Project Report

Rural pharmaceutical marketing

PROJECT REPORT

ON

RURAL PHARMACEUTICAL MARKETING

SUBMITTED IN PARTIAL FULFILLMENT OFDEGREE OF

MASTER OF BUSINESS ADMINISTRATION

SUBMITTED BY: MISBAHUL HODA

UNDER MENTORSHIP OF: DR.SADAF SIRAJ

MBA (PHRMA) 2ND SEMDEPARTMENT OF MANAGEMENT, FMIT

JAMIA HANDARD NEW DELHI

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EXECUTIVE SUMMARY

Rural India accounts for more than 70 per cent of the country’s one billion population and also accounts for 60 per cent of India’s income. In the early 2000s, around 700 million people, i.e. 70% of the Indian population lived in 6, 27,000 villages, in rural areas. Of this, 90% were concentrated in villages with population less than 2000.

In recent years, rural markets of India have acquired significance, as the overall growth of the Indian economy has resulted into substantial increase in the purchasing power of the rural communities. On account of green revolution, the rural areas are consuming a large quantity of industrial and urban manufactured products. In this context, a special marketing strategy, namely, rural marketing has emerged.

Rural India with its traditional perception has grown over the years, not only in terms of income, but also in terms of thinking. The rural markets are growing at above two times faster pace than urban markets; not surprisingly, rural India accounts for 60% of the total national demand.

Today, rural market occupies a larger part of our economy and it is expected to grow at least four times the existing size. Another contributing factor for rural push was growing saturation in urban markets.

The Union Budget for 2009-10 hiked the allocation for the National Rural Employment Guarantee Act (NREGA) to US$ 8.03 billion, giving a boost to the rural economy. This is in addition to the ambitious Bharat Nirman Programme with an outlay of US$ 34.84 billion for improving rural infrastructure.

According to a study on the impact of the slowdown on rural markets commissioned by RMAI and conducted by MART, the rural economy has not been impacted by the global economic slowdown, according to a study by the Rural Marketing Association of India (RMAI).

In present situation, our huge population is helping marketers to think new marketing strategies. 700 Million rural populations are greater than total consuming markets of many countries like Canada, South Korea, etc.

India's pharmaceutical industry is now the third largest in the world in terms of volume and accounts for 10 per cent of the world’s production. The Indian pharmaceutical industry is now over US$ 20 billion. India ranks fourteenth in terms of value. The country ranks fourth in terms of generic production and seventeenth in terms of export value of bulk actives and dosage forms...

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According to a detailed research by Angel Broking, by 2015, India is expected to rank among the top 10 global pharmaceutical markets. The industry is typically growing at around 1.5-1.6 times the country’s gross domestic product (GDP) growth.

According to estimates, rural areas account for 21 per cent of the country's pharmaceuticals market. In 2006-07, the rural Indian pharmaceuticals market was estimated at around US$ 1.4 billion, having grown at about 40 per cent in 2006-07 against 21 per cent in the previous year.

Given the potential of the rural markets, these days, companies are more open to reaching the rural consumer than even before. However, most of the products that are being advertised and marketed aggressively are the low risk-low involvement products like pain balms, lozenges, and cough and cold syrups.

The high risk-high involvement products like cardiac or cancer products are not advertised or marketed through media as regulations prevent this. However, companies have often taken the community-welfare route to educate the rural consumers about a particular disease segment and make them aware of the treatments available. Companies are conducting healthcare workshops in the rural areas by tapping the doctors there. Such program offer mutual advantages to both the parties concerned. The doctors benefit through the increased footfall of prospective patients and companies benefit through the brand awareness and possibility of increased prescriptions. The research was conducted on 600 rural practioners and 170 rural chemists in about 330 panchayats of Darbhanga. - A district of north Bihar. The questionnaire mainly includes the questions related to prescribing behavior of rural practitioners and factors affecting sales of rural chemists. Most of the rural practitioners do not have proper education and there practice is basically based on experience. The prescribing behavior of rural practitioners basically includes 1-2 branded drugs along with 3-5 generic or low quality drugs. Generics or low quality drugs have made space in rural market because of its low cost and good distribution channel. Regular detailing of drugs by Medical Representatives plays an important role in shifting brand loyalty of rural practitioners. Prescribing behavior in rural areas also changes with income, profession and education of patients.Prescription flow is major factor behind stocking and selling of drugs by rural chemists.Substitution of brand is done by rural chemists and it’s mainly due to high profit margins.The whole sellers at nearby town or city do not disclose company’s schemes to rural retailers and retailers are not at all satisfied with the attitude of whole sellers. The rural pharmaceutical marketing has huge potential and will be money making machines for pharmaceutical companies if proper strategies and marketing model is employed.

