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Accelerating Footfalls In Less Charted Pharma Marketing Frontiers

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Having experienced unprecedented disruptions, especially in the pharmaceutical and biopharmaceutical business, many global and local drug majors, are rethinking their marketing strategies. These have, no doubt, been prompted by the challenges of change, which are sometimes stark, but more often than not - nuanced.

Many of them are now, therefore, charting into less charted or even uncharted frontiers of pharma marketing warfare. Most companies had no choice, though, but to embrace new approaches, at least as a stopgap, to reach their target audience – hoping to revert to pre-pandemic practices, ultimately.

Interestingly, some pharma majors could envisage that long-term focus on many of these new and innovative areas – more effectively than even the pandemic lockdown time, could be a game-changer in the business. Accordingly, they tried to adapt, several of these approaches, quickly and effectively – for sustained excellence in the post-COVID paradigm.

In this article, I shall focus with several global and local, publicly available examples, of innovative pharma marketing approaches that are now being tried by several top drug companies in the post-COVID period.

I. Continuation of pandemic induced innovative approaches – global examples: 

  • Virtual Conferences and Events: Experiencing success with virtual events and conferences during the COVID-19 pandemic, many pharma companies are leveraging this digital space to reach out to healthcare professionals and patients. These events now include webinars, selected virtual conferences, and online workshops.

Pfizer, reportedly, held its first virtual investor day in September 2020, which was attended by thousands of participants from around the world. The company also organized several virtual events to educate healthcare professionals about its vaccine.

  • Social Media Marketing: The use of social media marketing is also increasing in the pharmaceutical industry. Companies are using platforms such as Facebook, Twitter, and LinkedIn to reach out to their customers and engage with them on a regular basis to build long-term relationships.

For example, Novartis, among a few others, is using social media to promote core values of its products and engage with customers. The company has built a strong presence on social media platforms where it shares news and updates about its products and research, as well.

  • Influencer Marketing: Many companies are partnering with influencers in the healthcare industry to promote their products. These influencers can be doctors, nurses, patient advocates, or even celebrities who are passionate about health and wellness. Influencer marketing can help companies reach a wider audience and build trust with their customers.

The French pharma major – Sanofi, has partnered with celebrity chef and diabetes advocate Charles Mattocks who was diagnosed with type 2 diabetes in 2011. The objective is to raise awareness about diabetes and promote the company’s diabetes products through social media and other channels.

  • Patient Education Programs: Companies are investing more on patient education programs to educate patients about their health conditions and treatment options. These programs can include online resources, mobile apps, and support groups. By providing patients with accurate and reliable information, companies can improve patient outcomes and build brand loyalty.

Merck, another global player, developed an online resource called MerckEngage to educate patients about their health conditions and treatment options. The platform provides patients with information about various health topics, including diabetes, cancer, and heart disease.

II. Continuation of pandemic induced innovative approaches – Indian examples: 

Some Indian pharma players are also not far behind in several innovative areas for business excellence in the post pandemic paradigm. Following are some of those examples from Indian pharma companies, as available in the public domains. These seem to have attracted greater focus in the pandemic period, and are continuing even today, with undiluted focus:

Virtual Conferences and Events: Illustratively, Lupin has been using virtual events to promote its products in the post-COVID period. The company is organizing virtual conferences and webinars to reach out to healthcare professionals and other customers. Similarly, Sun Pharma launched a virtual conference for healthcare professionals to discuss the latest developments in the field of dermatology.

Digital and Social Media Marketing:  Several Indian pharma companies are increasingly adopting digital marketing “strategies to reach out to their customers. Companies are using social media, online ads, email marketing, and other digital channels to promote their products and services.

For example, Dr. Reddy’s Laboratories continue using social media platforms like LinkedIn, Twitter, and Facebook to engage with healthcare professionals and consumers. Even, Cadila Healthcare, reportedly, has been using search engine optimization (SEO), pay-per-click (PPC) advertising, and social media marketing to reach out to its customers.

Telemedicine: With the rise of telemedicine during the pandemic, pharma companies are partnering with Telehealth/Telemedicine platforms to reach out to patients. Companies like Cipla have partnered with telemedicine platforms to offer online consultations and delivery of medicines to patients’ doorsteps. Sun Pharma has also been using telemedicine to reach out to its customers and has partnered with telemedicine providers to offer its products to patients who cannot visit a doctor in person.

  • Direct-to-Consumer (DTC) advertising: DTC advertising is gaining popularity among Indian pharma companies. With the rise of online pharmacies, companies like Abbott and Pfizer are launching DTC campaigns to increase disease and treatment awareness programs directly to consumers.
  • Collaborations and partnerships: Indian pharma companies are increasingly collaborating with other players in the healthcare ecosystem to provide integrated solutions. For example, as mentioned above, Lupin has partnered with a health-tech firm to offer a platform for online consultations and home delivery of medicines.
  • Greater patient-centric approaches: Some Indian pharma companies are adopting more patient-centric approaches for more effective omnichannel patient engagement initiatives. For example, Dr. Reddy’s Laboratories have launched an initiative to educate patients on the proper use of medicines and the importance of adherence to treatment.

As the industry continues to evolve, we can expect to see more companies adopting newer and more innovative marketing strategies to engage with their customers.

Summary:

Many of the above examples are pandemic triggered innovative approaches to keep the neck above water during unprecedented business disruptions in the pharma industry. Interestingly, some companies are not just continuing but further sharpening these initiatives in the post pandemic days. Moreover, it’s good to note that these are now being implemented by the concerned sales and marketing teams with greater gusto and zeal.

The point to ponder, therefore, is pharma industry ready now to excel amid start and more often nuanced – the challenge of change? To respond to these challenges effectively, more companies now need to seriously evaluate and consider adapting such strategic footsteps, first as pilot studies and then gradually scale up, for business excellence in the contemporary period.

Let me hasten to add, in this ball game pharma leadership mindset change to act decisively, after accurately studying – based on data-science, to ascertain where and how to change could well be a win-lose situation. However, the good news is, recent data vindicate the accelerating footfalls in many these less or even un- charted pharma marketing frontiers, both globally and locally.

By: Tapan J. Ray        

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

Deliver The Best Patient Outcomes With Right High-Tech-High-Touch Combo

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Healthcare is regarded as an industry where high-quality technology and high-quality human touch can’t possibly be separated from each other, ever. Since long, this is considered essential in delivering better treatment outcomes – the core value most patients desire, and buy – directly or indirectly.

Why high-quality technology helps make treatment of various diseases increasingly more effective, is no-brainer. However, amid high decibel ‘digital’ buzz during Covid-19 pandemic, some may also wonder how does ‘high-touch’ help improve treatment outcomes? Against this new backdrop, I shall explore in today’s article: why high-touch is so important for most patients alongside high-tech, and the critical need of striking a right balance between high-tech and high-touch in most areas of healthcare delivery. Let me start with a brief recap of the same in the pharma industry perspective. 

Balancing high-tech and high-touch in pharma – a brief recap:

In a similar context – against the  contemporary market dynamics, I discussed about Pharma’s new and still evolving pathway for digital and F2F customer engagement on February 15, 2021. This is primarily because, today’s patient-centric marketing model has to be on Omnichannel platforms to deliver patient-expected value, effectively – and more.

In this mix, F2F customer engagement process is just one among several channels – but a critical brand demand generation tool, though – giving a feel of ‘high-touch’ – in-person interactions to many key customers. Many studies show, alongside acceptance of ‘high-tech’ digital channels, customer expectations for ‘high-touch’, by and large, continue to exist, even today. Thus, one of the key responsibilities of pharma marketers is to arrive at the optimal combination of in-person F2F engagement channel, and high-tech digital channels for remote engagement.

