ISSN 0976 -3090 (Print), 2231- 0541 (Online)

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REVIEW ARTICLE

ROLE OF E-MARKETING IN PHARMACEUTICAL BUSINESS

V.S.SHEEJA*, M.V.NAVEEN, N.R.PRASAD, T.SATHIBABU and R.MURALI KRISHNA College of Pharmacy, SRM University, Kattankulathur, Chennai 603 203, India.

ABSTRACT The advent of the Internet has opened a vast new frontier to marketers. The pharmaceutical industry is in its infancy in this area. This paper provides an overview of problems and challenges of e-marketing in developing nations, particularly focusing on Indian pharmaceutical market. Specific physicians that treat a specific diagnosis are hard to reach. The same may be said for the patients this industry may try to market their product to. The industry has so far, focused its attention on a marketing mix of traditional marketing ideas such as printed materials, educational materials, and the traditional sales force. Overcoming these challenges will elevate the Indian contribution to worlds pharmaceutical market which is currently less than 2%.These challenges lead to compelling research questions and possible future research agendas within this domain. The internet is helping to globalize and to change the nature of pharmaceutical marketing, and thus raises some new challenges for regulators. KEY WORDS Electronic detailing, E-Marketing, Search Engine Marketing, Drug promotion

INTRODUCTION The pharmaceutical marketing strategies (as well as advertising strategies) are different from other businesses because pharmaceuticals or drugs can negatively affect both- the end consumers or the patients and the health care profession. Also, the advertising strategies included in the marketing plan of any pharmaceutical company are not 'direct to consumer'. Any pharmaceutical marketing strategy targets the health care professionals or the Doctors who in turn prescribe the drugs to the patients (end consumers) liable to pay for the products.1

can greatly expand a company's reach. For example, a popular video on YouTube may potentially be seen by thousands of people. Perhaps more importantly, internet-based technologies are enabling new styles of communication between the industry and its targets, including more interactive and customer-responsive campaigns.. SATATEMENT OF PROBLEM The marketing of prescription drugs is a significant business. Prescription drug sales in the USA alone were $228.8 billion in 2003. Therefore, companies are assertive in their promotion of prescription drugs. In addition, there does not appear to be any slowing down or leveling off of the drug company expenditures on promotion. In fact, expenditures on promotion more than quadrupled

The internet and related technologies have revolutionized many aspects of society. For the pharmaceutical industry, as for other sectors, this has brought new marketing opportunities. The internet

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from 1998 to 2004, increasing from $12.7 billion to $57.5 billion. Physicians are facing financial pressure as reimbursement from managed care and government decline. Coupled with rising malpractice insurance costs, physicians are reacting by seeing more patients daily. These changes leave little time for visits with PSRs. Since 1995, the physician over the same period, the number of pharmaceutical representatives has grown 94 percent, to more than 81,000 populations has grown just 15 percent. The quest resulted in the emergence of electronic detailing (e-detailing). PHARMA E-MARKETING In the context of drug promotion, detailing has traditionally involved face-to-face contact between a visiting sales representative and a health professional. However, drug companies, especially in North America and Europe, are increasingly adopting electronic detailing as the process to market their products. E-detailing includes diverse strategies, such as videoconferencing, the provision of electronic education modules, and the use of email and related technologies as prompts and to promote two-way communications. Presentations to a pharmaceutical marketing conference in Europe suggest that e-detailing is not popular with all doctors. However, it is cheaper than traditional sales representatives and can result in a significant return on investment through increased sales. Top companies are providing financial incentives for doctors to participate in e-detailing, such as honoraria, product samples, practice tools, and patient education resources.2 REVIEW OF LITERATURE Presentations to a pharmaceutical marketing conference in Europe suggest that e-detailing is not popular with all doctors.3 However; it is