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ACKNOWLEDGEMENT

I would like to thank my mentor Dr.Sadaf Siraj for all the help rendered to me during the

project work and going out of way to help me with each and every aspect of project.

I wish to express my gratitude to Mr. V. K. Arora, Regional Sales Manager , Sritech

Pharma for his valuable guidance and suggestions which has saved me from many pitfalls

during the course of my study.

I would like to thank all the Rural Doctors and Chemists for their support and help which

made whole project the learning experience of life time.

I would also like to thank my Family for their moral as well as financial support during the

study.

My sincere thanks to my guide Mr. Shams Tabrez who guided me to the 330 panchayats

during the course of study and made whole experience enjoyable with his quick wit and

humor.

The work is dedicated to all innocent villagers whose minds are still not corrupted by

evil practices of Capitalism and Materialism.

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DECLARATION

The Project entitled “RURAL PHARMACEUTICAL MARKETING’’ is an original piece

of work and which was carried out under the supervision of Mr. V. K. Arora, Regional

Sales Manager , Sritech Pharma and under the guidance of Dr.Sadaf Siraj , Department

of Management ,Jamia Hamdard .

I further declare that this project work is based on my original work and no part of this

project has been published or submitted to anybody.

LIST OF CONTENTS

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ACKNOWLEDGEMENT

DECLARATION

INTRODUCTION

INTERVIEW WITH EXPERTS

RESEARCH METHODOLOGY

DATA COLLECTION

QUESTIONNAIRE

DATA INTERPRETATION AND ANALYSIS

LIMITATIONS OF THE STUDY

CONCLUSION OF THE STUDY

RECOMMENDATIONS OF THE STUDY

BIBILOGRAPHY

Introduction

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In the early 2000s, around 700 million people, i.e. 70% of the Indian population lived in 6, 27,000 villages, in rural areas. Of this, 90% were concentrated in villages with population

less than 2000. According to a study conducted in 2001 by the National Council for Applied Economic Research (NCAER), there were as many "middle income and above" households

in rural areas as there were in urban areas.

In recent years, rural markets of India have acquired significance, as the overall growth of the Indian economy has resulted into substantial increase in the purchasing power of the rural communities. On account of green revolution, the rural areas are consuming a large quantity of industrial and urban manufactured products. In this context, a special marketing strategy, namely, rural marketing has emerged.

Rural India with its traditional perception has grown over the years, not only in terms of income, but also in terms of thinking. The rural markets are growing at above two times faster pace than urban markets; not surprisingly, rural India accounts for 60% of the total national demand. The Union Budget for 2009-10 hiked the allocation for the National Rural Employment Guarantee Act (NREGA) to US$ 8.03 billion, giving a boost to the rural economy. This is in addition to the ambitious Bharat Nirman Programme with an outlay of US$ 34.84 billion for improving rural infrastructure.

According to a study on the impact of the slowdown on rural markets commissioned by RMAI and conducted by MART, the rural economy has not been impacted by the global economic slowdown, according to a study by the Rural Marketing Association of India (RMAI).

The study found that the rural and small town economy which accounts for 60 per cent of India’s income has remained insulated from the economic slowdown. Moreover, rural incomes are on the rise driven largely due to continuous growth in agriculture for four consecutive years.