However, this isn’t the unique need of the new normal. On April 29, 2019, I wrote about the evolving new pathway is a hybrid business model. It is customer-centric and helps create a right blend of high-tech and high-touch approaches. Striking an optimal balance between the two is critical to successful business outcomes. This brings me to the point of the relevance of ‘high-touch’ in healthcare.

The relevance of ‘high touch’ in healthcare:

Since time immemorial, a strong bond of trust-based doctor-patient relationship has remained pivotal in the disease treatment process, across the world. This still exists regardless of the socio-economic status, and degree of patient literacy, including digital – particularly for moderate to severe ailments.

A recent article – ‘High-Touch Telemedicine’, published by CFHA on June 04, 2020, also highlighted, “Touch has been central to the physician-patient relationship for as long as there have been physicians. Patients allow their doctors to touch them in places and in ways that they would allow to no one else.  The gentleness and the carefulness that doctors are trained to use on this touch is a bonding experience that supports healing.  If this trust is violated, if a doctor is unduly forceful or disrespectful, this can be a cause for grievance and even litigation.”

The scientific pertinence of physicians’ high touch for patients:

This point was lucidly elaborated in the above paper. It said, the doctor’s comforting physical touch, and interactional touch, have impacts on the Neuroendocrinology of the patients involved. Thus, physicians’ high touch when used in a benevolent conversation, releases the neuropeptide oxytocin in the brains of both participants. This, among others, helps to improve recognition of emotions, increase mutual trust, so compliments and the recognition of a person’s efforts and successes.

Covid-19 propelled ‘high tech’ in healthcare to a new high sans ‘high touch’:

The Covid-19 pandemic, undoubtedly, propelled healthcare into a virtual world. It triggered the development of a plethora of ‘high tech’ innovations to deliver prompt healthcare to patients suffering from various ailments, even from remote locations. One such example is telehealth. Many healthcare providers, including the Government of India realized that leveraging the potential of ‘Telemedicine’ can effectively address the healthcare needs of a large population, across the world.

That said, I reckon, although, healthcare can’t survive without high tech. But, a high-tech-healthcare, like telemedicine, can’t totally replace high touch, at least, in the treatment process of several moderate to severe ailments.

The Best and the worst-case scenario for only high-tech healthcare:

As studies indicate, only high-technology based healthcare sans high-touch, in the best case scenario, would facilitate affordable access to treatment for more patients, bringing down administrative time and cost, in tandem. Which is why, when Covid-19 pandemic posed unique challenges to providing health care, India’s health policy makers revised the nation’s Telemedicine Practice Guidelines on March 25, 2020. They acknowledged in the manual, high-tech Telemedicine ‘increases timely accessto appropriate interventions, including faster access and access to services that may not otherwise be available’.

Whereas, in a worst-case scenario, only digital access to healthcare may create some barrier to direct physical examination of the patient by the doctor, and their interaction. This may impact patient emotion – so important in the disease treatment process. Thus, although high-tech is essential for the advancement of healthcare, but can’t totally replace a patient’s need for high touch care.

High tech is essential, but can’t replace high touch-based trust:

Several recent papers deliberated this point with umpteen evidences. One such paper was published in the Harvard Business Review on October 30, 2019. The article is titled, ‘AI Can Outperform Doctors. So Why Don’t Patients Trust It?

The research points out, ‘patients are reluctant to use health care provided by medical artificial intelligence, even when it outperforms human doctors. This is because, patients believe that their medical needs are unique and cannot be adequately addressed by algorithms. To realize the many advantages and cost savings that medical AI promises, care providers must find ways to overcome these misgivings.’

The study also found that when health care was provided by AI rather than by a human care provider, patients were less likely to utilize the service and wanted to pay less for it. They also preferred having a human provider perform the service even if that meant there would be a greater risk of an inaccurate diagnosis or a surgical complication.

Given a choice – ‘patients will always highly value and seek out human touch’:

This point was also deliberated in another study, published in the MedCity News on January 14, 2021. Acknowledging: ‘Effective, modern medicine cannot survive without technology,’ it brought to the fore an important finding: ‘Regardless of how intuitive the software – or how advanced the technology – patients will always highly value and seek out human touch’ because of several reasons. Some of which are as follows:

  • Patients believe that their medical needs are unique and cannot be adequately addressed by algorithms. Patient experiences aren’t meant to be 100% digital. And despite the accuracy of computers, humans prefer to seek care from other human beings.
  • Different patients have different emotional needs. Life-altering diagnoses and unforeseen outcomes are best delivered by a living, breathing, feeling individual who can fully understand and address these needs.
  • Physical examinations by a doctor are more reassuring and restorative for patients.

The author concluded, high tech is absolutely necessary for the progress of health care, in general. However, in the foreseeable future, high touch would remain an instrumental part of patients’ healthcare experience.

I believe, one can even experience it as the Covid-19 safety restrictions will start easing, or even now – to some extent. Therefore, ‘healthcare professionals must find a way to blend the sophistication of technology with the power of touch in order to continue improving patient experiences, care, and outcomes’, the paper underscores.

Conclusion:

Just as in the pharma business, a right-mix of high-tech and high-touch is also necessary in overall healthcare space, to deliver the best health outcomes to patients. After initial disruptions, a similar trend is emerging even in the new normal. No doubt, usage of high-tech digital platforms is here to stay, and further improve in the years ahead. But, digitalization alone in the healthcare space, should not be construed as something that can make high-touch totally irrelevant or redundant in a patient’s journey for disease treatment.

The mindset of mutual exclusiveness of high-tech and high-touch, if any, either during patient-treatment or in the customer engagement process needs a revisit. As it appears, it is neither desirable in customer engagement, nor in patient treatment processes – akin to one approach suits all. This is because, healthcare is very personal to patients – more than most other areas. A lot of individual feelings and emotions are involved in patients’ end-to-end journey for treatment, where only high tech-based solutions may not meet all patient expectations – sans high-touch of physicians, as I deliberated above.

Thus, effective integration of high-tech-healthcare with high-touch of physicians, nurses, and some technicians, is evolving as the right way to deliver patient expected values, for better health outcomes. From this perspective, alongside most other stakeholders, astute marketers are realizing that high-tech digitalization isn’t a panacea for effective pharma marketing. Delivering the best patient outcomes with the right high-tech-high-touch combo, is the name of the game.

By: Tapan J. Ray       

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

 

2020: Learnings From A Yearlong Catastrophic Disruption And Crystal-Gazing 2021

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 Wishing All My Readers A Very Happy, Healthy, Peaceful and Prosperous 2021

Just a few days left for the year 2020 to merge with history. It will be remembered by all – as a year of all-round catastrophic global disruption. With unprecedented impact on human lives, livelihoods, economy, and ways of doing things – sparing virtually nothing. The sole cause of which is an unprecedented single event – Covid-19 pandemic. As of December 27, 2020 morning, India recorded a staggering figure of 10,118,392 new Coronavirus cases with 147,659 deaths. The threat of subsequent waves for further infection of Covid-19 infection continues.