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cheaper than traditional sales representatives and can result in a significant return on investment through increased sales. Some companies are providing financial incentives for doctors to participate in edetailing, such as honoraria, product samples, practice tools, and patient education resources.4 In the USA, Pfizer runs such a program (www.get-quit.com) for varenicline users, providing regular emails and other prompts such as a personalized web page to support their product use. Wyeth Consumer Health Care website (www.caltrate.com.au) sounds the alarm on osteoporosis and encourages people to see a doctor if they answer yes to any questions on a 'one minute risk test'. An important aspect of e-detailing is that it enables 'predictive marketing'. This means that companies can be more effective and timely in eliciting feedback from prescribers in order to tailor marketing strategies to their individual preferences and needs.5 Reuters Business Insight Health Care (2003), Physician targeted internet promotion: online solutions to declining productivity in the sales process stated that Video e-detailing is more closely related to traditional detailing than virtual e-detailing (Reuters Business Insight Health Care, 2003). Forrester surveyed several hundred physicians who were asked if they believe that e-detailing is a replacement for representatives. The study results showed that more than half of the physicians surveyed (53 percent) disagreed or strongly disagreed with that statement in comparison to 24 percent of physicians who agreed or strongly agreed. The global reach of the internet means that Australians now have easy access to overseas

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blogs and websites promoting prescription

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Large or overly-complicated websites connected to the Internet via dial-up connections The inability of shoppers to touch, smell, taste or "try on" tangible goods before making an online purchase can be limiting. Cyber crime: Many consumers are hesitant to purchase items over the Internet because they do not trust that their personal information will remain private. Recently some companies that do business online

medicines and other products, and even selling them. Safety concerns have been raised about the purchase of prescription, non-prescription and complementary medicines over the internet.6,7 Pharmaceutical companies are also seeking to capitalize on medical social networking sites. Pfizer, for example, is reportedly collaborating with Sermo Inc, a web venture based in Cambridge USA, where tens of thousands of doctors discuss diagnostic and treatment issues in anonymous postings. 8,9 Search Engine Marketing It referred to as Search Marketing or SEM, is fast upand-coming as a great online client achievement feed. A lot of companies are now attracting Search Engine Marketing very acutely because, it has an unbelievable return on investment (ROI) and has incredible potential for Lead generation, increased sales revenue, Greater brand attentiveness and better corporate visibility. Search Engine Marketing is about making sure that your web site appears on the top 20 of search results every time potential customers search for whatever products and/or services that you offer on any of the major Search Engines including Google, Yahoo and MSN which collectively accounts for over 90% of all Search Engine originating traffic. CHALLENGES IN PHARMA E-MARKETING 10 The main challenges in E-marketing being faced by developing countries are listed below: E-marketing requires customers to use newer technologies rather than traditional media. Low-speed Internet connections.

have been caught giving away or selling information about their customers. Another major security concern that consumers have with e-commerce merchants is whether or not they will receive exactly what they purchase. Online payment mechanisms (credit cards, PayPal, Google Checkout) are not more preferred due to the hike in online frauds. Low E-marketing Education: A well informed and educated people tend to be prosperous investors and consumers. This is because they will imbibe the culture and tenets of marketing. But Emarketing education is still generally low in developing countries. Even when some people acquire higher degrees in the field of Emarketing and business administration, they come out doing the contrary, instead of practicing the true E-marketing concept or relationship E-marketing for the benefit of the society as a whole most of the people, though educated, yet often compromise ethical Emarketing practices for worst alternatives such as sharp practices, unwholesome behavior and smuggling that contribute less to gross total earnings of any country.

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high cost of doing business in developing

Preferences for Foreign Products: Because of the development process of most Asian countries and their inability to produce most goods (especially technologically sophisticated products), they tend to prefer buying from the more industrialized countries. This makes the development process of local industries and commercial life of the people more impoverished. Developing countries constitute 71% of the worlds population, but only contribute about 12% of the worlds industrial production that often boost Emarketing in these economies.

countries. Few Competitive Opportunities: are not Lucrative much in

competitive

businesses

developing countries. What are commonly found within African continent are peasant farmers, petty traders and negligible number of investors that are not engaged in multimillion dollars business. In most developed societies economic policies have long assumed that competition among businesses is the most efficient method of producing and E-marketing goods and services. Political Instability and Civil Unrest: Rapid economic growth and development of Emarketing techniques cannot be achieved or attained in an environment of political and social instability or political hostility. Political stability implies an orderly system for a positive change in governance and peaceful co- existence amongst the citizenry that, poses a great challenge to marketing. Therefore, E-marketing does not thrive where there is political instability and insecurity or civil disturbances.

