The Pharmaceutical industry is a really various industry with several regulative Torahs followed by rigorous administration in order to keep the ratio of public wellness ( Shakala, 2010 ) . Pharmaceutical drugs are loosely classified into over the counter and prescription drugs ( Paninchukunnath, 2007 ) . OTC ( over the counter ) drugs are lawfully allowed to sold by the druggist without prescription of registered medical practician. Prescription drugs are sold on the demand of physician prescription ( oppi, 2010 ) . By and large, OTC drugs consist of medical specialties for common alliances such as cough, cold, febrility and caput aching. Drugs for bosom diseases, malignant neoplastic disease, and thyroid will come under prescription drugs and if taken in unequal doses may ensue in terrible wellness jobs ( Nagaraju,2009 ) .
2.2 Pharmaceutical Selling:
Pharmaceutical selling is an of import field as it deals with human life ( Gardner et al. , 2003 ) . Due to the hazardous nature of medical specialties, the pharmaceutical industries have been capable to heavier selling and advertisement limitations than other industries like cosmetics and Beauty attention merchandises ( hypertext transfer protocol: //www.globalbusinessinsights.com/content/rbhc0031m.pdf ) . Pharmaceutical companies must keep high ethical criterions when carry oning promotional activities and comply with applicable legal and professional demands ( Bhandari. etal, 2008 ) . Drug advertizements are controlled by Food and Drug Administration ( FDA ) and it see that all advertizements are up to the jurisprudence. OTC drugs are been marketed straight to clients in about every portion of the universe ( Health Action International, 2001 ) and direct-to-customer advertisement of prescription drugs are non allowed in throughout the universe ( Gardner et al. , 2003 ) except in USA and New Zealand. ( Hoek and Gendal, 2004 ) .
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2.3 US health care system:
Healthcare services in United States are mostly owned by private administrations. The US spends more of its GDP ( Gross Domestic Product ) on health care than any other developed states ( like ) . ( Samuel.D, 2010 ) . From the Fig.1, US have spent 16 % of the GDP on the health care, compared with 8.4 % of GDP spent by United Kingdom on Healthcare. ( BBC News, 2009 ) . On the other side India has spent merely 5 % of its GDP on health care. ( Asiatic wellness infinite, 2010 ) .
Fig.1: Percentage OF GDP SPENT ON HEALTHCARE IN 2009.
Beginning: Writer ( 2010 ) compiled from BBC News ( 2009 ) and Asiatic wellness infinite ( 2010 )
Doctors and infirmaries in USA are mostly funded by payments from patients and insurance programs. With health care chiefly funded in private by consumers in the USA, consumers tend to reason that larning about new drugs on the market should non be the sole sphere of physician to patient communications ( Morris and Griffen, 1992 ) . In the yesteryear, medical advertisement was confined to scholarly medical diaries read by physicians ( Smith, 2006 ) . This clip slowdown between blessing of a new drug and the physician ‘s cognition was seen as inefficient, a procedure that could be improved upon by utilizing DTCA. The intent of DTCA is to act upon consumers to bespeak prescriptions from their physicians and thereby increasing the gross of pharmaceutical companies ( Hollon, 1999 ) . Direct-to-consumer advertisement ( DTCA ) of prescription drugs is purely regulated in USA, but the pattern of utilizing authoritative selling communications tools is legal ( Hoek and Gendal, 2004 ) . DTCA of prescription drugs in the USA chiefly involves aggregate media such as Television, Internet etc. ( Barrett, 1998 ) . Direct to consumer advertisement is appropriate for medical specialties on which patients have a greater involvement than physicians. Non-life baleful conditions, such as erectile disfunction… ” ( Rutter, 2008 ) .
Patient in the US now relies on a assortment of media and resources to research disease, intervention, and wellness care information ( watershed, 2007-2010 ) . Harmonizing to Manhattan research conducted in 2009, 60 million U.S. grownups use the wellness related information from societal media content, such as web logs, support groups, chat suites, message boards, online patient support groups and other societal webs. One of the grounds for addition in use of Health 2.0 ( web2.0 in wellness attention ) among the American consumers is due to the online evaluation of infirmaries, practicians, prescription drugs and wellness related insurance programs. It besides helps the clients to compare their experiences and to go more proactive towards their health care determinations ( Manhattan research, 2009 ) . An American single sits before the computing machine for on-line wellness information before assignment with the physician. U.S. physicians study that some of the patients bring wellness information they found online to an assignment. As a consequence of this fact, physician spends more clip with the patients. Now the traditional doctor-to-patient audience are altering to two manner conversations between the physician and informed e-Health consumers. ( Cybercitizen wellness, 2009 ) .