Moreover, the rural consumer market, which grew 25 per cent in 2008 when demand in urban areas slowed due to the global recession, is expected to reach US$ 425 billion in 2010-11 with 720-790 million customers, according to a white paper prepared by CII-Technopak. That will be double the 2004-05 market size of US$ 220 billion.

According to the study, while the durables market shrunk in urban India, the rural market is seeing a 15 per cent growth rate. Fast moving consumer goods (FMCG) sales are up 23 per cent and telecom is growing at 13 per cent.

In present situation, our huge population is helping marketers to think new marketing strategies. 700 Billion rural populations are greater than total consuming markets of many countries like Canada, South Korea, etc.

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Potential of rural market

India Inc was urged to invest in rural India, which according to a McKinsey survey will provide a market worth $500-600 billion by 2020.

At a CII annual session, Bharat Nirman, the government's design for rural infrastructure development, was the subject of a presentation by McKinsey CEO Adil Zainulbhai, who made a strong case for increased investment in rural areas.

Zainulbhai said homogenization of rural and urban elite was incorrect and provided a four-fold classification for rural areas. Of the 593 rural districts that the McKinsey survey looked at, 67 were classified as urban cousins, 118 as those close to rural economic centres, around 160 as able districts with a basic minimum infrastructure and 248 districts as deprived.

An insight to the rural customer

Rural India buys

Products more often (mostly weekly)

Buys small packs, low unit price more important than economy

In rural India, brands rarely fight with each other; they just have to be present at the right place

Many brands are building strong rural base without much advertising support, like Chik Shampoo is second largest shampoo brand of India, and Ghadi detergent is third largest detergent brand in India

Fewer brand choices in rural areas; number of FMCG brands in rural areas is half that of urban

Buys value for money, not cheap products

Exposure of Rural Markets in India

It is an upcoming market and the following facts substantiate this: -

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700 million people

In 2001-02, LIC sold 55% of its policies in rural India

Of the two million BSNL mobile connections, 50% are in small towns / villages

Of the six lakh villages, 5.22 lakh have a Village Public Telephone (VPT)

41 million Kisan Credit Cards issued (against 22 million credit-plus-debit cards in urban) with cumulative credit of Rs. 977 billion resulting in tremendous liquidity

42 million rural households are availing banking services in comparison to 27 million urban households

Investment in formal savings instruments: 6.6 million households in rural and 6.7 million in urban India

Nano-Marketing or sachets worked well in rural India and there is ample scope for the products to be accepted by consumers if the price is competitive

The rural market is highly fragmented and the supply chain for the FMCG goods has to be strong

4 P's of Rural Marketing

FMCG and consumer durable companies have, in the past, tried tinkering with all the four 'P's - product, pricing, promotion and place - of the marketing mix. The area where innovation has moved to center-stage is in the fourth P - place (or distribution). Infrastructure has always been the bug-bear of the Indian marketer.

Distribution channels can make or break a company's rural marketing efforts. To sell in villages, products must be priced low, profit margins must be kept to the minimum, and the marketing message must be kept simple. Rural marketing seems to be essentially a problem of price and place (distribution). And products designed for the urban market seem to do decently in rural India as well. Perhaps the urban / rural divide is not as large as most people believe it to be.

The problem for most companies is that Product and Promotion is strangely enough, the easiest to redo or remake. Cost competencies which affect Price and Distribution, and supply chains, which make Place irrelevant, are far more difficult to obtain. They take experience and initial investment.

4 A's of Marketing Strategies

4 A's means Affordability, Availability, Acceptance & Awareness.

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Affordability

Rural consumer affordability is very low. So marketers need to concentrate on this. LG developed a TV in late 1990s with on-screen displays in Indian languages such as Hindi, Bengali, Tamil & Marathi. The sub-brand, SAMPOORNA, has predominantly kept for the rural markets price Rs. 2000 to Rs. 3000 than competitive national TV brands. As an extension of SAMPOORNA, an entry-level CTV called CINEPLUS was launched in rural markets, priced attractively at Rs. 5000.