In this article, I shall focus on some critical lessons learnt from the 2020 health crisis, while crystal-gazing 2021. I’ll do this purely from the health care perspective, in general, and the pharmaceutical industry, in particular. Keeping this in view, some of the lessons learnt during the pandemic are as follows:

A. Never allow a sense of hubris setting in:

This is easier said than done. Nonetheless, before the Covid pandemic played havocs with all, many top pharma leaders were, apparently, in a hubris. It was often laced with excessive confidence, if not arrogance. The predominant belief was nothing can go so wrong sans unfavorable policy decisions by the governments. This was against a much-known management dictum for all – always anticipate future probabilities that may impact the business and keep prepared for the worst, while hoping for the best. On a hindsight, this was, obviously jettisoned – lock, stock and barrel. No one was prepared for any biological threats, such as, Covid pandemic, till the deadly virus caught the humanity off-guard around December 2019, as we see below:

The pandemic was expected, but struck unexpectedly:

A pandemic wasn’t totally unexpected either. Therefore, they question that surfaces - Experts warned of a pandemic decades ago. Why weren’t we ready? Just in 2015, even Bill Gates, during a Ted talk titled, “The next outbreak? We’re not ready,” also predicted - based on available facts that an epidemic would kill millions in the future.

He further added: “If anything kills over 10 million people in the next few decades, it’s more likely to be a highly infectious virus rather than a war – not missiles, but microbes.” Gates further emphasized: “We have invested a huge amount in nuclear deterrents, but we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic.”

B. Research on anti-infective drugs shouldn’t be pushed to the back burner: 

These warnings were, apparently, ignored by the pharma industry. For example, as reported in the first quarter of 2020, many research-based pharma companies shifted ‘resources away from emerging infectious diseases into more lucrative areas like cancer treatment. Their business decisions risk leaving gaping holes in the fight against epidemics, such as the one caused by the novel Coronavirus.’

Let’s now take a pause for pharma players to ponder. Are they ready, at least now, with a robust plan – based on almost a year’s experience of an unprecedented agony along with its customers, specifically to counter any future biological threat? Be that as it may, there have also been some good outcomes out of the Covid crisis, both for the pharma industry and also for the health care customers.

C. The pandemic hastened pharma’s digital transformation process:

As is known, compared to many other industries, pharma industry was a late learner in the digitalization process of organizations. The new realities of disruptions caused by the pandemic had significantly expedited this process to keep the business going. There were no other effective options available, either, but to move beyond business stabilization and redefine how they do business. The IQVIA article, ‘Digital transformation in a post-Covid-19 world,’ published in the Pharmaceutical Technology, on August 31, 2020, also reiterated this point.

Elaborating the point further, the article pointed out: ‘As a result, acceleration of three key capabilities is occurring to create sustainable competitive advantage,’ as follows:

  • Digital capabilities with modern technology are enabling companies doing the right things during the pandemic and accelerating the process.
  • Providing access to granular data to support the extraction of precise insights into the needs of patients and physicians.
  • Ensuring capabilities for sustaining relationships. While face-to-face interaction has been dramatically reduced, relationships with HCPs and patients are taking new shapes and are of more importance than ever before.

D. Telemedicine came under mainstream care, supported by Government:

Finding no other viable alternatives during the Covid lockdown period and the need to stringently follow prescribed health measures, many patients were pushed to search for a robust digital solution for health care needs. Just as many of them were already using online platforms to meet other regular needs. In that sense, Covid propelled health care into a virtual world, bringing telehealth or telemedicine toward mainstream care, supported by the Government with a policy, for the first time, ever.

E. Quality of pharma response to pandemic enhanced industry image:

As I had discussed before in this blog, Consumer centric communications, driven by the  ‘hope and confidence as companies rushed to come up with COVID-19 vaccines and treatments’ of all, helped to significantly enhance the industry’s image during the year. In my view, pharma shouldn’t let go this opportunity to reposition itself, to reap a rich harvest in the years ahead.

Crystal-gazing 2021: 

A. A lurking fear will keep haunting:

Moving away from the outgoing year – 2020, if one crystal gazes the incoming – yet another brand-new year – 2021, a lurking fear still haunts most peoples’ minds. Will the all-round disruptions of 2020 be the new normal in 2021 – with no further escalation of the current situation?

B. Vaccine rollout will reduce rapid spread, but not eliminate Covid-19:

Gradual rolling out of vaccines may reduce the rapid spread of pandemic, provided Covid-19 doesn’t throw more surprises, such as, complicated mutation, blunting this initiative. However, currently available evidence indicates, the new variant could be more transmissible, yet vaccines may work very well against it.

 C. Masking, physical distancing, hand washing, etc., will continue:

Besides, many yet unknown side effects, the duration of immunity following coronavirus vaccination is still largely unknown due to the simple lack of time we’ve had to study such immune responses. Moreover, the trials do not tell us if the vaccines can block the transmission of the disease from those who are asymptomatic and have been vaccinated. Thus, masking, physical distancing, hand washing, testing, treating and contact tracing, reportedly, will continue to be important in the global campaign against COVID-19, even after vaccine rollout.

D. NDDS for Covid drugs and vaccines may come: 

New formulations, new Covid drug delivery systems, newer methods to bring Covid vaccines, like nasal sprays, in a powder form for easy transportation and to reach more people around the world, are expected to commence in 2021.

E. Waiting for going back to pre-Covid game plan is a losing strategy:

Vaccines are unlikely to take us back to pre-Covid time, any time soon. Even McKinsey & Companypredicted the same in its article: ‘‘How COVID-19 is redefining the next-normal operating model,’ published on December 10, 2020. It emphasized: “With everything disrupted, going back to the same old thing is a losing strategy. The strongest companies are reinventing themselves by embracing pandemic- driven change.”

Many pharma majors are also echoing the same, even as Covid-19 vaccines have started rolling out for public in different parts of the world. After weighing-in the pros and cons of waiting, many of them have articulated: ‘We will not return to the old ways of working.’ They believe, it’s too early to put a specific timeline on turning that page now. Hence, the year 2021, working of the pharma companies is unlikely to be significantly different from the year 2020.

F. Need to capture and respond fast to changing customer behaviors:

Covid-19 pandemic is fast changing many human attitudes and behaviors, forcing organizations to respond. ‘However, the need to respond won’t end when the virus’s immediate threat eventually recedes,’ reaffirmed the Accenture article ‘COVID-19: 5 new human truths that experiences need to address.’ The massive behavior changes of key pharma stakeholders, at a never before scale and speed, will continue to prompt many leading drug companies to respond to them with well thought through digital tools, to gain competitive advantages.

G. Virtual meetings with reps, doctors and others will continue:

As witnessed in 2020, often for the first time – virtual meeting of sales reps, key opinion leaders and others will continue in 2021, even after ‘live’ ones return, but with more innovative structure and content. Pharma marketing’s long awaited and comprehensive digital foray will continue gaining a strong foothold, entering into new areas, without glancing back over the shoulder, in 2021.

H. More new drug launches will move entirely digital:

It began in 2020. For example, dozens of new drug launches moved entirely to digital, for the first time in 2020. As a pharma leader remarked, with the traditional launch framework gone during the pandemic, “we had to throw out the playbook and really embed into people’s heads that playbook is no longer meaningful. It no longer works, and we have to think outside the box.” She further added: “There’s truly no bigger place for a marketer right now. This is the new world.” None can deny this fact as we enter into the new year.

I. Success requirements of pharma professionals will be different:

With significant transformation of pharma’s operational strategies, success requirements of pharma professionals will also be significantly different in the new normal. Quick capturing and fast adaptation to the changing customer behavior for multi-channel engagement digital platforms, will be fundamentally important – not just for business excellence, but for its long-term sustainability, as well. This is a totally new and highly cerebral strategic ballgame, where obsolescence of cutting-edge technology is much faster than anything in the tradition driven old normal.

J. More pharma companies will explore inorganic growth opportunities:

More pharma companies will look for acquisitions to bridge the strategic gaps, as AstraZeneca did in 2020.