In the yesteryear, medical advertisement was limited and confined to scholarly medical diaries and intelligence read by physicians ( Smith, 2006 ) . Previously Pharmaceutical companies employed gross revenues representatives to advance their merchandise to physicians. Now physicians can easy obtain the latest cognition with the application of web2.0. In fact, on an mean physician spends eight hours a hebdomad on cyberspace for their professional intents. Even physicians are provided with the societal web support groups such as sermo etc. , through which they can chew the fat any physician in any portion of the universe. The engagement of physicians in societal webs doubled between 2008 and 2009 ( Digital wellness tendencies, 2009 ) . 40 % of U.S. doctors are utilizing merchandises which are designed to assist “ cut down medical mistakes, better patient attention and increase productiveness ” ( Pfizer, 2010 ) . A Harmonizing to Manhattan Research ( 2009 ) , 72 % of doctors are utilizing smart phone now which will increase to 80 % in two old ages.
2.4: SOCIAL NETWORK MARKETING IN PHARMACEUTICAL INDUSTRY:
Harmonizing to Michael ( 2009 ) , 80 % of the cyberspace consumers are traveling for societal media content for wellness information instead than depending on the company websites and words of the doctors. It is going of import to utilize on-line support groups to discourse about the medicine or interventions to the patient. Pharmaceutical companies should seek to utilize societal webs as the patients prefer it to be the primary beginning of wellness information to them. Marketing through societal webs is more effectual as patients become more enlightening than before to do smarter determinations, go more complaint, and will seek to propose their societal contacts. This is besides being supported by the words of Fard johnnar ( laminitis of envision solutions ) that the recent surveies has shown that clients sometimes trust equal generated information by societal media to that of information provided drug houses, authorities organic structures and other non-profit groups ( Fard,2008 ) . In contrast to these surveies Ajith ( 2007 ) argues that depending on good experient physician is more dependable beginning than those of on-line webs. Pharmaceutical companies try to act upon the perceptual experience forms of the physicians towards their trade names by offering the physicians by supplying them with touchable and intangible benefits. Tangible benefits are such as gifts, samples, engagement in conferences etc. whereas the intangible benefits are company image, patient conformity and continuance of therapy effectivity ( hypertext transfer protocol: //pharmahelpline.org/article2.doc ) . In pharmaceutical selling, usage of societal media may sometimes take to inauspicious effects due to user generated informations ( Asanth, 2006 ) . Harmonizing to worden ( 2010 ) , user generated information may incorporate informations that is private and confidential to third party and sometimes misdirect the patients for taking incorrect medicine.
2.5 UK health care system:
In UK wellness attention is chiefly provided by England wellness service i.e. , National Health Service. National Health Service provides health care installations to lasting occupants of UK free of cost and are paid for national insurance revenue enhancement. Though public system dominates the health care in UK, there is besides handiness of broad assortment of private wellness attention for those are willing to pay. ( Boyle.s, 2008 ) A Patient needing specializer attention at infirmary for clinic will be informed by the GP of the infirmaries where they can acquire their intervention. ( BMA, 2008 ) The NHS will pay for intervention in a private scene if the infirmary meets the cost and service standards that NHS infirmaries adhere to. Otherwise choosing for a private infirmary makes the patient apt for private infirmary fees. Because the private sector frequently has higher costs, most people choose to be treated for free in an NHS infirmary. If the GP Judgess the instance to be highly pressing, the physician may by-pass the normal engagement system and arranges an exigency admittance. The UK has comparatively short waiting times for basic medical attention and non-emergency entree to services after hours, but has longer waiting times for specializer attention and elected, non-emergency surgery ( BBC News,2009 ) .
