn about new medicines and
about ongoing research in their areas of specialisation largely through effective and personalised
interaction with prescribers and dispensers and ensuring that individual preferences are catered
for The medical system benefits significantly from this form of education eg
diams to enable doctors and other health care professionals to learn timely and accurately about new
therapies and diagnostic tools
diams to keep up with medical advances
diams to provide a mechanism for doctors to get prompt answers to their questions about medical
research and the proper use of medicines
diams to provide doctors the opportunity to learn about new indications for existing products and
updates on side effects warnings and other essential prescribing information
diams to provide accurate and balanced clinical data based on approved comparative clinical studies
on medicines regarding safety and efficacy against standard treatment regimens and placebo
If an appointment with a medical representative is used correctly the representative could assist
in making the most efficient use of the health professionalrsquos time This is done by stating a clear
objective for the interview for example any one or more of the following
diams Introduction of a new product or indication
diams Obtaining more clinical and cost effective information about established products
diams Discussing other services available such as CPD training
diams Probing for experiences with the companyrsquos products particularly the newer ones and
implement the standard operating procedure in the event of a complaint or adverse event
diams Provide solutions to problems by networking with various resources
Other services offered by the Representative
37 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Being a major link between the pharmaceutical industry on the one hand and the doctor and
pharmacist on the other the pharmaceutical representative can arrange a number of services
such as to
1048707 provide additional technical clinical and scientific information about products
1048707 arrange literature searches about company products and comparative clinical studies
1048707 advise when appropriate on the reporting of adverse reactions
1048707 initiate liaison on proposed clinical trials
1048707 discuss clinical data or issues of concern regarding the pharmaceutical company andor its
products and services
1048707 provide information to the prescriberdispenser on the national or international pharmaceutical
industry
1048707 provide facts on diseases and the pharmaceutical product development process
1048707 discuss applicable pharmaco-economic data
1048707 provide support in practice management and issue resolution
1048707 help doctors to interact with payers
TRAINING OF THE MEDICAL REPRESENTATIVE
A medical representative is a well trained person with a background in life sciences often at
degree level such as in a pharmacy nursing pathology laboratory or other paramedical
disciplines Medical Representatives must acquire a full knowledge of the companiesrsquo products
pass internal company examinations which normally comprises of anatomy physiology disease
processes microbiology pharmacology and information on the pharmaceutical industry
The training of medical representatives is a continuous process and individuals will undergo
company training when new products are introduced Attending in-company conferences is
mandatory to allow interaction between representatives to exchange views on improved
customer support
38 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
PROMOTION AND MARKETING OF PHARMACEUTICAL PRODUCTS
Pharmaceutical marketing is an essential part of the RampD process that brings new products into
medical practice More importantly it serves a critical educational role in our health care
delivery system and is a vital extension of the process of searching for and developing new and
better means of preventing and treating illness Promotion and the dissemination of educational
information ensures that the full benefits of the years of work and enormous expenditure in
terms of skills and money to discover and develop a new medicine will be made available timely
to patients Currently the estimated cost to discover and develop a medicine is approximately R5
billion and it requires about 10 ndash 12 years to develop and register a new chemical entity leaving
approximately 8-10 years for product exclusivity to provide the necessary funding for future
innovation
The medical representativersquos services are an important part of the process of ensuring that
patients benefit from current and new medicines Promotion is a useful element in the process
whereby physicians and pharmacists become aware of and allow them to evaluate and decide on
the selection of medicines It is well known truism that no matter what the investment cost of a
new medicine it means absolutely nothing if the patient is not treated with it
Claims and comments made by manufacturers are based on medical and scientific evidence
approved by regulatory authorities and conform to legal and ethical standards
39 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Promoting Medical Products in a Changing Healthcare
Environment BY CIPLA
During the past few years several medical product sponsors have acquired or entered into
agreements with healthcare organizations or pharmacy benefits management companies (PBMs)