Conclusion:

In 2021, Covid Mayhem may possibly be over with a gradual rollout of vaccines. But, the impact of utter disruptions that the pandemic has caused in multiple areas of businesses in 2020, especially within the pharma industry, would continue, as we step into 2021. As the drug industry overwhelmed by Covid-19, reset themselves with the digital transformation in the new normal -for growth beyond Coronavirus, one may also view this much awaited metamorphosis, as a blessing in disguise, as it were.

Overall, as the W.H.O observed very rightly on December 27, 2020: “We throw money at an outbreak, and when it’s over, we forget about it and do nothing to prevent the next one. This is dangerously short-sighted, and frankly difficult to understand.” He further added: “History tells us that this will not be the last pandemic, and epidemics are a fact of life.” I hope, all concerned will realize this point in 2021. Alternatively, we may need to keep ourselves prepared to move, in a similar way, from the current new normal to yet unknown next normal.

By: Tapan J. Ray     

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

 


Creative Pharma Marketers To Unshackle Covid Fetters

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Pharma industry, just as most others, has started recognizing that the business needs to be brought back to normal, despite Covid fetters. Some early evidences suggest, a new breed of pharma marketers is refusing to get confined to Covid triggered operational limits, without breaching any prescribed safety norms.

These pacesetters no longer grapple with finding right answers to the question – when and how the brand building activities can be brought back to the old normal? Truly speaking, none has its answer, as yet. Covid has the power to strike back, anytime – anywhere, in waves, when the guards are even slightly down. Moreover, as and when vaccines will come, these may not be ‘silver bullets’ for many – throughout a lifetime, at least, in the foreseeable future.

Accordingly, these forerunners are effectively leveraging the art of turning challenges into opportunities. They are conceptualizing new business models for making path-breaking progress in contemporary purpose driven branding exercises. For all pharma marketers, I reckon, this is the moment of truth, when what you do reflects what you really are, in this area. Thus, in this article. I shall deliberate, with examples, how these creative new age pharma marketers are trying to unshackle Covid fetters.

Today’s reality on the ground: 

A number of global surveys on how patients’ have reacted to Covid-19 pandemic with reasons behind the same, are now available. One such study was conducted by Medisafe, during March and April, 2020. Some of its key findings are as follows:

  • More than half of the respondents, especially those with comorbidities, worry about getting Covid infected while accessing to in-person treatments.
  • Over 9 out of 10 respondents were practicing social distancing, as a remedial measure.
  • Consequently, they are missing doctors’ appointments, and many are opting for telehealth wherever appropriate and necessary.

In many situations, such as,  common and repetitive health issues, including some mental health conditions, virtual health care are more convenient. It has also been established during the pandemic that telehealth can deliver similar outcomes at a lower cost, than in-person visits. In addition, remote monitoring of some key health parameters, like heart rhythm, blood sugar, weight, respiratory rate, also help people control their chronic conditions better, and assist clinicians with diagnosis and treatment.

More doctors prefer telehealth, but the majority wants some in-person visits too: 

An interesting study – ‘Want Both In-Person and Virtual Visits with Sales Reps,’ published by Bain & Company on June 02, 2020, ferreted out today’s reality, in this space. It found, prior to Covid, about three-fourths of physicians preferred face-to-face engagement with sales reps. In contrast, today more of them are asking for a reduction in Rep visit frequency and more remote support or virtual approaches. Curiously, a majority still prefers, at least some in-person interaction ‘once the pandemic passes.’

Interestingly, no one seems to know, just yet, when exactly will this pandemic get over. Besides, whether or not Covid will keep coming back in waves, for an indefinite period. Or, any similar or even worse global health crisis, in future, could bring greater disruption for the industry.

Driven by such apprehensions, it is possible that more and more patients will prefer telehealth, expanding access to health care for an increasing number of people. Nonetheless, one should also take into consideration that virtual health care has also some significant limitations, especially those which may lead to serious or life-threatening conditions.

Some key limitations to overcome:

Alongside multiple advantages of telehealth, it has some significant limitations, which can’t be wished away, either. This point was also well articulated in the article – ‘Where Telemedicine Falls Short,’ published in the Harvard Business Review (HBR) on June 30, 2020. The author, who is also a primary care physician gave a number of examples in this regard. For example, in one place he wrote:

‘I have found treatable cancers multiple times in routine exams that would be impossible to replicate in the virtual world. Could a Zoom visit detect a lymph node too firm, a spleen or liver too large, or an unexpected prostate nodule (with a normal PSA)?’ The paper also emphasized: ‘Trust and face-to-face encounters are even more important for patients with complex and intertwined problems.’

Be that as it may, the task to encourage patients, even with serious ailments, for in-person consultation and examination by doctors’ in their clinics, won’t be ‘a piece of cake’ too. On the contrary, it will be rather a colossal exercise.

Why will this task be colossal?

One can get a sense of tough challenges involved in this effort from the IQVIA report titled, ‘COVID-19 Pandemic and the Impact on SEA Healthcare Market.’ Along with other areas, the study captured several details of the above area, specifically for the South East Asia (SEA), as follows:

  • Decrease in patient visits (Out-Patient): 2 out of 3 hospital doctors are experiencing >60% decrease in patient visits.
  • Extended period of time before patient load resumes to normal: ~50% of doctors think that it will take 4 to 6 months to resume normal operations.
  • Increase in prescription duration: ~25% of doctors have 2x their standard prescription duration to reduce patient visits.

The study also observed, ‘in order to reduce the risk of getting infected, patients are reducing their visits to the HCPs.’ Such an unusual situation is unlikely to be mitigated, soon, with any traditional or ‘one size-fits all’ type strategy. Particularly when Covid threat still looms large on the population. As is happening today, even after signs of waning, Covid may return in waves – for an indefinite period. Thus, innovative marketing interventions, backed by actionable insights, are essential to help overcome the fear of getting Covid infected, by both patients and doctors.

How to respond to this situation in a creative way?

The creative marketing response to overcoming the possible barriers on the way, would call for predictive rather than reactive pharma strategies. The game plan not only needs to be purpose drivenfor the marketers, but should also be perceived that way by all concerned. For example, the core purpose of marketing in this scenario, will be to provide a life-saving patient ‘service’, with win-win outcomes.

And the additional ‘service’ in this case is encouragement in-person physician visits during early symptoms of life-threatening health conditions – taking all safety precautions and overcoming ‘paranoia’ of getting infected. The win-win outcomes will include – saving lives, preventing deterioration of the disease condition, and of course, facilitation of the brand demand. The good news is some global pharma majors have already started making progress in this direction.

Promoting doctor visits during the pandemic – an example:

Leaving footprints to follow, some pharma marketers have already started creatively working on it. Let me cite a recent example of this unique initiative. This was reported by Fierce Pharma in its November 02, 2020 issue. The marketing process carries all the required ingredients for excellence, as mentioned above.

It wrote, ‘Pfizer and Bristol Myers Squibb are the latest drugmakers to join the swell of campaigns promoting doctor visits during the pandemic.’ This decision was based on data, showing many people haven’t been going to their primary care appointments for symptoms that may lead to potentially serious conditions.

This initiative is focused on three critical health conditions, namely, atrial fibrillation, deep vein thrombosis and pulmonary embolism. The rationale for selecting these three indications is, these are all treated by the partners’ anticoagulant Eliquis.

Accordingly, the BMS-Pfizer Alliance launched a campaign to raise awareness and encourage people to seek prompt medical attention. The American campaign was built around the theme – ‘Your symptoms could mean something serious, so this is no time to wait.’ In tandem, the companies also widely communicated through multiple channels that ‘Decreases in Americans’ Primary Care Visits May Lead to Late Diagnoses of Potentially Serious Conditions.’