In 2002, European Parliament rejected a proposal to let advertisement for drugs used to handle asthma, AIDS, and diabetes straight to the consumer. ( Mintzes, 2005 ) i.e. direct to consumer advertizements of prescription are non allowed in U.K. In contrast to this fact, National wellness and Wellness Survey ( NHWS ) Results showed that while one in three patients in the US requests a specific drug from their doctor, the same proved true of respondents from France, Germany, and the UK, where makers are prevented from publicizing prescription drugs straight to consumers ( Calabro and Sara,2003 ) .
2.6 Indian health care system:
Health attention services in India are provided by both public and private. Harmonizing to indicus estimations, 78 % of the wellness attention services are provided by private administrations and staying 22 % by authorities ( Trivedi, 2010 ) . Unlike all developing states India spends really less sum of its GDP on health care. Rajiv Gulati ( manager of Indian-china scheme at Eli Lilly ) said that India basking as the exporter of generic drugs, despite of this fact most of the Indians have ne’er seen the tablets. He continued that patients from USA and UK come to India for intervention whereas 70 % of Indians have ne’er seen a physician ( IndiaKnowledge @ Wharton, 2010 ) as prescription drugs are sold without prescription due to hapless monitoring of FDA in India ( Paninchukunnath, 2007 ) . In footings of health care there exist two types of India, one which can supply high quality intervention to middle category Indians and medical tourers while others are people who live rural countries can non afford to quality health care and has limited handiness of healthcare resources.
In 2007, it is estimated that 25 % of the Indian population have entree to western ( allopathic ) medical specialties who live in urban countries where two-third of the infirmaries are located and the other people who live in rural countries must trust on alternate ways of traditional medicines such as ayurvedic and unani ( Pandeya and Radhieka,2007 ) . There are about 6.5 hundred thousands qualified physicians in India, in which four-fifth lives urban countries go forthing 20 % to take attention of the staying 76 % of the population ( Paninchukunnath, 2007 ) . In support to this Kelly etal ( 2008 ) , said that more than 80 % of the Indian population depends of Home redresss for handling diseases and unwellness. Ravichandran ( 2009 ) argue that this nature of Indians may be due to possible jobs like low rewards, deficiency of consciousness and deficiency of cognition sing modern medicine and installations. Harmonizing to national study, 61 % of Indian hapless usage populace health care installations and acquire benefited from centrally funded wellness attention programmes meant for immunisation, TB and Hansen’s disease and 33 % are found to be non-poor who can afford private health care installations ( ravichandran, 2009 ) .
Majority of Indian population live in rural small towns and their entree to public wellness attention installations are hapless may due to going distance, deficiency of income and deficiency of assurance in the system. An Indian life in small town should go about 1.4 stat mis or 2.2 kilometers to see general physician, over 3.7miles ( 6 kilometer ) for a blood trial and about approximately 12.4 stat mis ( 20 kilometer ) for infirmary attention. Majority in Indians who live in small towns are famers and workers who income is low. Due to the hapless route conveyance installations in rural small towns, undependability on health care supplier, cost of conveyance and lost net incomes, some of the hapless choose to see local self-proclaimed physician, while others opt for place redresss which they feel as safe medicine ( ravichandran, 2009 ) . This may be one of the grounds for high ego medicine inclination of Indians ( Paninchukunnath, 2007 ) and they sometimes believe in the druggist for medicine.
India has merely 1.5 beds for 1000 patients whereas China, Brazil, Thailand and Korea have about 4 beds for 1000 people. India needs a investing of 20 billion in order provide sufficient physicians and beds in following five old ages. This may be doubled in following 10 old ages due to alter in demographic, diseases and increasing costs ( IndiaKnowledge @ Wharton, 2010 ) . As per Pandeya and Radhieka ( 2007 ) , India requires 74,150 community health care centres per million populations of which it has merely half of them. In India, 11 provinces do non hold research lab installations for proving drugs and some of the bing research labs are non good equipped.
Healthcare industry of India is altering from unorganized to organized construction and is estimated to increase from US36 $ billion industry to US $ 280 billion industry in 2022 turning at a rate of 15 % CAGR. Even Suneetha reddy ( finance manager of Apollo infirmaries ) said that, health care sector in India is turning at rate of 15 % CAGR ( compound one-year growing rate ) due to of all time widening spread between supply and demand in health care ( IndiaKnowledge @ Wharton, 2010 ) .
