The insights driving superior healthcare
outcomes in Asia Pacific.
Asia-Pacific Insight Magazine brings together IMS Health experts from across the region to engage in conversations about the forces that are shaping healthcare in Asia - and the strategies necessary to surge ahead of the competition
1. IMS Asia-Pacific
INSIDE THIS ISSUE
• Improving Healthcare Access in India—A Role for Industry
• Patient Centricity: A Disruptive Strategy for Growth in Asia
• New Strategies for Reviving Growth in Australia
• Growing Pains in China
InsightIssue 4 | 2014
2. 2
Welcome Letter.................................................................................................................................................................................3
Improving Healthcare Access in India—A Role for Industry..............................................................................5
In July 2013, the IMS Institute for Healthcare Informatics, India provided a fresh perspective on healthcare access in India
– the most comprehensive of its kind since 2004.This article presents the highlights of that study, with suggestions on
what the findings mean for life sciences companies already in — or planning to enter — the Indian market.
Patient Centricity: A Disruptive Strategy for Growth in Asia .........................................................................11
As MNCs strive to innovate and stay competitive, understanding the patient perspective allows them to“see the
world in a different way.”And in Asia, where healthcare is hampered by the“Triple-A”challenges of Affordability,
Access and Awareness, understanding and empowering patients will be central to making significant advances.
New Strategies for Reviving Growth in Australia ......................................................................................................17
The Australian pharmaceutical market is one of the most mature in the region; it is also one of the toughest.
This article looks at the all-too-familiar challenges facing MNCs, and discusses new approaches — even radically
different ones — to turn the situation around.
Growing Pains in China......................................................................................................................................................23
Although at first glance China would seem to be a world of never-ending opportunities for Pharma companies, there
are key variations in growth across regions, therapy areas and drug categories, each of which demands analysis, not
assumption. Here, IMS Health experts discuss the variety of options MNCs have to improve their actual performance,
ranging across levels of difficulty and the degree of transformation necessary.
Contents
3. 3
Welcome letter
Here in Asia Pacific, IMS Health is committed, as we are elsewhere in the
world, to helping our clients anticipate the ever-changing healthcare
marketplace. Many events that occurred in 2013 in our highly dynamic
region — whether related to compliance in China, access and affordability
of healthcare in India or tighter drug regulation in Korea and Australia —
corroborate the necessity for us to provide meaningful insight to power
your winning strategies.
To further this effort, we’re increasing our investment in technology and
services, enabling end-to-end solutions for our clients. We are also
establishing stronger ties with stakeholders across the healthcare continuum,
ranging from payers and providers to patients and governments.We are, in fact, in an
increasingly central position to help“connect the dots”for all players in the healthcare environment, and
ultimately to improve our healthcare systems.
I hope you will see evidence of these broad goals and their specific supporting initiatives in the pages that
follow. We’ve analyzed a wealth of data and drawn upon our best-in-class knowledge of local and regional
market practices and trends to deliver insights and recommendations that offer a fresh perspective on the
challenges and opportunities in this incredibly dynamic part of the world.
In this issue, you’ll find:
• A summary of the IMS Institute for Healthcare Informatics report on UnderstandingHealthcareAccessin
India, which is the first comprehensive study on the subject in nearly a decade.
• An exploration of how patient centricity could be a“game changer”for multinational companies
operating in Asia.
• Recommendations on strategies that multinational companies operating in Australia, one of the toughest
markets in Asia-Pacific, can use to overcome such challenges as market access, payer cost containment
and loss of exclusivity to spur growth.
• Our views on how MNCs should be analyzing the Chinese market in order to close what for many will be a
double-digit gap in top-line growth over the next three years.
As we move forward in this environment, we will maintain our unrelenting focus on combining information,
technology, and services in new ways to help our clients realize their potential for growth and achieve improved
health outcomes across the region.
Sincerely,
Robert Chu
President Asia Pacific & China
5. 5
AHolisticDefinitionofAccess
Traditionally, access to healthcare has been evaluated purely on the physical accessibility to, and affordability of,
care. Access, however, is a much more complex issue that must be viewed holistically along four dimensions:
1. A patient's physical accessibility to healthcare facilities
2. Availability/capacity of the required resources for patient treatment
3. Quality/functionality of the resources providing care
4. Affordability of the complete treatment to the patient
The most fundamental findings of the
study involve the interconnectivity of
these dimensions, such that:
• All types of access must be met
for a patient to receive appropriate
healthcare treatment.
• The more dimensions on which
gaps exist, the lower the level of
access will be.
• Issues involving the first three
dimensions must be addressed
before efforts to improve
affordability can have any
significant impact.
The last comprehensive study on healthcare access in India was conducted nearly a
decade ago. In July 2013, the IMS Institute for Healthcare Informatics, India provided a
fresh perspective in Understanding Healthcare Access in India: What is the Current
State?This report summarizes the most comprehensive assessment of healthcare
access since 2004 and delivers current, objective evidence on its various dimensions.
The quantitative study involved an extensive nationwide survey of households and was
supplemented by qualitative interviews with doctors and experts.
The study highlights are presented below, with suggestions on what the findings mean
for life sciences companies already in—or planning to enter—the Indian market.
Ideally, the industry will use this information to adopt a common message platform
in discussing how to improve healthcare access in India in the coming years.
Improving Healthcare Access
in India—A Role for Industry
Stages of Healthcare Access
FIGURE 1 Dimensions of healthcare access
1.
Physical
accessibility/
location
2.
Availability/
Capacity
3.
Quality/
Functionality
Location:
Rural vs Urban
IP1
vs OP2
Acute vs Chronic
Channels:
Private vs Public
Impact on Usage
Components:
IP vs OP
Acute vs Chronic
Income Levels
4.
Affordability
1
IP-Inpatient 2
OP-Outpatient
6. 6
Study Highlights: Gaps Caused by
Insufficient Infrastructure
Over the past decade, the Indian
government's investment in
improving healthcare access
has brought about remarkable
improvement. Nonetheless, India
still suffers from inadequacies in its
healthcare infrastructure with the
following effects:
• Provision of healthcare services is
skewed toward urban centers
and the private sector. Urban
residents have access to a
disproportionate number of the
country's hospital beds, and
healthcare workers are highly
concentrated in urban areas
and the private sector. As a result,
rural patients have to travel greater
distances to access healthcare
(either to other villages or to the
nearest urban center), a hardship
that is exacerbated by the poor
connectivity of highways and the
lack of public transportation.
In addition, "unless drastic
measures are taken to increase
the number of doctors in
the public facilities, other
investments to improve access—
either by constructing new
health facilities or providing free
medicines—will go to waste,”says
Amardeep Udeshi, Associate
Principal, IMS Health India.
• Physical proximity to healthcare
facilities poses a challenge in
rural areas, particularly for
patients with chronic ailments.
As a result, treatment is often
deferred or sought at a closer,
more costly facility that may not
bebestsuitedtothepatient'sneeds.