Availability

1. Availability of electricity is hurdle in the countryside. PHILIPS developed free power radio, a radio set that does not need batteries for electricity. It runs on simple winding of a layer provided in the set with an attractive price at Rs. 995 per set.

2. To remove fluoride content from hand-pumps, Ion Exchange designed water-purifying attachments to the pumps that do not need electricity.

3. NOKIA developed affordable cell-phones for rural areas with unique features like local language capability, present time / cost units on calls, etc.

4. ICICI Banks' rural ATMs are battery operated.

5. DENA Banks' ATMs have VOICE INSTRUCTIONS for rural areas.

6. BP Energy Cells have SMOKELESS biomass run stoves (Oorja) for rural markets with attractive price at Rs. 675 in Tamil Nadu.

7. Bank of India introduced BHUMIHEEN Credit Card for providing credit facilities to landless farmers.

Why Different Strategies are needed for rural marketing

These markets, as part of any economy, have untapped potential. There are several difficulties confronting the effort to fully explore rural markets. The concept of rural markets in India is still in evolving stage, and the sector poses a variety of challenges. Distribution costs and non-availability of retail outlets are major problems faced by the marketers. The success of a brand in the rural market is as unpredictable as rain. Many brands, which should have been successful, have failed miserably. This is because most firms try to extend marketing plans that they use in urban areas to the rural markets. The unique consumption patterns, tastes, and needs of the rural consumers should be analyzed at the product planning stage so that they match the needs of the rural people.

Common Strategies employed for rural marketing

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By proper communication in Indian language. By communicating and changing quality perception. By target changing perception. By understanding culture and social values. By providing what customer wants. By promoting products with Indian models and actors. By associating themselves with India. By promoting Indian sports team. By developing rural specific products. By giving Indian words for brand. By effective media communication. By adopting localized way of distribution. Through melas and paintings.

Strategies to be Followed for Prospects

Marketing Strategy: Marketers need to understand the psyche of the rural consumers and then act accordingly. Rural marketing involves more intensive personal selling efforts compared to urban marketing. Firms should refrain from designing goods for the urban markets and subsequently pushing them in the rural areas. To effectively tap the rural market, a brand must associate it with the same things the rural folks do. This can be done by utilizing the various rural folk media to reach them in their own language and in large numbers so that the brand can be associated with the myriad rituals, celebrations, festivals, "melas", and other activities where they assemble.

Distribution Strategy: One of the ways could be using company delivery vans, which can serve two purposes - it can take the products to the customers in every nook and corner of the market, and it also enables the firm to establish direct contact with them, and thereby facilitates sales promotion. However, only the big-wigs can adopt this channel. The companies with relatively fewer resources can go in for syndicated distribution where a tie-up between non-competitive marketers can be established to facilitate distribution. Annual "melas" organized are quite popular and provide a very good platform for distribution because people visit them to make several purchases. According to the Indian Market Research Bureau, around 8000 such melas are held in rural India every year. Also, every region consisting of several villages is generally served by one satellite town (termed as "Mandis" or Agri-markets) where people prefer to go to buy their durable commodities. If marketing managers use these feeder towns, they will easily be able to cover a large section of the rural population.

Promotional Strategy: Firms must be very careful in choosing the vehicle to be used for communication. Only 16% of the rural population in India has access to a vernacular newspaper. So, the audio visuals must be planned to convey the right message to the rural folk. The rich, traditional media forms like folk dances, puppet shows, etc., with which the rural consumers are familiar and comfortable, can be used for high impact product campaigns. The advertisement has to be done in the local languages. This gives a powerful

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impact on the minds of rural people. The marketer needs to first grab their heart share by inducing local elements and flavors to the product so that they have some emotional attachment to it, then their mind share by advertising in the local medium that is easily accessible, and ultimately, the market share by being available abundantly in the rural market so that a competitor finds it difficult to penetrate.