The factors responsible for growing of Indian health care industry are as follows
Turning economic system:
Turning economic system: GDP of India is increased from 9.0 % during 2005-06 to 9.4 % during the period 2006-07 and it is besides expected that will traverse USA by 2050 ( Trade chakra, 2010 ) . Today, India being 4th in buying power para in the universe will traverse the China ( 3rd in buying power para ) in the coming 10 old ages ( Indian healthcare.in, 2010 ) .
Turning options for healthcare funding:
In recent old ages awareness of wellness insurance among Indians has increased. This is supported by the fact that there substainal addition in insurance purchases in India. There is about 50 % rise in insurance policies from 2006 to 2007 and many new private administrations entered in to the sector. This is can be one of the factor responsible for addition in healthcare industry in India ( Indian healthcare.in, 2010 ) .
Growth of medical touristry:
India ranks 2nd in medical touristry and about approximately 4.5 hundred thousand of foriegn patients are treated in the 2007 ( Nagaraju,2009 ) . Harmonizing to ‘Booming Medical Tourism in India ‘ market research India ‘s portion in planetary touristry will increase by 2.4 % by the twelvemonth 2012 by bring forthing a gross of US $ 2.4 Billion at growing rate of 27 % ( CAGR ) from 2009-2012 ( Report Linker, 2009 ) . Deolite after its two twelvemonth research said that patients are non merely coming from Asia but besides started coming UK, US and Europe. This can be explained by the fact that low cost incured in medical treatmentin India than in other states ( Nagaraju,2009 ) . For illustration disease called nose job will be about 2.64 Lakh in United States, whereas in India it costs 50000 rupees merely. Similarly, face lift in India costs 1.5 Lakh rupees and in USA are 5.28 lakh rupees ( India wellness visit.com, 2009 ) . This makes India better attractive force for foreign patients and thereby increases the gross for health care industry.
Increasing demand for quality health care with in the state:
In recent old ages, there is significant addition in demand for quality health care within Indians. In today ‘s universe patients are going choosier about the health care determinations due to increased figure of options for health care information than of all time before. Healthcare suppliers need to offer up to day of the month services and merchandises that can assist the consumers to be more informed about their wellness. So this has increased the force per unit area on health care suppliers to better their services and to convey better universe category services. As a whole the diseases profile within Indians are altering. Latest wellness betterments like duplicating the length of service from 32 old ages to 64 old ages, lessening in maternal mortality rate from 301 in 2001-03 to 254 in 2004-06 per 10000live births, Infant mortality rate is decreased from 58 in 2005 to 53 in 2008 for 1000 unrecorded births, instances of HIV, TB and malaria are drastically decreased ( The universe bank group, 2010 ) . All the above wellness betterments gave rise to increase in healthcare industry in India.
2.7 Barriers to healthcare communicating in India:
2.7.1: Cultural factors:
Culture is the primary component that determines the individual ‘s values and belief. India is rich of different civilizations and traditions. Culture in India differs when move from north to south portion or from west to east of India. Indians civilization is more towards household oriented and westerns states prefer Individualist civilization ( Durham, 2010 ) . Pharmaceutical companies frequently design their selling schemes maintaining in the civilization of consumers in head. Ad in United States is more enlightening than in Britain which can be explained as Americans prefer Individualism where as Britain ‘s prefer societal life ( Ahmed, 2000 ) . This is besides known as diverseness selling. For illustration: In India pharmaceutical consumers are more likely towards herbal or Ayurvedic medical specialties as it is a portion of Indian civilization to utilize Haldi, Neem and Tulsi. This makes the sellers easier to place non-allopathic drugs than allopathic drugs due to the cultural apparatus of India. Germans pronounce the missive ‘V ‘ as ‘F ‘ and they spell VICKS as FIX. In Germany sellers should articulate VICKS as FIX to accommodate the German civilization ( hypertext transfer protocol: //pharmahelpline.org/article2.doc, 2010 ) .