High cost of production: E-marketing has suffered dearly in most developing countries because virtually all production techniques are imported from the developed world. The cost of acquiring equipment and other inputs used for production locally to boost E-marketing is sometimes extremely exhaubitant for the poor developing countries to buy and finance. The income generated from them can only buy little from all that is needed to encourage domestic production, in order to enhance marketing.

Inadequate Infrastructures: Most developing countries are very poor, such that some of them depend on aids from abroad. There are cases of debt accrual and debt burden hugging on to be paid. It invariable becomes difficult for some of them to provide the necessary infrastructures that would engender and propel smooth Emarketing scenario. Apart from the deliberate embezzlement by some top government officials, the government is yet to provide these infrastructures, and this has made it difficult for E-marketing activities to be performed effectively and efficiently. Moreover, the inadequacy and poor state of these infrastructures contribute to

OPPORTUNITIES IN E-MARKETING 10 Growing Population: Before multinational

companies establish their hold in any country they expect to have a ready market for their products and services. No business flourishes where people are not living or where it is not habitable by people. Developed countries with their small population and saturated domestic markets prefer E-marketing their products and services to emerging markets in developing countries. Nigeria being one of the most populous nations in Asia is a ready market for both domestic products and foreign brands. This is

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because E-marketing does not operate in a vacuum but requires a large population of people with the willingness to do business and patronize businesses. Absence of Competition and Large Unexplored Markets: By virtue of their large populations and underdevelopment, developing countries have large markets that are not yet served or are partially served. Thus they are not as saturated as those of developed countries. The economies of these nations hold great opportunities for innovators, investors and marketers to enjoy booms in their markets with much challenge from competitors within and outside. Attractive Government Incentives: Trade policies in most developing countries are becoming quite favorable to both local and foreign investors. These incentives include profit tax holidays, reduced or even free customs and excise duties, liberalization of immigration and profit repatriation laws for foreign investors. There are also improvements in infrastructural facilities that will ginger the performance of E-marketing in these economies. Growing Affluence: Quite a large number of the consumers in developing countries are becoming affluent. This will enable them to have reasonable discretionary income and purchasing power. This means that a growing number of the consumers in many developing countries can now afford luxuries and other products they could not purchase in the time past. Availability of Cheap Production Inputs: Most developing countries are endowed with abundant human and material resources that are yet untapped. These will be readily handy for Geo targeting: Geo

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companies and businesses to exploit. Despite the high level of poverty and low exchange values of the national currencies of developing countries, labour and raw materials or inputs are often found to be cheap and it is envisaged that in the nearest future it will be cheaper because of better opportunities and more goods will be produced for consumption. OTHER PROSPECTS OF E-MARKETING 10 One-to-one approach: The targeted user is typically browsing the Internet alone therefore the marketing messages can reach them personally. This approach is used in search marketing, where the advertisements are based on search engine keywords entered by the user. Appeal to specific interests: Internet marketing and geo marketing places an emphasis on marketing that appeals to a specific behavior or interest, rather than reaching out to a broadlydefined marketers demographic. typically "Onand their Off-line" markets segment

according to age group, gender, geography, and other general factors. Marketers have the luxury of targeting by activity and geo-location. targeting (in internet

marketing) and geo marketing are the methods of determining the geo-location (the physical location) of a website visitor with geo-location software, and delivering different content to that visitor based on his or her location, such as country, region/state, city, metro code/zip code, organization, Internet Protocol (IP) address, ISP or other criteria. Different content by choice: A typical example for different content by choice in geo targeting is

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the FedEx website at FedEx.com where users have the choice to select their country location first and are then presented with a different site or article content depending on their selection. Automated different content: With automated different content in Internet marketing and geomarketing, the delivery of different content based on the geographical geo-location and other personal information is automated.

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This ultimately led pharmaceutical companies to use e-marketing as a complementary approach to traditional one. Many commercial studies show inconsistent reports for e-marketing prevalence among physicians in the USA that ranges from 25 percent to 60 percent. The review has uncovered several areas where scientific research should be valuable. From the institutional policy makers perspective, studies are needed for conducting and reporting well designed research studies on the effects of e-detailing on prescribing.11 Results of such studies could help in understanding and quantifying e-

Through social networking dating sites: The situation analysis for E-marketing bridges the internal audit and competitor research. It answers the question where are we now in terms of our E-marketing (internal v external

detailings impact on the physician decisions of prescription drug selection.