Sales Strategy: Rural sales strategy will include hiring employees who genuinely like spending time in the rural areas and who are comfortable with the local language. Marketers can continuously assess all aspects of the business by interacting with people and their family members personally, evaluating product choices for popularity, and keeping favorites on the list so that the marketer rotates the pumping of products weekly and seasonally. Looking at the challenges and the opportunities which these Indian rural markets offer to the marketers, it can be said that the future is very promising for those who understand the dynamics of rural markets and exploit them to their best advantage. A radical change in attitudes of the consumers is expected in a short period of time and the marketers should be ready to quench the needs of the rural customers. If the products are cost effective with a marginal profit going to the manufacturer, then it will be a Win-Win situation for both the consumers and producers. FMCG companies focus on urban markets for value and rural markets for volume. And rural markets are extremely price-sensitive and vital for survival, since the urban markets are getting saturated in India.

Myths about Rural Marketing

Myth 1: Indian Rural Market is a Homogeneous Mass

Reality: It's a heterogeneous population. Various tiers are present depending on the incomes like big landlords, traders, small farmers, marginal farmers, labourers, artisans. People belonging to different social classes stay in a concentric area, so the available products should suffice the consumption for everyone.

Myth 2: Disposable Income is Low

Reality: Number of middle class households (annual income Rs. 45,000 - 2,15,000) for rural sector is 27.4 million as compared to the figure of 29.5 million for urban sector.

Rural incomes CAGR was 10.95% compared to 10.74% in urban between 1970-71 and 1993-94. The disposable income is still higher in the rural market.

Myth 3: Individuals Decide About Purchases

Reality: Decision making process is collective. Purchase process influencer, decider, and buyer, one who pays can all be different. So marketers must address brand message at several levels. Rural youth brings brand knowledge to households. Basic awareness of the

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product brand has to be there in the market. This can be done by putting up small advertising sheets at the mandis and places where the rural masses meet regularly.

Indian Pharmaceutical industry

India's pharmaceutical industry is now the third largest in the world in terms of volume and accounts for 10 per cent of the world’s production. According to the Mr Srikant Kumar Jena, Minister of State for Chemicals and Fertilizers’, the Indian pharmaceutical industry is now over US$ 20 billion.

India ranks fourteenth in terms of value. The country ranks fourth in terms of generic production and seventeenth in terms of export value of bulk actives and dosage forms, according to Mr Jena.

According to a detailed research by Angel Broking, by 2015, India is expected to rank among the top 10 global pharmaceutical markets. The industry is typically growing at around 1.5-1.6 times the country’s gross domestic product (GDP) growth.

Moreover, according to a FICCI-Ernst & Young study, the increasing population of the higher-income group in the country will, by 2015, open a potential US$ 8 billion market for multinational companies selling costly drugs. Besides, the report said the domestic pharma market is likely to touch US$ 20 billion by 2015, making India a lucrative destination for clinical trials for global giants.

The Indian pharmaceutical off shoring industry is slated to become a US$ 2.5 billion opportunity by 2012, thanks to lower R&D costs and a high-talent pool in India.

Exports

India's exports of drugs, pharmaceuticals and fine chemicals grew by 29 per cent in 2008-09 to US$ 8.25 billion compared to 2007-08.

The Indian pharmaceutical sector has emerged as one of the major contributors to Indian exports with export earnings rising from a negligible amount in the early 1990s to US$ 6.08 billion by 2007-08.A report by industry research firm, RNCOS, forecasts that pharmaceutical exports will grow at a compound annual growth rate (CAGR) of 18.5 per cent between 2007-08 and 2011-12. This growth will be fuelled by multi-billion dollar patent expirations and growth in the global generics market.

Growth

The domestic pharma market will outshine the global market, growing at a compounded annual rate of 12-15 per cent as against a global average of 4-7 per cent during 2008-2013,

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according to a study by market research firm IMS.According to detailed research by Angel Broking, socio-economic factors such as rising income levels, increasing affordability, gradual penetration of health insurance and the rise in chronic diseases would see the Indian formulation market touch US$ 13.7 billion by 2013, at a CAGR of 12.2 per cent over the period from fiscal year 2008 to 2013 (estimated).