According to reports, the net result of this creative marketing, so far, is no less than outstanding, as compared to many other pharma players operating in similar situations. ‘Eliquis’ brand sales for the first six months of 2020 topped $4.8 billion, a 21% increase over the same time period last year. Doesn’t this initiative demonstrate that creative pharma marketers can unshackle even Covid fetters?

Conclusion:

Meanwhile, as on November 08, 2020 morning, India recorded a staggering figure of 8,507,754 of Coronavirus cases with 126,162 deaths. The average number of daily new cases appeared to have slowed down in the last few weeks. But, the threat of further spread of Covid infection, in waves, still looms large in the country.

Most scientists agree – while effective vaccines offer the best chance of reaching zero COVID-19 – eliminating the virus across much of the world, while not unthinkable, could take a significant number of years. Thus, it may be realistic for some time to focus on flattening the curve with stringent control measures, involving efficient contact tracing, testing and isolation, together with social distancing and mask wearing – till it happens, ultimately.

Meanwhile, the business must flourish, even amid a new normal. And this is, in no way, a pipe dream, but a proven reality, as we have seen above. No doubt, this calls for most pharma marketers wearing a fresh thinking cap, equipped with more cerebral power, as it were, to unshackle Covid fetters on their way – effectively.

By: Tapan J. Ray    

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

 

Covid Propels Healthcare Into A Virtual World: A New Growth Driver For Pharma?

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Amid ongoing Covid pandemic, most discussions on pharma specific ‘digitalization’ initiatives continue to predominantly hover around its traditional business growth drivers. In fact, even before the Covid time, it was no different, in a smaller scale and with a lesser intensity, though.

Incidentally, since quite some time, with the explosion of different types of web-based businesses, offering opportunities to buy and receive, virtually everything, at one’s doorstep, many things started changing rapidly. Almost all businesses started offering the state of the art, easy to use smartphone app-based e-commerce solutions, in different formats, to grow their businesses. Alongside, more and more people started managing their daily needs and wants online, even in India. Intriguingly, despite the availability of telemedicine, telehealth and e-pharmacies, even in the old normal, most people continue to prefer in-person health care solutions, including buying medicines.

Then came a bolt from the blue – the unprecedented global health crisis, caused by Covid-19. Almost overnight, amid requirements of maintaining stringent personal measures to keep Covid at bay, making in-person doctor-calls for brand demand generation activities, posed a great challenge. Doctors, too, became hesitant to meet general patients and medical representatives, in that situation. Thus, to keep the business up and running, most pharma companies gave top priority in finding out a digital solution for the brand demand generation processes. Interestingly, this was happening, when many patients, especially those with non-Covid ailments, also faced a similar situation to meet their health care needs.

Finding no other viable alternatives, many patients were pushed to search for a robust digital solution for health care needs, as well – just as they were already meeting their other regular needs – online. In that sense, Covid propelled many patients to step into a new virtual world of healthcare - telehealth or telemedicine. As mentioned above, although, these services were up there in pre-Covid days, many patients, apparently rediscovered them, in a new Avatar, to get relief from ailments and also save their lives.

On a hindsight, it appears, why the need to leverage telehealth or telemedicine in that crisis, did not appear to be a priority for most pharma companies to foster patient-centric growth of the business. Thus, continuing with the core concept of my previous article, – this article, will focus on the possibility of pharma spearheading the process, aiming for a win-win outcome – boosting access to high quality affordable care for all, on the one hand. And simultaneously, harnessing this new growth driver to excel in the business, on the other.  

Telehealth or e-health will grow just as other e-businesses, unhindered: 

With the Government of India issuing guideline for telemedicine practices on March 25, 2020 and later, on May 12, 2020, publishing those guidelines in the gazette, ‘Telemedicine’ has been made a high priority health care enabler. The notified guidelines also make telemedicine consultation provided by a Registered Medical Practitioner (RMP) under the Indian Medical Council Act, 1956, legally permissible. In addition, effective October 01, 2020, Telemedicine costs will be covered under medical insurance in accordance with the Insurance Regulatory and Development Authority of India’s (IRDAI) new guidelines.

The net effect of these measures will not just help reduce pressure on the fragile public healthcare infrastructure of the country, but will also expand access to lower cost and high-quality private care to a large number of people.  

Telemedicine is here to stay and be a key pharma growth driver:

With Covid propelling health care into virtual platforms, providing and receiving medical care through telehealth has become a necessity for many people, for different reasons. However, the question that surfaces, will patients return to the old normal, if and when the pandemic ends?

The article – ‘3 reasons telehealth is here to stay,’ published by the MedCity News on October 09, 2020, presents a practicing physician’s perspective on this issue. The author envisages, ‘telemedicine will continue to gain traction with my colleagues and most likely, become a permanent clinical option for patient care.’ Going by such hands-on experience, I reckon, telemedicine will continue to grow for several important reasons, such as:

  • Technology to make telehealth increasingly user friendly: Ongoing IT innovation is making telehealth platforms simple and more effective for doctors and a large number of patients belonging to all age groups. “All they have to do is click a link on their smartphones, which is sent to them via text automatically.” Thus, these tools will increasingly become the best option for treating a broad range of conditions, long after the pandemic subsides.
  • Telemedicine costs are covered under medical insurance, now: Effective October 01, 2020,Telemedicine costs will be covered under medical insurance, even in India. Moreover,‘Telemedicine’ has now been made a high priority health care enabler, carrying a permanent legal status in India. 
  • Health Equity and affordable care: Access to affordable health care is not evenly distributed across the India. Telehealth can help fill these gaps, with increased affordable access for all, even in rural India, as patient location won’t be a problem in getting prompt and quality care at a low cost.

From the above perspective, it appears, it’s high time for pharma to leverage Telemedicine and Telehealth as a major growth driver, powered by innovative business strategies.

Is there any difference between Telemedicine and Telehealth?

Very often these two words are used interchangeably. Mostly because, both telemedicine and telehealth are the practice of medicine using technology to deliver care at a distance.

Telemedicine offers remote clinical services, such as, virtual consultations, diagnosis, prescriptions, preventative care, monitoring via telecommunication platforms, including text, video chat, wearable devices or even phone calls. Whereas, telehealth, in addition, can include remote non-clinical services, such as health care training, administrations and continuing medical education.

Reasons for pharma’s cashing on this new growth driver at a low cost:

Besides Government’s support to telehealth and telemedicine, growing health care consumer demand and user-friendly technologies, are catapulting virtual care to the mainstream health care delivery systems. In tandem, driven by unique and long-term value offerings, telemedicine is being increasingly recognized as a critical means to get prompt care for minor but urgent ailments. Consequently, moreusers are getting attracted to its convenience and benefits, which may have a snowballing effect. Some of which are as follows:

  • Prompt access to disease treatment services, as and when needed by patients, without any long waiting time, for any reason.
  • Significant health care cost saving for all – more for rural population who will be able to avoid long distance travel, involving both time and money, besides associating hassles.
  • Prompt follow-up consultation facilities, will help avoid disease complications, reducing the burden to hospitals for secondary or tertiary care.
  • Further, pharma can offer even greater patient satisfaction by leveraging virtual healthcare platforms, as these will help ensure more effective follow-up and enhanced treatment convenience than traditional in-person visits. Several studies, such as the article, published in ‘The American Journal of Managed Care,’ on January 15, 2020, vindicate this point.

In short, accelerating rate of use – with the increasing need for prompt, easy and affordable access to care, are driving telemedicine to be an integral part of healthcare service delivery system. Which is why, expansion of pharma business in this new virtual space, with well-integrated collaborative strategies, could prove to be a key growth driver – over a long period of time.