Cipla often use such healthcare organizationsPBMs to promote their products including the
dissemination of promotional labeling and advertising FDA generally does not exercise
jurisdiction over materials disseminated by individuals or entities that are not in any way
affiliated with a medical product sponsor However when a medical product sponsor is involved
in promotional activities performed by healthcare organizationsPBMs the sponsor should not be
permitted to avoid regulation by changing the form through which their communications are
accomplished Accordingly this document provides guidance to medical product sponsors by
describing circumstances in which they may be held responsible for promotional activities
performed by healthcare organizationsPBMs that violate the Federal Food Drug and Cosmetic
Act (the Act) and regulations promulgated there under Generally a medical product sponsor will
be held responsible for promotional activities performed by its healthcare organization or PBM
subsidiary that violate the Act or regulations (eg the dissemination of false or misleading
labeling or advertising) Promotional labeling and advertising disseminated by the subsidiary are
subject to the existing post marketing reporting
requirements
Under certain circumstances a medical product sponsor may ldquoSubsidiaryrdquo used herein is to be
interpreted in its broadest sense to include any corporate relationship in whole or in part and a
company unit division subsidiary company or any other entity within or attached to a
corporation be held responsible for promotional activities performed by other persons (other
than subsidiaries) that violate the Act or regulations In determining whether violative
promotional activities performed by non subsidiary healthcare organizations or PBMs are
attributable to a medical product sponsor the agency will consider a number of factors
including among others the relationship between the sponsor and the healthcare
organizationPBM and whether the sponsor has control of or influence over the activities of the
40 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
healthcare organizationPBM or the content of the violative material disseminated by the
healthcare organizationPBM These factors are described below
1 Relationship
The agency will consider the nature of the sponsorrsquos relationship with the healthcare
organizationPBM (eg whether that relationship is defined by a contract or other agreement)
For example if a contract between the sponsor and the healthcare organizationPBM to promote
the sponsorrsquos product(s) exists the sponsor will generally be responsible for promotional
activities performed by the healthcare organizationPBM that are violative
2 Control and Influence of Information Content and Distribution
The agency will consider whether the sponsor has control of or influence over the
promotional activities of the healthcare organizationPBM For example the agency will
examine whether the sponsor scripted the disseminated information targeted points for
emphasis or otherwise acted to control or influence the content of the information whether
individuals involved in designing or disseminating promotional materials are also involved in
advising or otherwise assisting the sponsor with respect to sales or marketing of the sponsorrsquos
product whether similar messages are contained in promotional materials disseminated by the
sponsor directly whether the targeted audience was determined by the sponsorrsquos sales or
marketing department and whether any complaints have been raised regarding attempts by the
sponsor to influence the content of disseminated information
41 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Pharmaceutical marketing in cipla
Pharmaceutical marketing is the business of advertising or otherwise promoting the sale of
pharmaceuticals or drugs Evidence show that marketing practices can negatively effect both
patients and the health care profession Many countries have measures in place to limit
advertising by pharmaceutical companies The marketing of medication has a long history The
sale of miracle cures many with little real potency has always been common Marketing of
legitimate non-prescription medications such as pain relievers or allergy medicine has also long
been practiced Mass marketing of prescription medications was rare until recently however It
was long believed that since doctors made the selection of drugs mass marketing was a waste of
resources specific ads targeting the medical profession were thought to be cheaper and just as
effectiveThis would involve ads in professional journals and visits by sales staff to doctorrsquos
offices and hospitals An important part of these efforts was marketing to medical students
Physicians are perhaps the most important players in pharmaceutical sales They write the
prescriptions that determine which drugs will be used by the patient Influencing the physician is
the key to pharmaceutical sales Historically this was done by a large pharmaceutical sales force
A medium-sized pharmaceutical company might have a sales force of 1000 representatives The
largest companies have tens of thousands of representatives around the world Sales
representatives called upon physicians regularly providing information and free drug samples to
the physicians This is still the approach today however economic pressures on the industry are