Denmark-based world leader in diabetes care, Novo Nordisk, is looking at making India the hub for manufacturing insulin for the sub-continent. The company has set up a dedicated facility with a capacity of 26 million vials per annum in partnership with Ahmadabad-based Torrent Pharmaceuticals Ltd.

Pharmaceutical Retail

The Indian drug retail market grew by a 29.24 per cent in value terms in October 2009 over the same period a year ago. This is more than double the average monthly revenue growth rate of 13-14 per cent posted in the recent past, as per market research firm ORG IMS.

Generics

According to a report by IMS Health, the Indian generic manufacturers will grow to more than US$ 70 billion as drugs worth approximately US$ 20 billion in annual sales faced patent expiry in 2008. With nearly US$ 80 billion worth of patent-protected drugs to go off patent by 2012, Indian generic manufacturers are positioning themselves to offer generic versions of these drugs.

Indian generic drug makers received half a dozen more approvals from the US Food and Drug Administration (FDA) in 2009, over the previous year. Dr Reddy's Laboratories received the highest number of tentative and final approvals in 2009 at 32, followed by Aurobindo at 26 and Wockhardt at 23.

Diagnostics Outsourcing/Clinical Trials

The Indian diagnostics and pathology laboratory business is presently around US$ 864 million and is growing at a rate of 20 per cent annually, according to industry experts.

Moreover, the US$ 200 million Indian clinical research outsourcing market is estimated to reach up to US$ 600 million by 2010, according to a joint study done by KPMG and the Confederation of Indian Industry (CII).

Research & Development

The search for innovative drug molecules and better technologies by pharmaceutical MNCs is expected to offer a windfall for the smaller research-oriented Indian firms. With their drug

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pipelines drying up and more blockbuster drugs going off-patent, MNCs are looking at alliances for drug co-development, buying or licensing out innovative molecules which can further be developed into finished drugs.

Moreover, in a bid to boost R&D in the pharmaceutical sector, the government will provide US$ 422.96 million for establishing six National Institutes of Pharmaceutical Education and Research over the next five years.

Government Initiative

The government has taken various policy initiatives for the pharmaceutical sector:

The government has offered tax breaks to the pharmaceutical sector. Units are eligible for weighted tax deduction at 150 per cent for the research and development (R&D) expenditure incurred

Steps have been taken to streamline procedures covering development of new drug molecules and clinical research

The government has launched two new schemes—New Millennium Indian Technology Leadership Initiative and the Drugs and Pharmaceuticals Research Program —especially targeted at drugs and pharmaceutical research.

Investment

According to the Ministry of Commerce, domestic investment in the pharmaceutical sector is estimated at US$ 6.31 billion.

The drugs and pharmaceuticals sector has attracted foreign direct investment (FDI) worth US$ 1.43 billion between April 2000 and December 2008.

Road Ahead

The Indian pharmaceutical industry will see tremendous growth in the coming years as consumer spending on healthcare increases in India. Consumer spending on healthcare is expected to increase to 13 per cent of GDP by 2015, up from 7 per cent in 2007

Indian pharmaceuticals market will grow 10-14%; to touch $40 billion by 2015: Mckinsey

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Growing at compounded annual growth rate of nearly 14% in the next few years, the Indian pharmaceutical market is expected to touch USD 40 billion by 2015, predicts the global management consulting major Mckinsey and Company.

Indian pharma market, which is currently valued at USD 20 billion, could see the figure almost double in next 5 years majorly propelled by the steady growth in the domestic segment The domestic market which is growing at almost 10 to 14 per cent at present itself will provide US$ 20 to 24 billion in 2015 and the exports and contract manufacturing business, which are growing at 10 per cent per annum, will contribute to achieve the predicted growth. Contract manufacturing business, which registered US$ 4 billion in 2007 is expected to reach 10 billion in 2015, with a 25 per cent growth rate. Contract manufacturing opportunity for India including for the international generic business is forecast to the level of US$ 18 to 20 billion. Contract manufacturing of core products of multi nationals in India is another opportunity for domestic companies as that business itself could add US$ 7 to 8 billion by 2015.India’s potential in R&D will be between US$ 8 to 10 billion by 2020.