REFERENCES 1. International Journal of Pharmaceutical and Healthcare Marketing, Electronic detailing (edetailing) of pharmaceuticals to physicians: a review Vol. 2 No. 3, 2008, pp. 235-245 2. 3. Australian Prescriber, pharma internet marketing (Aust Prescr 2009;32:(2-4) Heutschi R, Legner C, Schiesser A, Barak V, sterle H. Potential benefits and challenges 73. 4. Bates AK. Conference Insights: Online marketing and eDetailing: in-depth report from an eye for pharma conference. J Med Market 2006;6:298300. 5. Lerer L. E-business in the pharmaceutical industry. J Med Market 2002;3:69-73. 6. Bessell TL, Anderson JN, Silagy CA, Sansom LN, Hiller JE. Surfing, self-medicating and safety: buying non-prescription and complementary medicines via the internet. Qual Saf Health Care 2003;12:88-92. of edetailing in Europe. J Med Market 2003;3:263-

perspective)? The analysis literally considers your E-marketing situation by considering the fit between internal and external factors. REGULATION The Medicines Australia Code of Conduct attempts to regulate the promotion of prescription medicines on the internet. However, it is difficult to police the anonymous marketing of drugs on blogs and forums, or to regulate consumers' access to information from countries where pharmaceutical marketing may be less regulated than in Australia. From the buyer's perspective, the inability of the doctors to touch, smell, taste or "try on" tangible goods before making an online purchase can be limiting. However, there is an industry standard for e-commerce vendors to reassure customers by having liberal return policies as well as providing in-store pick-up services. CONCLUSION A combination of different factors has led to an ever decreasing ROI from traditional marketing practices.

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7. Armstrong K, Schwartz JS, Asch DA. Direct sale of sildenafil (Viagra) to consumers over the Internet. N Engl J Med 1999;341:1389-92. 8. Pfizer becomes latest to partner with fastgrowing online doctors' forum Sermo. The Age (Melbourne). 2007 Oct 15. http://healthyskepticism.org/library/2007.php Go to HSL12469 [cited 2008 Nov 18] 9. Johnson A. Pfizer-doctors web pact may get looks. The Wall Street Journal. 2007 Oct 15. http://healthyskepticism.org/library/2007.php Go to HSL12470 [cited 2008 Nov 18] 10 www.nkadoj.blogspot.com By Nkado Joshua. 11 Boulos MN, Maramba I, Wheeler S. Wikis, blogs and podcasts: a new generation of Web-based tools for virtual collaborative clinical practice and education. BMC Med Educ 2006;6:41. 12 Story, Louise and comScore (March 10, 2008). "They Know More Than You Think" (JPEG). in Story, Louise (March 10, 2008). "To Aim Ads, Web Is Keeping Closer Eye on You". The New

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13 Food and Drug Administration. Patient safety news: New safety warnings about Chantix www.youtube.com/watch?v=ep3U0SVfpW4 [cited 2008 Nov 18] 14 Mediapost (Blog) - Why Marketers are Not Investing Online 15 Baker London. 16 Kinsey, J. (1988). E-Marketing in Developing Countries. Macmillan Publishers, London. 17 kotler, P. and Armstrong, G. (2001). Principles of Marketing. Prentice Hall of India, Private Limited New Delhi- 110001, Ninth Edition. 18 Stapleton, J. (1984). E-Marketing. London: M. J. (1985). E-Marketing: An Introductory Text. Macmillan Publishers Ltd. .

Hodder and Sronghtonal Research. 19 Pearce, M. (1998). Macmillan Dictionary of Modern Economics. Macmillan Press Ltd. London. Social Development. 20 http://healthyskepticism.org/library/2007.php 21 www.biomedcentral.com/1472-6920/6/41

York Times (The New York Times Company).

Retrieved 2008-03-09.

ADDRESS FOR CORRESPONDENCE vssheeja76@hotmail.com

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