• Gapsinthequalityandavailability
ofservicesatpublichealthcare
facilitiesaredrivinganincreasing
percentageofpatientstoprivate
facilities. Over the past 25 years,
rural and urban patients alike have
increased their use of private
service providers due to long
waiting times and a lack of
diagnostic equipment at public
options. Physician absenteeism is
a key cause of these gaps in quality
and availability within public
facilities.This problem exists in both
ruralandurbanareas,butistypically
mostintenseinthelesseconomically
developed states of India.
• Patientsusingprivatefacilities
faceaffordabilityhardships.
The cost of treatment at private
healthcare facilities is two to nine
times higher than at public
facilities. Each outpatient
treatment for a chronic condition
received at a private facility costs
patients an average of 44 percent
of their monthly household
expenditure.
• Medicine costs as a proportion
of out-of-pocket (OOP) healthcare
expenses remain high (at 60 percent
for outpatient and 40 percent for
inpatient). Low insurance
penetration—and current
insurance plans that do not cover
drug costs—make the total cost
ofmedicinesacontinuing,significant
component of OOP expenses and
an inconvenience for a majority of
the population.The trend, however,
is in the right direction. Over the
last two decades, the share of OOP
expenses for outpatient care
devoted to medicines has
decreased from 82 percent to 63
percent. In other non-reimbursed
markets,itisinthe30-35percent
range.
StudyConclusions: ManyIssues
MorePressingthanPrice
IMS Institute analysts modeled and
assessed the relative impact of
improvements across each of the
four components of healthcare
access: Physical accessibility, resource
Improving Healthcare Access in India—A Role for Industry
Channel diversion due to lack of availability of quality healthcare resources
FIGURE 2 Diversion of patients to private channels from public healthcare facilities
74% Patients Doctor Consultation Diagnostics/Medicine
Government Sector
Private Sector
Most patients are
using high cost
private channel
Further diversion when government doctors send patients
for diagnostics to private facilities or when patients have
to purchase essential medicines from private channels
26%
1 2
Patients Doctor Consultation
Diversion
Diagnostics/Medicine
7. 7
availability/capacity, quality of
resources, treatment affordability.
They determined:
• The challenges are different in
different segments of the
population. Thus, interventions
need to be tailored to each
economic stratum and
geography.
• Solutions for improving
healthcare access must be
multi-pronged and, because
the challenge is so daunting,
will need to involve government
entities, private enterprises and
non-government organizations
(NGOs). Affecting any meaningful
change will take years.
• Improving the quality and
availability of public healthcare
facilities would drive the greatest
reduction in patient out-of-pocket
costs. By curbing the diversion
of patients to high-cost private
channels, this could realize a
40-45 percent reduction in
out-of-pocket expenditures
for both outpatient and inpatient
treatments.
• Pricing is just one issue—and
not even the most pressing one.
Simply making drugs affordable
will not fix the problem; if there
are no doctors available to treat
patients, and if diagnostics and
medicines are in short supply,
the cost of drugs is almost
irrelevant. (What is more, no
matter how much the price of
drugs is reduced, anything short
of offering them for free leaves
them still out of reach for the 40
percent of the population below
the poverty line).
• Creating sustainable policy
solutions to healthcare financing,
infrastructure and human resource
shortages will require recognizing
the interdependencies of the
issues, setting priorities, and
measuring ongoing progress.
ACoordinatedResponse
Any company operating in India
has undoubtedly experienced the
dilemma that the study underscores:
because the urban markets are
becoming saturated, future growth
will emanate from rural regions—
yet it is impossible to realize that
potential until the limitations in
the infrastructure are addressed.
And substantially improving the
availability of care in the rural
interior will take years and possibly
decades.
"The magnitude of the challenge
calls for heavy investment, a
systematic approach and both
short- and long-term initiatives
undertaken by multiple stakeholders,"
asserts Mr. Udeshi. "As leaders in
the life sciences industry read the
report, we hope they'll keep one
question in mind: is there scope for
our business to contribute to the
solution? At IMS Health, we believe
that the industry's participation can
be a win-win situation, ultimately
leading to market expansion and
growth."
Already, members of industry
associations such as the Organization
of Pharmaceutical Producers of
India (OPPI) have recommended
that the industry approach the
problem in a coordinated effort,
with individual companies
"adopting" each of India's 27 states
to form a close working relationship.
By fanning out in this fashion,
industry leaders could share their
understanding of the issues with
local authorities, identify their
specific bottlenecks to progress,
learn what kinds of assistance
they need and then engage in a
discussion of how they can help.
Arun Maira, a member of the Planning
Commission of India, notes, "Fixes
to only parts of the system cannot
produce the systemic changes
required. In fact, fixing only a part,
without considering their effects
on other parts of the system, can
backfire—as indeed some attempts
are. IMS Health's study provides an
objective map of the whole system,
which can be used to show where
the leverage points for action are
and to engage stakeholders to
arrive at agreements of what
strategies will improve the system’s
performance."
Creative,butRealisticInitiatives
forImprovingAccess
Individual companies, working in
collaboration with government
organizations and NGOs, could
lend their expertise and resources
to help improve how healthcare
services are being delivered in India.
Creative solutions delivered through
Public Private Partnerships (PPPs)—
such as those already established
to provide mobile hospital services,
improve emergency response and
support medical colleges—might
include:
• Helping to strengthen the medical
supply chain, which is currently
very inefficient. Shortages of
supplies and medicines in public
8. 8
Improving Healthcare Access in India—A Role for Industry
facilities are very common.
The pharmaceutical industry
has a very efficient distribution
model and could help the
government of India streamline
how drugs reach remote areas.
Some Indian officials have even
suggested that the supply chain
needs to be privatized. "This
notion has some merit," agrees
Amit Backliwal, General Manager,
IMSHealthSouthAsia."The
accountability inherent in private
enterprise would help ensure
efficiencies in the ongoing
management of the system."
• Developing and running disease
management and wellness
programs. This could take the
form of funding and training
auxiliary healthcare workers to
work in remote areas of the country,
increasing awareness of disease,
promoting health screenings and
offering education on nutrition
and women's health, for example.
• Sponsoring physicians in their
outreach programs. Currently,
many physicians take mobile
units into the countryside, and
MNCs could, for instance, fund
such ventures.
• Introducing telemedicine to
connect physicians and healthcare
workers with specialists and
supervising physicians who can
provide consultations and
monitor vital signs from a
distance.
• Helping to create awareness
about diseases and communicate
the availability and benefits of
existing government programs,
including insurance (less than 40
percent of the population is aware
of an existing government-
sponsored insurance scheme).
Companies might also, of their
own accord, create flexible
financing options for patients,
such as allowing them to pay for
an expensive treatment over the
course of a year. Such a short-term
move could help mitigate immediate
concerns related to affordability.