McKinsey has presented the latest forecast in the India Pharma Summit 2009, jointly organized by Department of Pharmaceuticals, Government of India, Federation of Indian Chambers of Commerce & Industry (FICCI) and the event management group – United Business Media (UBM) at Mumbai.

By 2015, the manufacturing opportunity in India including for the international generic business and the contract manufacturing business will be at US$ 18 to 20 billion. Considering the current growth rates and the opportunities available and the positioning of Indian pharma in the global generic market, it is not hard to expect Indian pharma industry to reach US$ 40 billion by 2015, Palash Mitra, partner, McKinsey and Company Inc, was quoted as saying while presenting his study – Indian Pharma – Status and Opportunities for Production, Investment & Trade, in the Summit.

India, however,will have to address certain challenges in terms of patent protection, intellectual property rights and regulatory changes to achieve the goal, Mckinsey noted.

Gaps in healthcare spendings and infrastructure facilities, low insurance penetration, lack of certain specialised disciplines and capabilities in various areas, especially in R&D and aspects related to product quality are the major challenges posed on the industry at present.

Infrastructure is another key impeding on India’s path to progress. Capabilities in critical functional areas and infrastructure in manufacturing and research sectors require urgent strengthening.Indian companies should shift their focus from market capture to market creation, by entering into rural or unexplored areas. The companies should also customize the India business model and should explore global scale partnerships with capable firms for future growth.

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Indian pharmaceutical industry is gradually picking pace in the rural markets. While metros and cities account for around 60% of the market share of the pharma industry, untapped potential of rural markets it is being seen as next volume driver of the industry.

About 70 percent of India resides in villages, which (according to various sources) comes approximately to 74,26,17,747 of the whopping 1.1 billion of the total Indian population. "In India, only 30 percent of the population has access to quality medicines and the treatment gap in almost every chronic disease segment is more than 65 percent. Therefore, the opportunity is huge.

Rising income levels leading to more affordability, speeding up of health infrastructure, and lifestyle diseases along with health insurance are fuelling the growth in rural areas.

Even today, the best and the largest of pharmaceutical companies reach only Class 1 towns. Marketing in the villages possibly includes some unplanned taxi tours or they leave it to the stockist’s network to make the goods available without any doctor promotion in the rural areas. Hence, the villages present a huge untapped market.

"The rural market is indeed very large and is growing. There is an estimated 20 million middle class households spread across 6,00,000 villages in rural India, which is equal to the number of middle class households in urban India," states Devendra Shinde, Marketing Manager, Boots Piramal Healthcare. In addition, the disposable income in rural India is much more as compared to urban areas. Food, shelter and primary education are virtually free in rural areas, whereas a substantial chunk of the income in urban areas is spent on these. "As a consequence, the spends on healthcare in rural India is also increasing," he adds.

"Rural market grew at about 40% to touch $1.4 billion in 2006-07 and is expected to have higher growth rate than overall pharma industry, said sector head - pharmaceuticals, KPMG, Hitesh Gajaria. In last couple of years, rural segment has managed higher growth year on year. The segment managed 21 % growth in calendar year 2005 and 9 % in CY 04. Growth in the rural markets has been led by favourable economic and demographic factors, including rising income, infrastructure, increased affordability of drugs, increased penetration of health insurance and growing organised retail in the rural area, said Gajaria. Health infrastructure also needs to improve, as only 20% of India's total health infrastructure is in rural areas where 70% population lives.

However, with rising rural healthcare expenditure and improving infrastructure facilities which are encouraging pharma companies to invest in rural markets and government announcement of five year tax holiday for hospitals in rural areas will further help in facilitating basic healthcare amenities, the KPMG official said.

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Pharma companies will have to focus on strengthening their marketing and distribution channels along with supply chain management to capitalize on the opportunities rural segment offers, he added.

