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Of branding and marketing: Let the doctor speak up!

Dr Rajan T. D.
Wednesday, November 16, 2005, 08:00 Hrs  [IST]

As a young, energetic medical student, I always wondered why there was a need for medical representatives (MRs) to visit a doctor at all. It seemed quite logical that a qualified doctor would usually know about the drugs that he needed to prescribe to his patients. If at all he were to forget the brand name of an uncommon drug, then he would refer to one of the drug indices available. As my 12-month rotating internship came to an end, I realised that there is more to it than meets the eye: there are numerous brands of the same drug in the market and they are manufactured by different companies with varying standards of purity which ultimately affects the efficacy of therapy. By then it was clear that visits by MRs are necessary for the physician to recall the best brands. Moreover, the competition among pharmaceutical companies necessitated that their brands are remembered better by the physician which eventually culminates in greater number of prescriptions.

The pharmaceutical companies in India are certainly doing a good job in providing world-class drugs for our healthcare needs. Yet, there are some significant marketing issues that affect the patient and the doctor which needs to be addressed. During an MR visit to a doctors' clinic the promotion is usually one-sided and ends with the MR hurriedly detailing his brands while the doctor is hard-pressed for time. During such interactions there are several points that physicians like to make but some of them are unable to put it across for want of clarity or time. Two specific areas of concern have been dealt within this issue.

Do frequent visits increase prescription flow?

There was a time when the small number of MRs from a handful of companies would visit the doctor to promote their products. Brands were fewer and sharp-eyed physicians could instantly rattle out the names of the MR, the company as well as the brands, the moment the MR shows his face.

Over the last 15 years the numbers of drugs have doubled, the companies have tripled and brands have quadrupled! According to current estimates there are over 200 major pharmaceutical companies in the country. Some small companies have been taken over by multinationals while others have merged to form large corporations. Many large organizations have split themselves into different divisions so as to focus on specific specialities. All in all there is a chaos of medicinal brands fighting for chemist shelf-space as well as the physicians' neuron-space! The result: today even the most talented doctor is foxed when an MR enters his cabin.

The indefatigable marketing managers sitting in their plush, air-conditioned cabins seem to have worked out a way to capture the doctor's attention. Besides gifting the usual complimentaries and sponsored clinical meetings, they increased the number of reminder visits their MR makes every month.

While in the past the MR visited the doctor once a month, they increased the frequency to once a fortnight. Before the unsuspecting doctor could react, some of the smart companies sent the MR to meet the doctor every week. So, where's the problem?

Undoubtedly, on the face of it, it is a shrewd marketing move to 'help the doctor remember the brands so as to help his suffering patient!' However, it shows a lack of concern for the doctor's precious time. A physician who has started his practice afresh may not mind the MR visiting him tri-weekly as it may give the doctor the opportunity of catching up on the local grapevine - which is one of the allied services provided by smart MRs! However, even fortnightly visits would not be appreciated by others who would like to use that little free time for other activities.

A busy doctor usually looks for short pauses between his consultation to call up his child's school principal or an ailing relative. Others would like to simply take a deep breath and unwind. The physician's free time should be respected. Simply because the doctor is not seeing a patient does not mean that he is truly free. It would be worthwhile to find out if he enjoys the MR's intrusion. A smart manager would enquire from the doctor what frequency of visits would be comfortable to him rather than unilaterally impose the MR on him!

The alphabet murderers

Brand names of most new drugs are so similar sounding that the doctors' ability to memorise names is put to the ultimate test. As if there is a shortage of alphabets in the English language, most pharmaceutical companies have stopped thinking beyond Z. In the past over a decade there seems to be a rush among some pharmaceutical companies to register all drugs with a name starting with the alphabet Z. You name it … Zo, Zocef, Zoxan, Zospar, Zocef, Zocon, Zinetac, Zyncet, Zyrtec, Zylera, Zoflut, Zevit, Zathrin, Zigat, Zimig, Zupar, zzzzzzz…puts one to zzleep!

The success of one brand name usually persuades the product management team to register a similar name for their newer drugs. One can understand their argument that it is easier to retain the doctor's mind space with a similar name which is already firing from his grey cells. It seemed like a well researched strategy for some time and it has helped improve the bottom-line of many companies. So what's the problem? The problem is very simple. The pharmaceutical industry has completed the entire barakhadi of Za zaa, zi zee, zu zoo, ze zy, zum zah….leaving no room for imagination.

These similar sounding names cause chaos both at the chemists' shops and also when patient consumes them.

These are not the only problems for the doctor. Even today a good number of doctors remember the Hippocrates's oath and carry out their practice ethically. Imagine what an educated patient who gets a prescription that is similar to Table 1 would think. Some doctors have been asked by patients whether they write all the medicines manufactured by just one company! Why? "Because, doctor, the last time I had fever your wrote Zocef and Zyrtec and now you have written Zathrin and Zylera."

Table 1:
Sample prescription by a dermatologist
T. Zathrin 250 mg 1 BD x 6 d
T. Zylera OD x 10 d
Z oflut cream for LA HS

The increasing tendency among physicians to prefer particular companies' brands are being noticed by keen patients. A preference for a single alphabet may have been a smart marketing move at the outset but repeatedly flogging the same horse may kill it!

-- The author is a specialist in Skin & Sexually Transmitted Diseases, Mumbai. Email: rajan.td@gmail.com


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