Of these possibilities, those that are
financially viable and follow clearly
laid out guidelines and standard
operating procedures are the ones
that are most likely to succeed. It will,
of course, take time to build a
relationship with the government
and to create a climate of trust.
However, having the fundamentals of
healthcare access clearly understood
by all parties will help private
companies in initiating and managing
conversations with policymakers.
A clear "take away" from the IMS
Institute report is that moving
the needle of access calls for a
multitude of approaches. "The
pharmaceutical industry needs to
play an integral part in contributing
to this development because,
ultimately, creating a strong
infrastructure will lead to a more
robust market with greater potential
for the industry," explains
Mr. Backliwal.
ASpringboardtoAction
Understanding Healthcare Access
in India gives all stakeholders the
information needed to advance
the debate on next steps and to
guide future investment. For the
life sciences industry and the
government, the study findings
provide proof points for re-orienting
the discussion away from measures
to control prices and toward ways
to improve availability of public
health resources and to raise overall
performance levels.
"Our hope," concludes Murray
Aitken, Executive Director of IMS
Institute for Healthcare Informatics,
"is that these findings serve as a
springboard to action. With fresh
insights into access barriers, the
industry can contribute in
meaningful ways to the solutions
and in the long run, improve their
own performance levels in India."
9. AbouttheStudy
The IMS Institute's study: Understanding Healthcare Access in India was conducted in 2012 in order to:
• Quantify current levels of access across the country
• Identify the issues limiting access
• Prioritize gaps to be addressed
• Present a roadmap to guide future improvements and resource allocations
Data was collected via on-the-ground research with 14,746 households across 12 representative states, urban
centers, villages and rural areas across all socio-economic segments. In addition, interviews were conducted with
1,011 doctors and external experts.
Funding was provided by the Organization of Pharmaceutical Producers of India (OPPI) and the Pharmaceutical Research
and Manufacturers of America (PhRMA) and supported by the Indian Drug Manufacturers' Association (IDMA).
The full study is available for download at www.theimsinstitute.org.
To continue the conversation, please contact
Amardeep Udeshi, Associate Principal, IMS Health India, at audeshi@imscg.com
9
11. 11
According to trendwatcher.com, "No matter what market or industry you're in, if you're
obsessed with catering to evolving consumer needs, desires, and expectations, you
will prosper through even insane global upheavals."This is especially true in the global
healthcare marketplace, and particularly in the emerging Asian market.
Asia has always challenged multinational companies (MNCs) to innovate and stay
competitive in a healthcare environment hampered by the "Triple-A”challenges of
Affordability, Access, and Awareness. Historically, MNCs have dealt with these through
commercial strategies that engage physician and payers. However, the balance of
power is rapidly shifting towards the patient, who is more empowered today and who,
in many Asian markets, pays for over 50% of healthcare expenditure out of pocket.
In such markets, understanding the patient perspective and addressing their unmet
needs along the key dimensions of treatment, services and access will be central to
making significant advances.
Patient Centricity: A Disruptive
Strategy for Growth in Asia
TheCallforPatientCentricityinAsia
In addition to patients’growing
importance as a key stakeholder, and
their ability and willingness to pay,
there are a number of other reasons
why patient centricity should be a
priority in Asia.
• Patient centricity offers MNCs a
means to differentiate from
generics and local incumbents.
To compete in the low price game
led by generics and local players,
MNCs are tasked with constantly
finding new ways to compete; one
way to do this is to partner with
governments and other stakeholders
to influence healthcare policy and
shape the value chain, improving
the healthcare landscape at large,
while also boosting brand equity
and recognition.
• Patient centricity is core to tackling
adherence issues, which is also a
key challenge in Asia. According
to a study by Capgemini, non-
adherence causes USD $564 billion
in lost revenue, globally1
. While a
number of pharmacos operating in
Asiahaveruneducationalcampaigns,
launched reminder programs and
offered incentives, these efforts are
insufficient to tackle the root of the
problem: getting patients more
engaged in their treatment decisions.
• Patient centricity in R&D can drive
better healthcare outcomes for
Asian patients. The disease profile is
shifting in many Asian countries,
and there is a strong trend of
emerging pharma R&D models
in Asia that aim to improve
treatment outcomes by specifically
targeting the Asian patient
population. For example, Novartis’
investment in Shanghai to establish
the company’s third largest R&D
centre worldwide aims to tap
into local scientific expertise and
address China’s healthcare needs.
“These challenges and opportunities
are not new,”contends Anthony
Morton-Small, Senior Principal, IMS
Consulting Group, Asia Pacific.
“Yet the relatively conservative
strategies that MNCs have employed
in the Asian market have not yet
fully addressed them.The situation
calls for disruptive approaches
to improving patient disease
awareness and engagement, access
to treatment and affordability—
approaches that are rooted in
patient centricity.”
1
EstimatedAnnualPharmaceuticalRevenueLossDuetoMedicationNon-Adherence,2012,CapgeminiConsulting
12. 12
HowtoBecomePatientCentric
Patient centricity requires
pharmacos to shift from a
traditional, transactional mindset
to a value-oriented model across
the three commercial endeavors:
stakeholder engagement, offering
development and value delivery.
Stakeholders:Whoareweengaging?
Today's model for engaging
stakeholders is complex and
continuously evolving, since multiple
stakeholders now operate in
increasingly interconnected networks
(See Figure 2).
All of these stakeholders directly
or indirectly influence the patient
experience at specific leverage
touchpoints. For instance, patient
forums, advocacy groups and
social networks play a significant
role in driving patient awareness,
education and treatment
experience. For pharmacos,
understanding patient emotions,
preferences and decision choices
by tapping into these channels can
provide a wealth of information on
adherence, switching, outcomes and
overall diagnosis and treatment rates.
Similarly, access and affordability
issues in Asia can be addressed
through innovative programs
which require partnership and
co-operation with a number of
stakeholders ranging from policy
makers and payers to micro-financers
and non-profit organizations.
Engaging with policymakers provides
pharmacos with the opportunity
to shape emerging standards and
policies in Asia, and requires
cooperation with institutional
providers, pharma industry
associations and government/
non–government development
agencies.
Patient Centricity: A Disruptive Strategy for Growth in Asia
Source:IMSSurvey;N=108;3%notdefined
PatientCentricityDefined…andRefined
The concept of patient centricity has been—and is still—evolving. As seen in Figure 1, the majority of IMS Health
clients in Asia view it as a strategic approach to understanding, integrating, and pro-actively addressing patient
needs throughout the healthcare value chain.While this marks a significant shift from traditional thinking, it is still
not transformational. IMS Health, on the other hand, sees patient centricity helping to achieve the "Holy Grail" of
personalized medicine, where pharma can be an active contributor to the patient’s wellness ecosystem by achieving
seamless integration within and across the patient healthcare delivery value chain.