Moreover, there doesn’t seem to be any need to deploy a large and cost-intensive field force, as is usually followed for expansion of pharma business in newer areas. This is because, ‘telemedicine requires a different approach to promotion.’

Telemedicine requires a different approach to promotion

That telehealth requires a different approach to marketing and promotion from traditional pharma marketing, was deliberated by ZS in the article -‘Four telemedicine myths for pharma to avoid,’ published on July 05, 2020. The paper underscored, ‘instead of building brand awareness and engaging patients in education and information, telehealth promotion needs to drive patients to take one specific action: call today!’ It further elaborated:

  • Brands that bury the telehealth link on page 8 of their website or make linking to a physician one of more than 20 different calls to action, will find low patient engagement and low pull through.
  • As virtual health care is here to stay, telehealth itself should be a strategy for active promotion, by optimizing the steps to get patients connected to a physician in the shortest and the easiest way possible.

From this perspective, brands that will find the right pathway for engaging in telehealth, will reap the benefits of increased engagement with patients and telehealth physicians. To achieve this objective, with a robust, commercial strategy, the first step for each brand will start with understanding the needs of patients and physicians that needs to be addressed on priority. Then comes, mapping out how the brand will get used to meet those needs.

Conclusion:

We are still in the midst of an unprecedented new Coronavirus pandemic. As of October 18, 2020 morning, India recorded a staggering figure of 7,494,551 of Coronavirus cases with 114,064 deaths.

With the pandemic severely curbing most patients’ access to care – following the traditional process, Covid propelled health care into a virtual world, almost in no time. Telemedicine brought to the fore, its game changing potential to provide expanded access to high quality and affordable health care, through multiple channels, sans physical presence. Location of a patient or of a competent physician isn’t an issue, any longer, in the disease treatment process. With telemedicine patients will be able to get treated as and when they will want.

The future of Telehealth or telemedicine appears to be promising even beyond Covid time, with more people preferring digital platforms for affordable and more convenient medical care than in-person visits. With virtual care getting integrated into traditional health care delivery systems, pharma players will need to explore this space, as a new growth driver – for wider reach, and greater share of mind of customers for their respective brands.

For Telemedicine to be successful – benefitting a vast majority of both urban and rural populations, country’s health policy makers and, especially the pharma industry should work in unison. Only then, the net outcome will offer a win-win situation – both for the Government and also for the drug industry. It will help expand access to high quality and affordable care to all – seamlessly, irrespective of location. Consequently, pharma marketers will get access to another powerful business growth driver – in telemedicine. Its time about time for all to act – sooner the better.

By: Tapan J. Ray    

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

 

With More Patients Preferring Telehealth Pharma Marketing Needs Retooling

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Even after six months of COVID-19 pandemic, the omnipresent chaos, general unease and apprehensions about a yet unpredictable future continues in all countries, including India. In absence of vaccines and proven medicines to address the disease, wearing face mask, maintaining social distancing and frequent hand sanitizing, remain the primary measures for all to combat this unprecedented health crisis.

The rapid spread of the lethal Coronavirus has not only impacted lives and livelihoods, besides changing the health care ecosystem – with a silver lining, though. The pandemic has instilled a sense of urgency – an accelerated speed – in the entire value chain of the health care systems, including the pharma industry.

To contain the rapid spread of the disease – many physicians, Governments and even patients themselves, are being encouraged to leverage technological platforms, for various non-Covid related medical needs. Realizing that there no other working alternatives in this situation, even most skeptical doctors and patients are now resorting to video consultations.

Consequently, ‘Telemedicine’, in different forms, has started growing in leaps and bounce. Its spin-off benefits favor the patients – better care at lower costs, sans any further strain on the existing health care systems. Along with many others, the Bloomberg article of April 10, 2020 – ‘Coronavirus Should Finally Smash the Barriers to Telemedicine,’ also expects it to grow, not just during the pandemic, but much beyond.

Echoing the World Health Organization (W.H.O) on the need to promote telemedicine in this health crisis, Niti Aayog of India also acknowledged, ‘‘Telemedicine: A Blessing In Disguise In Time Of COVID-19.’ It further added, ‘With the arrival of the COVID-19 pandemic, telemedicine has finally gained momentum. Telemedicine providers reported an overnight increase in demand, acceptance among doctors, paramedics, and consumers.’

As patient-doctor interactions are now expanding – from personal visits to physicians to remote telehealth, is there a need for recomposing notes of the pharma marketing playbook - to excel in the new world order?  This article would focus on this specific area of leveraging ‘The Break in The Clouds’.

Telemedicine and its key primary driver: 

‘Telemedicine’– often called telehealth or e-medicine, in simple term, involves the remote delivery of health care services, when both doctors and patients are not physically present at the same place. It includes, patient examination, doctor consultations, diagnosis, treatment and remote monitoring, over the technology enabled modern communication infrastructure.

Although, telemedicine is not a new concept, it was not very popular for various reasons, till Covid pandemic offered no other viable alternatives to non-Covid patients. The article – ‘COVID-19: The rise and rise of telemedicine,’ published in the MobileHealthNews on May 27, 2020, also vindicates this point. It reconfirmed: ‘Telemedicine has experienced a huge surge in adoption over the past few months, during the coronavirus pandemic.’

Even Frost & Sullivan’s recent analysis, ‘Telehealth – A Technology-Based Weapon in the War Against the Coronavirus’ of May 13, 2020, found the demand for telehealth technology rising dramatically, as the COVID-19 pandemic continues to disrupt the delivery of healthcare worldwide. Thus, ongoing stringent requirements of wearing face masks and maintaining social distancing to contain the virus spread, will continue to drive the growth telemedicine as the preferred way of accessing healthcare.

Indian perspective of increased online access to health care:

Practo’s Insight Report of June 20, 2020, titled, ‘How India accessed health care in the last three months,’ has revealed some interesting India-specific data in this area. This study was based on transactions of 500 million Indians accessing health care online, during March 1, 2020 to May 31, 2020 period. It found, while COVID-19 continued to remain India’s topmost concern, ‘telemedicine has helped doctors – patients stay connected, as people practiced physical/social distancing.’ This resulted into a ‘500 percent increase in online doctor consultations,’ in that time frame. Other important findings of this report include:

  • 80 percent of all telemedicine users experienced it for the first time.
  • 44 percent of the teleconsultations were from non-metro cities.
  • In-person doctor visits dropped by 67 percent.
  • Indians consulted their doctors 2 times per month, using telemedicine.

The surge in teleconsultations in India, reportedly, follows the long-pending telemedicine guidelines which were finally issued by the Ministry of Health and Family Welfare, in collaboration with NITI Aayog and Board of Governors, Medical Council of India (MCI).

Could ‘Telehealth’ be a game changer even beyond Covid time?

Many experts in this area believe so. For example, the article – ‘Telehealth could be a game-changer in the fight against COVID-19. Here’s why,’ published the World Economic Forum on May 01, 2020, makes some important observations. It suggests: ‘Beyond the pandemic, governments, insurers and healthcare providers need to work together to ensure that the innovation sparked by this crisis endures and accelerates. Post-crisis, telehealth can still help alleviate the pressures posed by healthcare resource shortages, the growing elderly population and issues with healthcare accessibility.’