causing pharmaceutical companies to rethink the traditional sales process to physicians
Pharmaceutical companies are developing processes to influence the people who influence the
physiciansThere are several channels by which a physician may be influenced including self-
influence through research peer influence direct interaction with pharmaceutical companies
patients and public or private insurance companies There are also web based instruments that
can be used to determine the influencers and buying motives of physicians
Cipla specialize in data and analytics for pharmaceutical marketing
42 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Individual research
Physicians discover pharmaceutical information from such sources as the Physicians Desk
Reference and online sources such as PDRnet as well as via PDAs with applications
They also rely upon pharmaceutical-branded e-detailing sites pharmaceutical sales and non-sales
representatives and scholarly literature Scholarly literature can be in the form of medical
journal article reprints often delivered by sales representatives at their place of employment or at
conference exhibitions
Peer influence
Key opinion leaders
Key opinion leaders (KOL) or thought leaders are respected individuals such as prominent
medical school faculty who influence physicians through their professional status
Pharmaceutical companies generally engage key opinion leaders early in the drug development
process to provide advocacy and key marketing feedbackSome pharmaceutical companies
identify key opinion leaders through direct inquiry of physicians (primary research)
Colleagues
Physicians acquire information through informal contacts with their colleagues including social
events professional affiliations common hospital affiliations and common medical school
affiliations Some pharmaceutical companies identify influential colleagues through
commercially available prescription writing and patient level data Doctor dinner meetings are an
effective way for physicians to acquire educational information from respected peers These
meetings are sponsored by some pharmaceutical companies
Direct physician contact with pharmaceutical sales representatives
Currently there are approximately 200 pharmaceutical sales reps in the in Bangalore pursuing
some 830000 pharmaceutical prescribers A pharmaceutical representative will often try to see a
43 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
given physician every few weeks Representatives often have a call list of about 200 physicians
with 120 targets that should be visited in 1-2 week cycles
Because of the large size of the pharmaceutical sales force the organization management and
measurement of effectiveness of the sales force are significant business challenges Management
tasks are usually broken down into the areas of physician targeting sales force size and structure
sales force optimization call planning and sales forces effectiveness A few pharmaceutical
companies have realized that training sales representatives on high science alone is not enough
especially when most products are similar in quality Thus training sales representatives on
relationship selling techniques in addition to medical science and product knowledge can make a
difference in sales force effectiveness Specialist physicians are relying more and more on
specialty sales reps for product information because they are more knowledgeable than primary
care reps
Physician targeting
Marketers attempt to identify the universe of physicians most likely to prescribe a given drug
Historically this was done by measuring the number of total prescriptions (TRx) and new
prescriptions (NRx) per week that each physician writes This information is collected by
commercial vendors The physicians are then deciled into ten groups based on their writing
patterns Higher deciles are more aggressively targeted Some pharmaceutical companies use
additional information such as
profitability of a prescription (script)
accessibility of the physician
tendency of the physician to use the pharmaceutical companys drugs
effect of managed care formularies on the ability of the physician to prescribe a drug
the adoption sequence of the physician (that is how readily the physician adopts new
drugs in place of older established treatments) and
the tendency of the physician to use a wide palette of drugs
44 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
influence that physicians have on their colleagues
Data for drugs prescribed in a hospital are not usually available at the physician level Advanced
analytic techniques are used to value physicians in a hospital setting
Opinion Leader Influence Mapping
Alternatives to segmenting physicians purely on the basis of prescribing do exist and marketers
can call upon strategic partners who specialize in delineating which characteristics of true
opinion leadership a physician does or does not possess Such analyses can help guide marketers
in how to optimize KOL engagements as bona fide advisors to a brand and can help shape
clinical development and clinical data publication plans for instance ultimately advancing
patient care
Sales force size and structure
Marketers must decide on the appropriate size of a sales force needed to sell a particular portfolio
of drugs to the target universe Design the optimal reach (how many physicians to see) and