FIGURE 1The Evolution of Patient Centricity
Howwouldyoudefinepatientcentricity? -SurveytoPharmaexecutives
Empowering patients with
information support
Information
Access
Value for
money
Proactive Tx
Management
Strategic Value Based
Planning
Personalized Medicine
Optimizing price –
outcome trade off
demonstrating value to
patients
Accounting for
leverage points along
the patient journey
to optimize patient
experience of care
Understanding,
integrating and
pro-actively addressing
patient needs
throughout the
healthcare value chain
Adopting an
individualized
approach to disease
management by
customizing
medical decisions
and products to the
individual patient
9% 5% 16% 49% 19%
Traditional Transformational
13. 13
Offering: What are we selling?
The next pillar of patient centricity
is the shift from selling products in
isolation, to selling a solution that is
informed by the needs, frustrations,
andvalue-driversallalongthepatient
journey. Many companies map
the patient journey to identify the
nodes of patient value. Some
companies offer innovative solutions.
“Only a few companies, however,
have pushed this to the next level of
mapping the full patient experience
from the pre-symptomatic state to
post-treatment stages,”observes
Amkidit Afable, Engagement
Manager, IMS Consulting Group,
Asia Pacific.“In capturing both on-
and off-treatment experiences,
companies can understand patient
emotions and frustrations that can
impact outcomes—particularly in
Asia where access to healthcare is
often limited.”
Value Delivery: How are we selling it?
For companies to achieve true
patient centricity, every function
across the value chain must become
patient centric (See Figure 3).
Indeed, as reflected in a recent
survey of top and middle managers2
,
IMS Health clients in Asia believe that
an integrated value chain strategy
that is centered on providing solutions
to patients will be a key priority in
the next three to five years. There
are examples of early movers such
as Novo Nordisk, who adopted a
holistic approach to enhancing
diabetes care in China by focusing on
physician training, patient education,
strengthening the healthcare system,
developing public awareness, setting
up local production and R&D. This
strategy has resulted in tremendous
value creation for China and Novo
2
SurveywasconductedbyIMSHealthinNovember2013.Atotalof41responsesweregatheredfromtopexecutives,and67frommiddlemanagers.Toaccessthefullsurveyreport,pleasecontactapac.info@imshealth.com
Lau
nch and comm
erciali
zation Life cycle
man
agement
BRAND
Reg.
Approval
KOL
KOL
Physicians
National
payers
ACADEMIA/
ACADEMICS
ACADEMIA/
ACADEMICS
DIAGNOSTIC
LABORATORIES
Productdevelopment
R&D
and
auth
orization
WHS and
distributors
KOL
Providers
Regional &
Local payers
Marketing &
commercialization
Trac
king, research
& develo
pment
Legacy stakeholder model: Limited stakeholders operating in silos
Lau
nch and comm
erciali
zation Life cycle
man
agement
Patient
Reg.
Approval
Media
Biotech
companies
PAGs and
patient
forums
Caregivers
&
influencers
Industry
association
Policy
makers
Institutional
providers
NGOs
Micro-
financing
bodies
KOL
KOL
Physicians
National
payers
Productdevelopment
R&D
and
auth
orization
WHS and
distributors
KOL
Providers
Regional &
Local payers
Marketing &
commercialization
Trac
king, research
& develo
pment
Emerging stakeholder model: Multiple, interconnected stakeholders
FIGURE 2 A New Model of Interconnected Stakeholders
Traditionalstakeholders/influencers
Emergingstakeholders/influencers
14. 14
Nordisk and resulted in Novo Nordisk
achieving 63% market share (2012)
in the world’s second largest insulin
market.
Broadly, this can take the form of:
• Using patient perspectives in R&D
to develop potential claims and
better inform outcomes. With
new sources of real-world evidence
(RWE) and new technologies
available (such as the ability to
mine social media), it is easier than
ever to understand the patient’s
perspective and identify unmet
needs. While still nascent in Asia,
such strategies are already being
employed in developed economies,
with companies such as Merck,
UCB and Novartis partnering with
PatientsLikeMe, a patient
organization, to gather patient
views on psoriasis, epilepsy and
organ transplant respectively to
better inform outcomes.
• Responding to the local patient
population’s preferences in how
products are manufactured,
supplied and distributed—perhaps
through local partnerships. “There
are nuances to patient behavior
and preferences in every market,”
notes Mr. Afable.“And an
understanding of these must filter
all the way back through the
organization.”Some manufacturers
such as Sanofi have committed
to developing a local
manufacturing strategy in their
priority Asian markets such as
Vietnam. Its recent 75 million U.S.
dollars investment in a new plant
in Vietnam3
is aimed at bringing
medicines within the reach of a
broader population beyond top
tier cities.
• Leveraging Real-World Evidence
(RWE) to improve market access.
There are numerous examples of
affordability and access programs
in Asia aimed at reducing patient
out of pocket spend and increasing
access to middle and bottom of the
pyramid patients. However, as
Asian governments are beginning
to leverage RWE to support their
reimbursement processes,
developing capabilities around
gathering, analysing and applying
patient based real-world outcomes
and "pay for performance" type of
access will become critical.
In Thailand, RWE is used to
facilitate the selection of products
for the national essential list of
medicines, while in Japan and
South Korea it serves to
supplement Randomized
Controlled Trials (RCT) data for
reimbursement listing.
Patient Centricity: A Disruptive Strategy for Growth in Asia
R&D and
portfolio
Supply Chain
& Distribution
Pricing
and Access
Sales and
Marketing
Life Cycle
Management
Manufacturing
Examples of patient centricity (non exhaustive)
• Patient research -
patient oriented
outcomes
• Personalized
medicine –
molecular analysis
• Localprocurement-
increase
affordability
• Partnerships on
delivery systems
& infrastructure
• Multichannel
stakeholder
engagement
• Patient experience
mapping
• Co-ordinate value
chain solutions
• SKU variations-
patient tiering
• Local
manufacturing
flexibility &
response
• Price volume
plays – expanding
the pyramid
• Payforperformance
and patient
outcomes
• Patient insights
for line extensions
(social media)
• Loyalty programs
FIGURE 3 Patient centricity across the value chain
3
http://news.xinhuanet.com/english/business/2013-03/30/c_132272285.htm
15. ConcludingThoughts
When implemented correctly, patient centricity can have a significant impact on the bottom line—particularly in Asia
where solutions to affordability, access and adherence issues all involve the patient. First movers who can integrate
and embed patient centricity into their overarching strategic direction stand to gain competitive differentiation in
the marketplace. This will entail recognizing how multiple stakeholders influence the patient experience, mapping
the full patient journey (beginning pre-diagnosis), and using strong leadership practices to keep everyone in the
organization focused on the same goals. Ideally, the entire organization will be aligned along the same market
construct, aiming for the same goals with the same strategy.