The article, published in the Invest in India website of the Government of India, on April 10, 2020, emphasized the relevance and benefits of ‘Telemedicine’ in India – even after Covid Time. Conceding, in-person health care delivery in the country is challenging, given the large geographical distances and limited resources, it enumerated all-time relevance and the key advantages of ‘Telemedicine,’ as hereunder:

  • Saves cost, effort and other related inconveniences, especially of rural patients, as they need not travel long distances for obtaining consultation and treatment, also limiting burden on the secondary hospitals.
  • Ensures higher likelihood of maintenance of records and documentation, minimizing the possibility of missing out advice from the doctor and other health care staff.
  • Provides safety to patients and health workers’, especially where there is a risk of contagious infections.
  • The doctor has an exact document of the advice provided via tele-consultation. Written documentation increases the legal protection of both the parties.
  • Enables the availability of vital parameters of the patient available to the physician with the help of medical devices such as blood pressure, blood glucose, managing.
  • Provides equal access to quality care to all, minimizing inequity and barriers to access.

The official guidelines for telemedicine practices in the country are aimed at allowing registered medical practitioners to providing remote consultation. Under this backdrop, Telemedicine is expected to remain in a growth trajectory, even in India. Accordingly, there arises a need for recomposing notes of the pharma marketing playbook - to excel in the new world order. 

Increasing telehealth preference prompts marketing strategy retooling:

As I wrote on July 10, 2020, pharma leaders need to leverage the art of turning challenges into opportunities, now – especially when telehealth is at the threshold of playing a pivotal role in the health care delivery systems. In this scenario, traditional pharma brand-demand generation strategies are unlikely to deliver expected business results, anymore. Pharma players would need to work out fresh and effective marketing models, in-sync with patients changing health care related needs. Conceiving, strategizing, and delivering changing patient-value based content, effectively, using modern omnichannel platforms, would be the new ballgame.

‘Telehealth is more than a channel for delivering care’:

As the ZS Insights article – ‘While telehealth continues to evolve, pharma needs to keep an eye on the future,’ published on August 03, 2020 reiterated: ‘Telehealth is more than a channel for delivering care, it reflects a fundamental shift in how brands reach patients and physicians.’ Following are some key points worth noting:

  • Until now, in-person delivery of care has anchored brand marketing in the sales territory-based geographic perspective. Whereas, telehealth platforms are free of sales territory-based geographic distinction.
  • Physicians now provide telehealth services to patients in two ways, having different implications for pharma players:
  1. Vertically integrated virtual practices, such as, Practo, Lybrate and others in India.
  2. Brick-and-mortar offices, where physicians provide telehealth visits through     FaceTime, WhatsApp, Zoom and other teleconference platforms.

It is envisaged, alongside patients avoiding the risk of contracting Covid, tangible benefits of lower treatment cost and escaping long waiting time to meet the doctors physically, will encourage people switching to Telemedicine, for an indefinite period.

Collaborative, not standalone pharma marketing may not work better:

In the era of telehealth or Telemedicine, the common ground where patients, doctors and drug companies can meet, would be the telemedicine platforms. These may well be some popular telemedicine apps for e-consultation, such as, Meddo, Practo, mFine and others in India. Besides, there lies an opportunity for pharma companies also to develop custom-made ones, for installation by doctors.

These platforms can be effectively leveraged with collaborative approaches – for content delivery to physicians, patients and other stakeholders, at the appropriate time and places. There are various innovative ways to prepare a grand strategy for this purpose – ‘tailor-made’ for each company. And astute pharma marketers should play the role of ‘master tailors.’

Conclusion:

Meanwhile, as on October 11, 2020 morning, India recorded a staggering figure of 7,051,413 of Coronavirus cases with 108,371 deaths. The daily number of new cases appeared to have slowed down during the last week.

Nonetheless, the unprecedented and savage onslaught of the new Coronavirus has unsettled the pharma industry, as it disrupted the old normal of the world. At the same time, many people have also demonstrated high resilience, grit and innovative mind to keep moving, in a relatively orderly manner – amid an omnipresent chaos, as it were. In the health care space, the need for responding to non-Covid related health emergencies, pushed people to experiment with not much used before – telehealth or  Telemedicine.

It worked and continues receiving support from all concerned. Its other major benefits also surfaced – as a breath of fresh air. It’s unlikely that people will let it go, in the foreseeable future, which has a great implication to pharma industry. With more patients and doctors increasingly preferringTelemedicine, in various ways, pharma marketing needs retooling its strategy kit – by expanding into collaborative approaches with Telemedicine providers.

By: Tapan J. Ray    

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

 

Digital Divide And Indian Pharma Industry

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

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

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

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

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

What it means?

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

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

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

It’s not just a technological issue:

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

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

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

Bridging the ‘Digital Divide’:

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

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

Can pharma industry hasten the process?

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

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

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

Increasing relevance:

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

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

Advantage pharma:

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

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

Key benefits:

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

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

Calibrated increase in usage of digital platforms:

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

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

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

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

In conclusion:

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

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

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

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

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

By: Tapan J. Ray 

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

‘Digi Gaon’: Will It Augment Access To Affordable Health Care In India?

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In the Union Budget speech of 2017-18, Indian Finance Minister articulated his intent, among several others, to launch a new initiative named ‘Digi Gaon’, which would extend the broadband digital technology in rural India. Besides education and skills, ‘Digi Gaon’ would facilitate affordable access to e-healthcare in the in the hinterland of the country.

“Under the Bharat Net, optical fiber has been laid in 1,55,000 km. I have stepped up the allocation for Bharat Net projects to Rs 10,000 crore in 2017-18 and by the end of 2017-18, high speed broadband on optical fiber will be available in more than 1.5 lakh gram Panchayats with hotspots and access to digital services at low tariff,” the Finance Minister said.

“This will give a major fillip to mobilizing broadband and Digital India, for the benefit of people living in rural areas,” he further added.

Increased penetration of ‘Telemedicine’, per se, in the country has the potential to improving time, cost and the quality of access to affordable health care in rural India, as confirmed by several important studies.

A broad perspective:

A report of the World Health Organization (W.H.O), titled “Telemedicine – Opportunities and developments in the Member States”, states that the term ‘Telemedicine’, was coined in the 1970s, which literally means “healing at a distance”. It signifies the use of modern Information and Communication Technologies (ICTs), such as computers, the Internet, and cell phones, to improve patient outcomes by increasing access to care and medical information.

Recognizing that there is no one definitive definition of ‘Telemedicine’ – a 2007 W.H.O study, after reviewing 104 peer-reviewed definitions of this word, adopted the following broad description:

“The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities”

‘Telemedicine’ in India:

Before I get into other relevant details in this area, let me briefly explore in which segments of the three important areas – Market, Services and Providers, ‘Telemedicine’ has already started working in India, though with a varying degree of success.

 Market segments:

‘Telemedicine Market’ in India can broadly be segmented into nine key categories. A recent research report on “India E-Health Services Market Outlook to 2020” by Ken Research captures the top three of these segments as follows:

  • Tele-radiology: The top segment in India that involves the electronic transmission of radiographic images of patients, such as, X-Ray, CT scan or MRI from one location to another location for an expert interpretation by a radiologist sitting there to quickly facilitate appropriate treatment.
  • Tele-consultation: Ranked second in terms of revenue earning of the Indian telemedicine industry in 2015. It involves establishing a clear audio and video communication link between the patient and doctors of different disciplines, as required. Patients’ demand for online consultations with the doctors is fast increasing as it helps to get disease specific medical advice from the different experts located anywhere in the world.
  • Tele-ICU: Was ranked as the third largest segment. It involves the use of an off-site command center in which a critical care team (intensivists and critical care nurses) connects with patients in distant ICUs to exchange health information through real-time audio, visual, and electronic means.