frequency (how often to see them) for each individual physician Decide how many sales
representatives to devote to office and group practice and how many to devote to hospital
accounts Additionally the customers are break into different classes each classes are differtiate
from their prescription behaviour and of course their business potential
Private and public insurers
Public and private insurers affect the writing of prescriptions by physicians through formularies
that restrict the number and types of drugs that the insurer will cover Not only can the insurer
affect drug sales by including or excluding a particular drug from a formulary they can affect
sales by tiering or placing bureaucratic hurdles to prescribing certain drugs
45 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Direct marketing to patients
Since the late 1970s direct-to-patient marketing of prescription drugs has become important
Many patients will inquire about or even demand to receive a medication they have seen
advertised on television In the India recent years have seen an increase in mass media
advertisements for pharmaceuticals Expenditures on direct-to-consumer (DTC pharmaceutical
advertising) have more than quintupled in the last seven years since the FDA changed the
guidelines from $700 million in 1997 to more than $42 billion in 2005
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this mammoth expense the industry is still
plagued with some very serious strategic and operational level issues
46 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
STAGES OF MATURITY OF MEDICAL RERESENTATIVE
Pharma Marketing Process and its Challenges IN CIPLA
While many pharmaceutical companies have successfully deployed a plethora of strategies to
target the various customer types recent business and customer trends are creating new
challenges and opportunities for increasing profitability In the pharmaceutical and healthcare
industries a complex web of decision-makers determines the nature of the transaction
(prescription) for which direct customer (doctor) of pharma industry is responsible Essentially
the end-user (patient) consumes a product and paysthe cost
Use of medical representatives for marketing products to physicians and to exert some influence
over others in the hierarchy of decision makers has been a time-tested tradition Typically sales
force expense comprises an estimated 15 percent to 20 percent of annual product revenues the
largest line item on the balance sheet Despite this other expense the industry is still plagued
with some very serious strategic and operational level issues
From organizational perspective the most prominent performance related issues are
enlisted below
a) Increased competition and unethical practices adopted by some of the propaganda base
companies
b) Low level of customer knowledge (Doctors Retailers Wholesalers)
c) Poor customer (both external amp internal) acquisition development and retention strategies
d) Varying customer perception
e) The number and the quality of medical representatives
d) Very high territory development costs
f) High training and re-training costs of sales personnel
g) Very high attrition rate of the sales personnel
h) Busy doctors giving less time for sales calls
i) Poor territory knowledge in terms of business value at medical representative level
j) Unclear value of prescription from each doctor in the list of each sales person
47 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
k) Unknown value of revenue from each retailer in the territory
l) Absence of ideal mechanism of sales forecasting from field sales level leading
to huge deviations
m) Absence of analysis on the amount of time invested on profitable and not-soprofitable
customers and lack of time-share planning towards developing customer base for future and un-
tapped markets
Patents
Patents are a vital aspect of the global pharma industry Patent protection is essential to spur
basic RampD and make it commercially viable But only the developed nations endorse product
patents Most third world countries have patent laws but enforcement is totally lax
New Drug Approval (NDA)
Prior to launching its products in any country a pharma company undertakes patent registration
to protect its own interests To protect the interests of the consumers it is necessary that the
product be approved by the drug authorities in that country Mostly the process for seeking
approval is initiated alongside the patent registration process
WTO
Due to pressure from the developed countries across the world uniformity in patent laws is being
implemented under WTO (World Trade Organization - earlier GATT ie General Agreement on
Tariffs amp Trade) Presently different countries have different patent types and life period WTO
has decided upon a product patent life of 20 years in all countries
RESEARCH amp DEVELOPMENT (RampD)
The pharmaceutical industry is characterized by heavy RampD expenditure It is only the large
pharmaceutical companies who can allocate significant resources for RampD to introduce new
products As the products are an outcome of significant RampD expenditures incurred by these
companies they have their products patented The patent allows the companies concerned to
wield immense pricing power for their new products
THE COMPETITION
The level of competition on day to day basis in very high in Acute segment however the degree