MeasuringandBenchmarking
PatientCentricity
Implementing patient centricity
consistently—and with impact—
requires organizations to diagnose
how patient centric they currently
are and to identify areas for
improvement. This can be done
by assessing their level of patient
centricity as an organization or as a
function, across financial, process,
talent and customer metrics as
illustrated in Figure 4. By doing so,
gaps in organizational structure,
capabilities and resources versus
best practice targets and
benchmarks can be identified
and addressed.
Measure Sample questions (not exhaustive; to be tailored by company) Score
1.To what extent are patient centric activities (e.g. awareness
campaigns, patient assistance programs) rooted in economic goals?
Financial 2. To what extent are we achieving cost synergies (cross brand,
cross function) in our patient centric activities?
3. To what extent are we investing intelligently in patient-related
activities in a systematic and sustainable manner?
4. To what extent is our organizational structure supportive of
providing patients with seamless solutions?
Internal Business
Processes
5. To what extent are we equipped with capabilities (e.g. MCM,
social media, healthcare apps) to interact with our patients?
6. To what extent is our mindset patient centric? (e.g. inclusion
of patient centric goals or business priorities in brand / franchise
plans)
7. To what extent can we map all our patient influencers?
(including their role, decision flows, nodes of influence)
Customer 8. To what extent can we capture and use insights from all our
customers?
9. Is patient satisfaction used in evaluating the performance of a
brand?
10.To what extent do we equip our employees to be more patient
centric?
Learning
and Growth
11.To what extent does our employee performance management
(incentives, KPIs) address patient centricity?
12. To what extent has our organization prioritized patient
centricity in terms of resourcing?
FIGURE 4 Illustrative Scorecard for Measuring Patient Centricity
StructurebasedonKaplan&Norton’sBalancedScorecard:TranslatingStrategyintoAction,
To continue the conversation, or to request our longer white paper on this topic, please contact
Anthony Morton-Small, Senior Principal, IMS Consulting Group, Asia Pacific, at amortonsmall@imscg.com
15
Aroundindustryaveragewithaddressable
gapsacrosskeymetrics
Outperformsindustryaveragewithembedded
bestpracticeinpatientcentricity
Belowtheindustryaveragewithsignificantgaps
acrosskeymetrics
17. 17
The Australian pharmaceutical market is one of the most mature in the region; it is also
one of the toughest. Growth rates have been declining since mid 2010, and the market
actually began to shrink in the latter half of 2013.The reasons are all too familiar to
multinational companies (MNCs): market access challenges, payer cost containment
practices, loss of exclusivity, and generic penetration.
Fortunately, when it comes to developing strategies to overcome these environmental
pressures, Australian affiliates need not be pioneers.They can "stand on the shoulders"
of their counterparts in other mature markets who, over the past few years, have begun
to pursue successful strategies to sustain growth.
The first critical step is to acknowledge that the "tried and true" methods of the past 50
years will no longer suffice and that new approaches—even radically different ones—
may be required to turn the situation around.While there is no turnkey solution, there
are options. However, one of them is not to wait and see; change is no longer optional.
New Strategies for Reviving
Growth in Australia
A Familiar Refrain
Not so long ago (in 2010), the
Australian pharmaceutical market
enjoyed growth rates approaching
10 percent (See Figure 1). Since
then, the growth rate has declined
gradually until late in 2013, when
it dropped more sharply and the
market actually began to contract.
IMS Health forecasts the decline
to continue through 2014 before a
slight recovery in 2015-2017.
This is primarily due to a more
challenging regulatory and
commercial environment—both
for new and mature products.
In general, the issues are similar to
those in other developed markets:
• Gaining market access is difficult
due to reimbursement hurdles.
• Government cost containment
measures are eroding market value.
• Patent expirations are opening
the market to generic penetration
and creating revenue gaps for
R&D companies. Although the
worst of the patent cliff occurred
in 2012, products that lost market
exclusivity in Australia suffered
higher sales erosion than had
historically been the case.
And, more patent expirations are
coming in the next five years.
But, beneath these general features
of a mature market are some
conditions specific to Australia:
• The Government's funding issues
mean that only drugs that can
demonstrate cost effectiveness or
MAT Growth of the Australian Pharmaceutical Market since 2010.
MATgrowth(%)
-4
-2,4%
Audits - Total market Audits - Prescription products only
MATApr10
MATMay10
MATJun10
MATJul10
MATAug10
MATSep10
MATOct10
MATNov10
MATDec10
MATJan11
MATFeb11
MATMar11
MATApr11
MATMay11
MATJun11
MATJul11
MATAug11
MATSep11
MATOct11
MATNov11
MATDec11
MATJan12
MATFeb12
MATMar12
MATApr12
MATMay12
MATJun12
MATJul12
MATAug12
MATSep12
MATOct12
MATNov12
MATDec12
MATJan13
MATFeb13
MATMar13
MATApr13
MATMay13
MATJun13
MATJul13
MATAug13
MATSep13
MATOct13
MATNov13
-1,3%
4
0
8
-2
6
2
10
Source: IMS Health Australia, National Sales Audits
FIGURE 1
18. 18
cost minimization, that are first
to market in a class, or that
address a critical need, will be
approved for reimbursement.
• A number of products seeking to
be included in the Pharmaceutical
Benefits Scheme (PBS) have been
delayed due to insufficient
evidence or variation to defined
comparitor. The Pharmaceutical
Benefits Advisory Committee
(which recommends products for
listing on the PBS) has made it
clear that it is seeking clinical
data with patient relevant
outcomes and an economic
evaluation that tracks the clinical
data from manufacturers to justify
price claims for a precise target
population with a clear
therapeutic indication.
• The mandatory price disclosure
system has been expanded and
accelerated. The price at which
the PBS reimburses drugs with
generics is now recalculated,
based on actual ex-manufacturer
price, every 12 months instead of
18. IMS Health estimates this
shift will cost the industry over
$600 million in value in 2014.
Together, the Australian
government's cost-containment
measures have caused a decline in
value for products on the PBS of
approximately $1 billion over the
12 months from December 2012
to November 2013 alone.
AndtheBeatGoesOn
Given this environment—and
the fact that it is not going to
improve dramatically on its own—
the industry’s performance will
continue to slip unless companies
operating in Australia take action.
The government will continue
to pursue cost containment and
efficiencies in healthcare provision
and coverage. Physicians' prescribing
power will continue to decline as
other stakeholders (e.g., patients,
patient groups, PBAC, PBS, and
pharmacists) exert more influence
on treatment choice. And branded
products will continue to lose share
to generics upon loss of exclusivity.
The combination of conditions in
this complex landscape makes a
compelling case for approaching
the market in new ways.
Unfortunately, there is no panacea
that will cure all, and perhaps even
no easy answers. However, there are
a variety of steps that companies can
take to make a difference. Especially
when undertaken as part of a very
broad and coordinated response,
they have the potential to increase
both top and bottom lines.