The following are the other six segments, which I am presenting below with a brief definition of each, for convenience:

  • Tele-ophthalmology: It delivers eye care through digital medical equipment and on telecommunications technology platforms.
  • Tele-dermatology: It involves communication technology to connect patients with dermatologists to improve skin health. The technology allows the patient to be examined and even treated without making a physical trip to a dermatologist.
  • Tele-surgery: It is the ability for a doctor to help perform surgery on a patient even though they are not physically in the same location. It is a form of telepresence.
  • Tele-pathology: It involves the practice of pathology at a distance using telecommunications technology to facilitate the transfer of image-rich pathology data between distant locations for the purposes of diagnosis, education, and research.
  • Tele-psychiatry: it is the application of telemedicine to the specialty field of psychiatry. The term typically describes the delivery of psychiatric assessment and care through telecommunications technology, usually video-conferencing.
  • Tele-Home Care and Nursing: This is primarily meant for patients who prefer receiving various health care services at home, such as those suffering from serious chronic diseases, post-surgery, and to cater to the critical regular heath needs of elderly persons.

Service segments:

Similarly, various international literature has segmented the ‘Telemedicine services’ into two broad types, as hereunder:

  • Real Time telemedicine services: These services include telephonic call or video-conferencing where both the doctors and the patients need to be present at the same time, and real time interaction happens between them.
  • Store and Forward telemedicine services: These do not require both the doctor and the patient be present at the same time and transmission and assessment of the medical records can be done at any convenient time.

Types of Providers:

Ken Research Report categorized the ‘Telemedicine Providers’ available in India into the following three groups:

  • Private Hospitals, such as Apollo Tele Health Services, Narayana Health Telemedicine Centers and Aravind Eye Care and telemedicine centers of Medanta, besides others.
  • Government Hospitals and Medical Colleges, such as, AIIMS, SGPGI and several others have made alliances with various districts and sub-district hospitals of different states in India. Some States such as Punjab, Gujarat and Uttarakhand have adopted a PPP model.
  • NGO run centers, such as, World Health Partners are the largest NGO in India that has 1100 with a market share of 56.1 percent.

The critical barriers to overcome:

There are several critical barriers to the rapid penetration of ‘Telemedicine’ in India. However, in this article, I shall discuss only five of those, which India has not cared much to resolve over a long period, and need to be addressed, sooner than later:

  • Frugal broadband Internet network:

Probably realizing that this stark reality still exists, despite earlier initiatives of ‘Digital      India’ slogan, the Finance Minister in his 2017-18 budget speech announced a fresh budget allocation for the new ‘Digi Gaon’ project.

An efficient broadband Internet is an absolute must for any efficient ‘Telemedicine’ project, as most of the applications of ‘Telemedicine’, as mentioned above, would work effectively only in that environment. In 2016, India’s broadband Internet penetration was an abysmal 7 percent, as reported in a white paper of the International Telecommunication Union (ITU), and quoted by the chairperson of the Telecom Regulatory Authority of India (TRAI).

  • High initial cost of setting up a telemedicine network:

The initial cost of setting up a viable ‘Telemedicine’ network, including training of personnel, developing user-friendly smartphone-based apps with state of the art technology, is high with low current Return on Investments (ROI).

  • Availability and training of personnel:

- At the village end: Availability of proper technician, other IT staff and qualified local doctors and their periodic training and performance assessment.

- At the consulting centers: Appropriate training, coordination with other relevant staff and administration as required for compliance and monitoring performance standard.

  • No legal framework governing Telemedicine in India:

At present, there is no legal framework in India governing Telemedicine of the country. The Government would need to urgently consider this issue, as it creates related facilities and infrastructure in the country.

  • Lack of revenue generating business models for sustainability:

In India, ‘Telemedicine’ is generally considered as a part of ‘social responsibility’ of public, private, large corporate hospitals and NGOs. In the some of the private hospitals it is alleged that the underlying objective is to raise the bed occupancy rate when the patients on ‘Telemedicine’ require hospitalization.

Currently, there exists a dearth of revenue generating business models for ‘Telemedicine’ in India, taking it beyond the realm of just ‘social responsibility’, and enabling it to play an increasing role in the overall health care space for long-term sustainability, with a win-win outcome for both its investors and patients.

Thus, the Government would require playing the role of an enabler to encourage, attract and support more and more private players and startups coming up with sustainable commercial business models in this area. Simultaneously, it should also play an active role to help increase public awareness in ‘Telemedicine’, eliminating patient inhibition, enhancing competition and reducing patients’ cost for various services.

Is ‘Affordable health care’ a victim of circumstances?

India with its public spend as a percentage of GDP on health care being consistently one of the lowest in the world over a period of a very long time, despite being the fastest growing global economy, the importance of high penetration of ‘Telemedicine’ in the country assumes a high importance. More so, when grossly inadequate public health care facilities continue to pose serious health risks for many of the country’s population.

On the other hand, in Indian private health care space, including drugs and pharmaceuticals, where a sizeable section of global pharma players and their lobbyists are continually pushing hard, predominantly an Intellectual Property (IP) orientated blatant self-serving agenda. They want to sell more of high price monopoly products and services to earn more and more profit, depriving a huge majority of local patients. It’s happening, even when the image of the global pharma industry has plunged to a new low, and is still going south, despite tons of money allegedly being spent on lobbying of various nature, more than ever before.

No wonder, why the globally acclaimed doyen of the IT industry – Mr. Narayana Murthy also openly acknowledged this fact, suggesting some science and technology based remedial measures. While addressing the Bio Asia 2017 on February 08, 2017 in Hyderabad he said: “India has fallen behind in healthcare, but science and technology can indeed play a role in bridging the gaps. Science and technology can play a key role in diagnosis and management of disease, of mass application of drugs and availability of drugs on a scale and at an affordable cost,” as reported in the Economic Times.

Thus, sandwiched between either side, ‘Affordable health care’ continues to remain a major victim of the circumstances, and is desperately looking for a strong Government intervention, just as what’s now happening in several developed countries, including the United States.

Conclusion:

Although ‘Telemedicine’ is an important enabler and enhancer, I reckon, it’s not a panacea. It would never replace brick and mortar high quality generally affordable health care facilities, along with affordable modern life saving medicines, any time in the foreseeable future.

The announcement of ‘Digi Gaon’ to facilitate ‘Telemedicine’ in India, without a well-charted roadmap and overcoming its critical success barriers, is intriguing. Nevertheless, this initiative has an underlying potential to transform ‘Telemedicine’ into a robust revenue generating model, even at the village level entrepreneurship, with sharp application of creative minds.

It’s a matter of great concern that in the space of Governance in India, public health care is increasingly becoming more a subject of a general lip service, rather than immaculate execution of a robust, comprehensive, time-bound National Health Policy with assigned accountability for each project and backed by requisite budgetary allocation, both by the Central and the State Governments. Consequently, one would seldom witness any such well hyped announcements on various public health care projects seldom coming to fruition on the ground, as promised.

Even if the recently announced ‘Digi Gaon’ initiative is considered as a standalone project for greater access to ‘Telemedicine’ in the hinterland of the country, it is important to understand that, in the short term, investment in ‘Telemedicine’ won’t be a magic wand for India to demonstrate a commensurate increase in health outcomes, along with reaping its consequential economic benefits.

To succeed in this area, several critical barriers need to be effectively overcome, soon. This would help showcasing ‘Telemedicine’ as an integral part of everyday e-health care solution for many. Otherwise, the Government is likely to face enormous challenges to leverage the true potential of ‘Digi Gaon’ for alleviation of acute miseries caused by poor, or lack of access to affordable health care, especially in rural India.

By: Tapan J. Ray 

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