of competition in not as much as high in Chronic therapy area As doctor has to prescribe drug
for a long time in chronic cases and patient is suppose to consume it without any change of
48 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
brand While in acute cases doctor is changing brands on day to day basis In acute area however
there is a large competition from local and propaganda companies
CIPLA Business Strategies
Whatrsquos the secret behind successes For one the company operates in niche formulations
(chronic) segments such as psychiatry cardiovascular gastroenterology and neurology
While most of the top Indian companies have focused on antibiotics and antindashinvectives (acute)
CIPLA focused on therapeutic areas such as depression hypertension and cancer The company
has introduced the entire range of products and has gained leadership position in each of these
areas Being a specialty company insulates CIPLA Pharma from the industry growth The first
quarter results for FY02 explain this to some extent While the industry was affected to a large
extent by a slowdown in the domestic formulations market CIPLA logged a growth of 26 in
revenue
The bases of marketing strategies can be best described in these two models in both
acute and chronic segments
(i) Super Core Model involving the search for and distribution of a small number of drugs from
Chronic Threapy Area that achieve substantial global sales The success of this model depends
on achieving large returns from a small number of drugs in order to pay for the high cost of the
drug discovery and development process for a large number of patients Total revenues are
highly dependant on sales from a small number of drugs This model incorporates highly
specialized approach in all the manner Initially the competition is seems more at entry level but
since growth is stable and more in this area every company is striving very hard to enter in this
area The major strategy in this model involves right focus to highly specialized customer by
well trained team
(ii) Core Model in which a larger number of drugs from Acute Threapy Area are marketed to
big diversified markets The advantage of this model is that its success is not dependant on sales
of a small number of drugs Here presenting a large number of product and taking the advantage
of opportunity cost is one of the important strategy Other strategy includes daily reminders to
cross the perceptual filter and get the brand name in to the sub-conscious state of mind
49 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Marketing approaches of Super Core Model
In pharmaceutical market there has been a significant shift from Acute towards Chronic Threapy
area Chronic segments are driving the growth of the market as leading prescribers in these
segments are specialists as opposed to general practioners This is evident from high growth rates
achieved by firms like CIPLA DrReddy Laboratories and Dabur Pharma Ltd Who have
focused on these segments The doctors prescription has become just the starting point in
determining what drug the retailer dispenses During last five years pharma companies have
started identifying the hidden potential of oncological market also A number of drugs have been
launched into the oncological market by pharmaceutical companies including new biological
drugs and drugs that can be used as a support for patients undergoing cytotoxic chemotherapy
As a matter of fact pharmaceutical companies are merging and through the merging process
the portfolio of the new companies changes Medical representatives are rearranged throughout
the new companies
Field force also required to ensure good availability of their products to
convince doctors and PUSH their products ie from to Stockist to Retailer to
Doctor It has been observed that sometimes there are more than fifteen or
sixteen representatives in a day are meeting with their customer and
requesting for same type of products Although field force visits are
important for an update on drugs and their use The doctors are in general
sneaking away trying to hide from sales representatives since there are too
many and they are too pushy and there is too little time and the
representatives probably have noticed that the reluctant doctors have
always less time for short meetings and less interest and tend to reduce the
time of the visit
SECONDARY SALES 2 ndash OPENING STOCK= ORDER
50 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
The relationship between clinicians and representatives has always been
good and pharmaceutical companies have provided and still provide the
major economical support
for customers continuous medical education Something needs to be done to
find a
solution to this problem that takes into account the needs of both
pharmaceutical companies and their representatives on one side and
physicians on the other for a better professional interaction
CIPLA PRODUCT DOING WEE IN THE MARKET
PRODUCT FOR
Farobact Hiv disease
pruflox Oral anti bacterial agent
I pill Contraceptive pill
viatran Gram negative bacteria
levozon Repiratory tract
crisanta Pregnancy
maxiflo Asthama
MAJOR COMPETITOR OF CIPLA
1 RANBAXY
2 GLAXO SMITH KLINE
3 LUPIN
4 SERDIA
5 NOVARTIS
6 SUN PHARMA51 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
7 AURBINDO PHARMA
8 CADILLA
9 BIOCON
10TORRENT
11 ABOTT
12 PHARMED
FINDINGS