Already, we have seen that the
strategies suggested below have had
an impact in other mature markets,
including the US where the industry
and health insurers are partnering
with IMS Health to consolidate and
evaluate large data sets to define
treatment outcomes in the real
life environment.We've also seen
that in Europe, Key Account
Management and improved
stakeholdercommunication is
enabling industry to move closer to
strategic partnerships with health
providers.
UseReal-WorldEvidence
toMaximizetheProduct
The Australian government's focus
on cost containment elevates the
importance of developing value
propositions that withstand economic
evaluation. In fact, the PBAC is
encouraging the industry to provide
Real-World Evidence (RWE)—validated
measures of how marketed products
are used, including their effect on
patient health and disease-related
costs—to support its reimbursement
decisions. RWE could be supplied
from other markets (if the populations
are comparable) where the product
is already marketed. Or, companies
could pledge to provide RWE
from Australia at a later date, in an
effort to either sustain or improve
a product’s initial reimbursement
status.
"At this point, due to competing
agendas, there is a misalignment
between the PBAC and the industry
in Australia," ventures Caroline
Beasley, Country Principal, IMS
Health Australia. "There's a sense
that much of the information
provided to the committee in recent
years has been biased or insufficient
to support companies' claims.
Providing RWE with submissions
for PBS listing would go a long way
toward restoring that sense of trust
and will undoubtedly speed the
time to approval."
Beasley continues,“To define the
value of their products—not merely
at launch but over the course of a
product’s lifetime—companies will
need to develop comprehensive
strategies, processes and capabilities
New Strategies for Reviving Growth in Australia
19. 19
in gathering and providing unbiased
evidence of what their health
technology achieves in the real
world. Fortunately, this information
is becoming readily available.”
At one time, RWE was expensive
to obtain via third parties and
involved a retrospective analysis.
Today, it is available from a multitude
of settings and sources, including
data on dispensed prescriptions
tracked over time for anonymous
patients, claims data from private
health insurers, and government
databases. This information can be
supplemented with demographic
and epidemiological data from
public sources as well as with a
company’s own data.
AdoptaNewCommercialModel
In Australia, as in other mature
markets, the stakeholder landscape
is growing ever more complex, and
the direct influence that prescribers
have on the treatment decision is
in decline. At the same time, with
the loss of exclusivity of so many
blockbuster products, much of the
market is becoming commoditized.
These conditions are rendering
traditional commercial models
(those based on share of voice with
prescribers) increasingly inefficient
from a cost-benefit perspective.
With the end goal of optimizing
their promotional resources,
companies need to create a more
flexible commercial organization
that can cope with variations in
stakeholders and apply different
sales and marketing strategies as
needed. This involves:
• Determining the relative
importance of each stakeholder
group and allocating resources
accordingly.This may mean
adopting an account-based sales
structure, employing virtual
sales reps or exploring other
alternatives to in-person sales calls.
• Engaging all stakeholders and
working continuously to provide
value to all customer types.
This includes government
authorities, private insurers
and patients. With respect to
government and private
payers, manufacturers must
come to understand their mindset
and find ways to deliver what
they need. And, by developing
stronger relationships with
patients, companies can earn
their loyalty to sustain usage
upon entry of either a generic or
a new competitor. (For more on
how to understand, integrate,
and pro-actively address patient
needs, please see“Patient
Centricity: A Disruptive Strategy
for Growth in Asia”on page 11.)
• Employing new marketing
technologies, such as closed-loop
marketing, enterprise-wide
relationship management,
and customer relationship
management. The goal is to
adopt customer-centric
approaches that provide more
differentiated messaging matched
to the needs of each segment.
TakingRWEbeyondHEOR
Real-world evidence, collected from various points in the patient’s health
journey, can be used to support product value stories, provide insight for
clinical and operational decisions, and as a tool for engagement.
RWE isn’t limited to HEOR
RWEhasvaluethroughoutanorganization
Descriptive Epidemiology
Outcomes of Care
Patterns of Care
Relative Safety
Comparative Effectiveness
Patients - Population
Management
Payers – Quality
Benchmarking
Providers - Quality
Intervention
Payers/Providers –
Key Account Management
Payers/PROVIDERS –
Pay For Performance
Trial Optimization
Supporting product
value stories
Providing insight to
internal organization
As tool for engagement
Pricing & Market Access
Product Development
Commercial Spend
Effectiveness
Launch Management
A B C
20. SUMMARY
With increasing environmental pressures, it is time for pharmacos to start with a clean slate and redesign their
approach to the market in Australia. In general, companies should envision what the market will look like in five
years and work backward from that to formulate their strategies. The good news is that there remain ample
opportunities to overcome market access hurdles and win customer loyalty.
To continue the conversation, please contact
Caroline Beasley, Principal, IMS Health Australia, at cbeasley@au.imshealth.com
• Interacting with stakeholders at
multiple levels. Rather than
maintaining communication with
a single contact within customer
organizations, expand the
number and level of relationships
such that peers are communicating
with peers. For example a
manufacturer’s CEO might
develop a relationship with the
chairman of a hospital’s board,
or a company’s finance director
might interact with the financial
controller in a government agency.
“When it comes to refining their
commercial model, companies in
Australia have a great advantage,”
suggests Frederic Lefebvre,
engagement manager, IMS Health
Australia.“They can examine what
their counterparts have done in
other countries and leapfrog over
their learnings, eliminating a lot of
trial and error.”
MovefromBrand-Focused
toCustomerCentric
Particularly in the primary care
market, pharmaceutical companies
must transition from selling
chemicals packaged into tablets
to selling integrated health
concepts that add value for patients
and intermediaries by improving
diagnosis, presentation, adherence
and persistence. An example of this
“whole product approach”would be
offering a comprehensive patient-
centered program that includes the
drug, diagnosis, patient counseling,
family support, diet and exercise,
mood monitoring and Internet
support. This approach achieves
value pricing through a
wholehearted commitment
and investment. Fortunately,
manufacturers already have
much of the needed elements,
including an understanding of
disease treatment, existing
relationships with providers and
insights into patient usage through
anonymous, patient-level data.
The basic categories of value-creation
tactics include:
• Stakeholder solutions that range
from customized patient
education, e-tools, and social
networking materials to
dashboards and value-based
focus groups
• Stakeholder resources as varied
as trial offers to healthy outcomes
programs and health calculators
• Offering extensions made possible
through value-chain aggregation
and a movement toward services
or non-prescription offerings.
• Partnerships with the government,
healthcare organizations, disease
awareness groups, and payers
and employers that focus on
health outcomes.
New Strategies for Reviving Growth in Australia
20
21. 21
Customer targeting is essential in a world of limited resources, and companies should
understand the relative value of their customers and allocate resources accordingly.
IMS Health’s Sales Force Effectiveness (SFE) services empower your sales force to
deliver efficiently and profitably. With our extensive experience across the entire SFE
continuum, tested methodologies and tools, local competitive industry intelligence
and access to granular data that’s not available to the market, we can help you
profile, segment and target the right customers
With IMS Health, your sales force will hit the right targets!