Among Indians joint households are still prevailing dwelling of grandparents, parents, kids and households of parental uncles. Due to increased demand for urbanization in India, atomic household came into image dwelling of parents and kids ( Kelly etal. 2008 ) . In contrast to this, in UK and USA atomic households are altering into individual individual households with a addition of 18 % to 29 % from twelvemonth 1971 to 2002. It is estimated that there will be more individual individuals than married twosomes by the twelvemonth 2020 ( Mandy borrow,2010 ) .In Indian households, work forces ( male parent ) are considered as caput of the household and manages the issues which requires interaction with persons of the society e.g. , health care ( Kelly etal. 2008 ) . In developed states such as UK and USA there is no hierarchy in the households is seen to lesser extent to that of India. Power distance in India is really high to that of UK and USA which clearly shows that kids depend on parents for wellness related issues. Older Indians are more supportive towards traditional medicines ( Etchey, 2009 ) . These housemans influence the kids to take traditional medicine.
Harmonizing 2001 nose count, the overall literacy rate in India is 65.38 % in which male literacy rate is 75.96 % and is 54.28 % ( Ioveindia.com, 2010 ) . In developed states like USA and UK about all the people are educated. As bulk of rural population depends on agribusiness and rate of illiteracy is high and is low in urban metropoliss as most of the people are employees and are more educated ( The positions paper, 2009 ) . Education in India is depends on the fiscal capablenesss of the household. An intelligent pupil but hapless can non afford to higher instruction. Some rich Indian pupils are migrating to UK and USA for higher instruction ( Kelly et al. , 2008 ) . Illiteracy is large job in supplying high quality health care installations to Indians as they are traditional in thought and will non favor techniques and engineerings in health care ( Devi and Mago, 2005 ) .
Computer literates are really less in India to that of USA and UK. There is about 20 % addition in internet users from September 2008 to September 2009 from 57 million to 71 million cyberspace users which is low in a state of 1.1 billion ( prabhudesai,2010 ) . From the fig ( ) it is apparent that internet incursion is low when compared to that on developed states like USA and UK.
Beginning: Writer ( 2010 ) , complied from IMRB International/IAMAI, ‘Internet in India 2007 ‘
Harmonizing to I-cube study ( 2009-2010 ) , most of people in rural Indians can non afford to computing machine. It besides found that about approximately 37 % cyberspace users entree cyberspace in cybercafe ( prabhudesai, 2010 ) . As per IMRB International study merely approximately 25 % of cyberspace users in India usage cyberspace while 3 % of them use less than one time in three months ( Digital scheme consulting,2010 ) . About approximately 87 % of the cyberspace users in India are utilizing cyberspace for look intoing mails and about 80 % are seeking general information on cyberspace. There is a rise cyberspace user who log on to societal media from 32 % in 2008 to 45 % in 2009 which indirectly shows that the consciousness of cyberspace is increasing among Indians ( prabhudesai, 2010 ) .
There are about 162 idioms and 80 different linguistic communications spoken in India. When we move from one portion of India to other portion of the India their imposts and linguistic communication differ from each other. For e.g. in Andhra Pradesh they speak Telugu and in Kerala they speak Malayalam ( Kelly etal. 2008 ) . In such a scenario it becomes hard for the sellers to do advertizements which can be promoted in both the provinces. In developed states UK and USA most spoken linguistic communication is English and it becomes easier for sellers to advance their merchandise.
The Drug and Cosmetic Act clearly explains about the forbidden drug advertizements in India. In India advertisement of drugs such as for retrieving sexual effectivity, catamenial upsets, lung diseases, asthma, malignant neoplastic disease particularly prescription drugs are non allowed. The advertizements which mislead or which create false claiming or feeling on populace are non allowed ( India oppi, 2010 ) . Drug and Cosmetic Act exempt ‘s ads in the signifier of literature associated with packaging of drug ( like drug dose, ingredients, jeopardies ) , publicizing in medical, proficient and pharmaceutical generals. Some of the others Acts that controls the usage of advertizements in Indian pharmaceutical industry are The Drugs and Magic Remedies Act 1954 ( India ) , The Federal Food, Drug, and Cosmetic Act ( USA ) ( Shakala, 2010 ) .
Lack of Infrastructure:
The internet advertisement industry in India is in early phases and behaves indistinguishable to that of European advertisement earlier 5 to 8 old ages ( Digital scheme consulting,2010 ) . The wide set rates in India are high to that of in USA and UK. The wide set strength and connectivity is 2.65 % which is really low than the western developed states ( Search Marketing India, 2009 ) . Merely rich Indians have entree to internet who can offer all the above necessities.