Indian companies are putting their act together to tap the retail generic markets in the
regulated high margin markets of the developed countries Due to its size the US market
will remain the most lucrative market for the Indian companies
Indian drug makers with their chemistry skills and low-cost manufacturing have an edge
in the business Indian firms are arguably the worldrsquos best in drug development (of both
APIs and finished dosages) With their superiority established in process development
they are refining their legal skills to fight the innovator companies in patent challenges
The other important ingredient is marketing distribution
Cipla Ltd holds its strength in Active Pharmaceutical Ingredients(APIs) and formulations
development and manufacturing in both the domestic and international markets Cipla is
also a major exporter of technology which is presently sold to companies in Canada
Germany UK and USA among others
Medical representative play an important role to enhance the sale of a pharma company
Medical representatives are the key contacts between the pharmaceutical industry and the
medical profession They have the responsibility of promoting their companies major
products directly to GPs and hospital doctors They do this via face to face meetings or
medical presentations at various types of meetings
All representatives tend to work what is a called a territory A territory is your area or
you and your territory team area As sometimes companies have double manned
territories rather than single manned territories
52 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
The territory size geography etc varies according to companies The day to day work of
the representative tends to be target based around sales call rates and other objectives set
around individual personal development plans
The image of the product and the company that a doctor forms is directly related to the
degree of professionalism of the medical representative
Hospital doctors have an appointment system for seeing medical representatives As so
many other companies are trying to see the same customers MR should be well organize
CONCLUSION
There can be various ways through which a business organization can
achieve success in the market but all those ways can be comprised into as
above then it can be rightly said that it revolves specifically around three
parties or more the triangular linkages or the relationship between these
three parties (company customers and competitors) determine the success
and failure of business organization In the medium to long run the domestic
pharmaceutical market will be largely driven by the increasing prevalence of
chronic segment The domestic industry is principally being driven by the
chronic segment which has grown by 178 this year The basis of success
in any competitive context can be at the most elemental level commercial
success and commercial success can be derived either from a cost
advantage or a value advantage or ideally from a combination of both In
other words the organization with Competitive Advantage tends to be the
cost leader in the industry or a seller of most differentiated products
amongst all the players At last the role of supply chain is very prominent in
both the phases (in acute as well as in chronic) But the successes of any
pharmaceutical industry when a company changes its concentration from
ldquoAcuterdquo to ldquoChronicrdquo therapy market depend on competitiveness of supply
chain Supply Chain Managers can provide considerable value to their
companies by understanding the customers delivery requirements A very
powerful tool for understanding these requirements is account segmentation
53 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
A company can use account segmentation to identify market segments Such
as Acute amp Chronic therapy market which is well positioned to serve and
then organize its product range and even SKUrsquos and service in a superior
way
Doing the management thesis was quite fruitfull and informative which made
me understand the Indian pharma sector and understand the work of a
medical representative in detailed manner
ANNEXURE(QUESTIONNAIRE)NAMEAGEGENDERDESIGNATIONYEARS OF EXPERIENCEQ1 How many doctors do you visit in a single day
1 1-5 2 5-10 3 10-15 415-20
Q2 How many chemist do you visit in a single day1 1-5 2 5-10 3 10-15 5 15-20
Q3 Who is the major customers for you1 Doctors 2 Chemist 3both
Q4 How do you explain your products to doctors1 Verbally 2 Print bouchers 3articles proofs
Q5 Do you provide samples of medicine to your doctors for new product1 Regularly 2 Sometimes 3 Rarely 4 Never
54 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
Q6 Do you provide samples of medicine to the chemist 1Regularly 2sometimes 3 Rarely 4Never
Q7 How many products do you have to promote in a single day1 1to5 2 5-10 310-15 4 15-20
Q8 Your company invests majorly to promote their product on which tool 1TV 2 Print 3newspaper 4 Public relation 5publicity 6keeping more MR
Q9 How many doctors demands fringe benefits to promote your products 180-100 2 60-80 3 40-60 420-40 51-20
55 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
REFERENCES
WEBSITE REFFERED
httpwwwciplacom
httpenwikipediaorgwikiCipla
httpwwwbharatbookcomdetailaspid=44690
httpwwwiitkacininfocellannounce
httpwwwnewspharma-mktingcom
httpwwwpharmabizcomarticledetnews
wwwallabout medical salescom
56 | P a g e
57 | P a g e
57 | P a g e