Ever feel that you are not hitting
the right targets?
IMS Health’s Consumer Health team can address your biggest business issues around:
Real-World Evidence
& HEOR
Payer
Management
Access, Pricing &
Reimbursement
Strategy &
Portfolio Planning
Sales
Effectiveness
Business Information
Management
Brand & Marketing
Effectiveness
23. 23
At first glance, China would seem to be a world of never-ending opportunities for
pharmaceutical companies. Indeed, the country’s pharmaceutical market is the third
largest in the world, estimated at USD 80 billion at the end of 20121
.
However, this growth is not the result of unilateral escalation; there are variations in
opportunity and growth across regions, therapy areas and drug categories, combined
with influences from a maze of regulations and government policies. Each of these
significant forces demands analysis, not assumption.
Pharma companies—especially multinational companies (MNCs)—that disregard such
granular trends when projecting their growth will likely be overly optimistic.To improve
their actual performance, companies have a variety of options, ranging across levels of
difficulty and the degree of transformation necessary. And while there is no "one-size-
fits-all" solution, action is critical to successfully adapting and thriving in China.
Growing Pains in China
China's new pharma reality, and the necessity of an informed strategy in
bridging the gap between assumed and realized growth
ALoomingGapfortheAverage
MNCPortfolio
To what extent is the typical MNC
player operating in China facing
top-line revenue growth pressure?
To answer this, IMS Health teams
reviewed the average business mix
of the top ten MNC pharmacos in
China (based on the IMS China
Hospital Pharmaceutical Audit).
After pooling their performances into
one“hypothetical company,”they
applied a series of top-line growth
assumptions, including, first, an
overall market CAGR of 15%, and then
more segment-specific growth rates.
This analysis revealed a 17% gap
between where companies assume
their portfolio will end up in 2015
(based on the 15% growth projection)
and their actual portfolio performance
based on the behaviors of individual
segments (see Figure 1).The off-
patent-originator group (OPO) turned
out to be the biggest source of risk,
with a forecasted growth of -2%.
“We are assuming the government’s
pricing pressures on OPOs will
continue, thus reducing prices,”
explains Matthew Guagenty, VP IMS
Consulting Group, APAC & China,
“but we’re also going to see volume
increases as a result. This inverse
relationship will eventually result in
modest declines for this segment."
And so MNCs are faced with both
upward and downward pressures,
and a need to more proactively
manage the different segments
of their portfolio, and their
environment.
1
IMSMarketPrognosis,2012
Figure 1
Potential gap between assumed and actual portfolio growth
-4
+13
2015 -
Future view
2012 -
Currentstate
100pts
152pts
in PRx
Portfolio
in OPO
Portfolio
in GX & OTC
Portfolio
Generic (Gx) & OTC
Patented Rx (PRx)
OPO
GAP
24
+26
26
4
53
69
+29
73
(17%)
15%
3-year CAGR
24. 24
AComplicatedEnvironment
In order to close this gap successfully,
companies must understand
the geographic, sociological and
governmental dimensions of a very
challenging market environment in
China.
GreatGeographicandDemographicDiversity
China is home to 1.4 billion people,
spread across 9.5 million square
kilometers and 34 provinces/regions2
.
With its myriad cultures, customs
and income levels, the country might
best be regarded as a multitude of
sub-countries.
For pharmacos, this demands a more
proactive—and a more innovative—
growth plan than what is required
anywhere else in the world. Building
market share here requires both
breadth and depth. And portfolio
diversity, resource allocation and
growth strategies across the value
chain must address a wide range of
market conditions, infrastructure
challenges and even personal
attitudes toward healthcare.
MultipleAccessHurdles
For pharma companies, especially
MNCs, navigating China’s complex
reimbursement system is the key to
securing widespread market access.
At the center of the system is the
Essential Drug List (EDL), which
outlines those medicines that receive
relatively high levels of government
reimbursement. Inclusion in this list
opens the door to the full spectrum
of China’s pharmaceutical market,
but also leads to a volume-driven
model for growth based on generics-
level pricing. In addition, there
are several other layers of listing,
tendering and bidding involved
in gaining access. These include
a National Reimbursement Drug
List (NRDL) and the Provincial
Reimbursed Drug Lists (PRDL),
as well as unique listing processes
in individual hospitals.
With this multi-tiered system—
perhaps the most complex in the
world—comes exposure to significant
price pressures. At the national
level, there have been therapeutic-
level price cuts annually over the
past decade. At the provincial level,
heterogeneous tendering systems
place direct price pressure on the
most common molecules, leaving
competitors to outbid one another.
AChangingRevenueModelforHospitals
Until recently, Chinese hospitals have
relied on markups from drugs that are
both prescribed and filled onsite as a
major source of revenue.
Therefore, the government’s recently
stated objective to separate
prescribing and fulfilling signifies
a fundamental shift in how the
provider market will operate in
the future.“This shift implies a
completely different approach
to provider-side economics, and
subsequently a new business model
altogether,”explains Mr. Guagenty.
Doctors, however, will continue to
be an important—if not the most
important—stakeholder in the
prescribing process.
StrategiesforSuccess
MNCs in China face a complicated
reality: growth is mandatory, but
is only possible by addressing
the market’s complexities and
contradictions. It also means not
falling victim to the common China
assumption that growing bigger
means growing stronger.
Ultimately, companies' chosen
strategies should reflect the degree
to which they are willing to invest
in difficult and/or transformative
processes. The options below are
neither mutually exclusive nor
collectively exhaustive, but are all
worth considering:
• Option #1: Embrace Generics
Today China boasts over 7,000 local,
regional or national pharmaceutical
product manufacturers, most of
whom play in the ultra-competitive
generics market. Branded generics,
especially, are poised for growth,
given the demand for low-cost
alternatives to off-patent brands.
However, pricing pressures from the
government will likely precipitate a
decline in unit prices for these drugs.
“Me-too-plus”versions of generics
offer a slightly more sustainable
Growing Pains in China
Any strategic plan needs to ensure that it doesn’t fall victim to the
common China assumption that growing bigger means growing stronger.
2
NationalBureauofStatisticsofChina2012
25. 25
outlook, though they require first-
mover advantage in addressing a
particular market/disease need.
It is important to note here that
national agencies aim to curtail
the practice of affording favored
bidding and tendering status to
firms with me-too-plus generics.
MNCs could fold any new generic
products into existing portfolios
and take advantage of synergies in
the supply chain. However, actually
bringing a new generic to market
could take several years. And local
competitors will compete heavily on
price, pushing down market prices in
the longer term.
• Option #2: Develop Strategic
Alliances & Partnerships
Many MNCs are exploring various
ventures with domestic Chinese
companies to diversify their portfolios
and leverage the market expertise
and local supply chains of leading
domestic manufacturers. This,
coupled with the financial might
and portfolios of the MNCs, could
mean significantly deeper market
penetration for both parties. Yet,
this option is certainly more difficult
to implement than a pure generics
strategy, given that:
• Finding a partner who can
complement existing portfolios
and capabilities is a challenge.
• Workforce integration can be
difficult, as can ensuring that the
production standards of any
acquired/partnered company
meet those of the MNC.
• There is threat of further regulation.
• The number of attractive, suitable
partners is dwindling.
• Option #3: Branch into New
Fields of Play
With Chinese technology and research
moving at such an astounding pace,
MNCs are beginning to develop
alternative strategies to keep ahead
of the game. Of course, innovative
ideas, while offering huge potential
rewards, are the most difficult to
implement. They invariably entail
significant internal transformations,
often with an over-reliance on
partnering firms that can supplement
expertise. And, there are fewer and
fewer attractive, applicable spaces
not occupied by competitors.
The options presented here are
certainly not“Band-Aids®”for a
short-term growth issue, but they
can be medium- to longer-term
planks on which companies can
build sustainable growth.
Mobile technology -Taking healthcare
into the future
With over 1.1 billion mobile phones
currently in use in China, and over
300 million 3G users, the potential for
mobile health (mHealth) applications
is clear.The opportunities range
from better understanding patient
behaviors, to improving preventative
medicine initiatives and increasing
compliance through third-party
patient management or medicine
reminders3
.
Diagnostics – Creating synergies
across portfolios
As China continues to make
preventative treatments a priority
in its reform initiatives, diagnostic
services are poised to be a significant
factor in the expansion of both
More
MoreLess
Difficulty
Transformation necessary
Generics
Strategy
Strategic
Alliances
New Fields
of Play
FIGURE 2
3
ChinaWirelessNews,Jan3,2013.(www.chinawirelessnews.com/2013/01/03/11699-china-had-over-1-1-billion-mobile-phone-users-by-november-2012)
TechAsia.com-(www.techinasia.com/china-now-has-over-300-million-people-using-3g//14C43AE4-F02B-4698-A7E8-D609AE56BFF6)
26. market access and new product
opportunities. For larger MNCs,
diagnostics offer an intriguing
opportunity for portfolio synergy
and to develop a presence across a
broader piece of the patient journey.
For example, in a complex disease
such as breast cancer, diagnostic
capabilities allow for earlier patient
interactions and then more targeted,
appropriate treatments later in the
disease cycle.
Creating your own demand – Solving
the affordability gap
Although China is experiencing a
phenomenal expansion of its middle
class, many drugs remain prohibitively
expensive. Cancer drugs, for example,
can cost up to 10 times the average
Chinese possessive worker's annual
income and, as premium medications,
are not included on any reimbursed
drug list.
The answer, for those companies
with the capability and appetite for
expanding into wholly new business
models, could be the development
of partnerships such as the one
Roche struck with Swiss Re. Through
this deal, Swiss Re, a provider of
reinsurance, will benefit from Roche’s
understanding of cancer treatment
and prevalence rates. Roche, in turn,
will leverage Swiss Re’s knowledge
of insurance to supplement public
insurance and cover more expensive
drugs such as Herceptin®.
Again, though any of these may be
attractive, based on a company’s
appetite for, and ability to, change,
there is a sweet spot, as Mr. Guagenty
points out:“The best investments will
be those that satisfy the unmet needs
of the population and align with the
government agenda.”Investment
outside this intersection can be riskier
and have a longer pay-off period.
InSummary
When viewed through the lens of growth, China is one of the healthiest pharmaceutical markets in the world.
However, this growth is by no means uniform. Surviving and thriving in this market going forward means proactively
addressing those dynamics that make China truly unique.
For MNCs, the imperatives are clear:
• Change is coming, and MNCs have the opportunity to use momentum, coupled with real market intelligence, to
shift their business forward
• Successful strategies will recognize the upward and downward pressures on the Chinese pharma market and not rely
on macroscopic growth projections
• A spectrum of strategies, from core bolt-ons to new fields of play, are real options for MNCs that want to be
proactive in managing pharma’s“growing pains”in China
Growing Pains in China
26
To continue the conversation, or to request our longer white paper on this topic, please contact
Matthew Guagenty, Vice President Consulting, Asia Pacific and China, at mguagenty@imscg.com
27. Asia Pacific is leading the world in terms of over-the-counter drug sales and showing growth rates
that indicate enormous potential for MNCs as well as local and regional players.
But the consumer’s path to purchase is not just complex – it is different across Asia Pacific’s
diverse markets. So to build relevant, powerful marketing strategies, pharmaceutical
companies need to understand how – and why – consumers behave at the point of sale (POS).
• When do consumers decide on a brand to buy?
• What is the influence of the pharmacist and POS materials in driving purchases?
To address this need IMS Health has developed unique Shopper Studies for Korea, China and
the Philippines, revealing critical insights into purchase drivers for each culture.
IMS Health Shopper Studies:
These primary market research reports are a critical tool for companies who want to be more
proactive in addressing the needs of their target audience. Sample insights include:
• The interaction between consumer and pharmacist in the Philippines is mainly transactional,
whereas in China and Korea, recommendations by pharmacists are a key purchase driver
• 97% of Filipino consumers have a brand in mind before entering the store vs. 30-40% in
China and Korea
• In China, posters/ads in drugstores appeal more to higher-income, well-educated shoppers
Winning the sale inside the
store means knowing which
levers to pull.
IMS Health Shopper
Studies have helped many
businesses understand
consumers at the point of
sale and influence them to
choose their brand.
Is your company next?
Call us to learn more about
our Shopper Studies today.
Illuminating the consumer healthcare
industry, one bright insight at a time
Real-World Evidence
& HEOR
Payer
Management
Access, Pricing &
Reimbursement
Strategy &
Portfolio Planning
Sales
Effectiveness
Business Information
Management
Brand & Marketing
Effectiveness
IMS Health’s Consumer Health team can address your biggest business issues around:
28. IMS HEALTH®
IMS Health Asia Pacific
8 Cross Street #21-01/02/03
PWC Building
Singapore 048424
Tel: +65 6227 3006
Fax: +65 6227 5448/9
IMS Health is a leading worldwide provider of information, technology and services dedicated to making
healthcare perform better. With a global technology infrastructure and unique combination of real-world
evidence, advanced analytics and proprietary software platforms, IMS Health connects knowledge across all
aspects of healthcare to help clients improve patient outcomes and operate more efficiently. The company’s
expert resources draw on data from nearly 100,000 suppliers, and on insights from more than 40 billion
healthcare transactions processed annually, to serve more than 5,000 healthcare clients globally. Customers
include pharmaceutical, medical device and consumer health manufacturers and distributors, providers,
payers, government agencies, policymakers, researchers and the financial community. Additional information
is available at www.imshealth.com.
IMS Health is present in over 100 markets.
For our office locations, visit: www.imshealth.com/locations
About IMS HEALTH