Market share of the rural pharma rose from 18% in 2005 to 21% in 2007. "By 2015 rural pharma market will be around 24% and market size is expected to reach $4.8 billion from $1.2 billion in 2005, as per McKinsey report 'Indian Pharma 2015'.

The report expects Indian pharma market to reach to $20 billion while also highlighted that after metros, rural segment will see the fastest incremental growth by 2015.

Growth in pharma industry will be contributed by 40% from income growth, 20% medical infrastructure and 15% by health insurance penetration as per McKinsey report. Although rural markets are still more or less dominated by acute ailments, of late, there have been signs of lifestyle diseases like diabetes.

Strategies for rural penetration

Given the potential of the rural markets, these days, companies are more open to reaching the rural consumer than even before. However, most of the products that are being advertised and marketed aggressively are the low risk-low involvement products like pain balms, lozenges, and cough and cold syrups.

The high risk-high involvement products like cardiac or cancer products, are not advertised or marketed through media as regulations prevent this. However, companies have often taken the community-welfare route to educate the rural consumers about a particular disease segment and make them aware of the treatments available. Companies are conducting healthcare workshops in the rural areas by tapping the doctors there. Such programmes offer mutual advantages to both the parties concerned. The doctors benefit through the increased footfall of prospective patients and companies benefit through the brand awareness and possibility of increased prescriptions.

For instance, Sorrento Healthcare Communications has been associated with Nicholas Piramal (NPIL) for over the last two years for an Epilepsy Outreach Program launched under the banner 'Reach More, Teach More'. With an 85 percent treatment gap in epilepsy management in India, NPIL was keen to make the most of the opportunity by spreading its reach to towns beyond their current coverage.

There are many myths surrounding epilepsy right from madness to black magic, especially among less educated rural masses. These fatal superstitions were addressed by folk theatre shows at markets and high traffic junctions. Auto rickshaw announcements, leaflet distribution in local languages, danglers and banners at strategic locations were also made use of. Camps were conducted at primary healthcare centers and later on mobile vans were

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used, wherein specialists from NIMHANS were brought in for the same. Besides promoting the brands, this project also generated a lot of goodwill for the company among the opinion leaders in epilepsy management.Strepsils lozenges has chosen to build brand awareness in the villages through traditional means like billboards at bus stands, branding buses, hoardings, promotions at haats, jatras and melas.

They have also done rural road shows in the interiors of Maharashtra in a traditional lawani set up. The objective was to generate sufficient word-of-mouth so that the brand remains on tip of the tongue when the consumers actually decide to make the purchase. "We have been participating in these activities on a regular basis and have come up with smaller pack sizes and low unit packs as they do well. Singles versus strips is the order of the rural market," states Shinde.

As far as Pinkoo Gripe Water, the flagship brand from the Ajanta Pharma stable, is concerned, the product was a rural product from the very beginning. The promotion too was rural oriented, ranging from stalls at fairs to showing slides in cinema halls. They also have vans that move across regions. "We also educate tertiary health workers, who work in smaller villages. We train and brief them so that they can try to promote the products," states Rajesh Agrawal, Director, Ajanta Pharma. For Pinkoo Gripe Water, the entire promotion strategy is executed in local languages.

Agrawal feels that high fundas of metro marketing do not work and one should focus more on what the rural consumer understands and what he likes. One of the strategies implemented by the company is by organising a ‘healthy baby’ contest.

A good example of rural promotion of healthcare products is the Goli Ke Humjoli Campaign, which helped trigger the sales of a whole range of oral contraceptive brands. The entire market grew by a good 22 percent and created an excellent platform for low-priced contraceptives in the bimaru states of India.

The speed breakers

So, what is stopping the pharma companies from exploiting the full potential of rural markets? "In my 22 years career with the pharma industry, I have seen many companies trying to make sense of the rural opportunity. But they often give up due to lack of skill sets, expertise and experience to reach these unexplored territories," declares Josi. "This is because most of the companies evaluate this opportunity in a knee-jerk manner and give up when it becomes logistically unmanageable," she explains further.

We, however, have some shining examples of companies like P&G and Reckitt, with their OTC offerings trying to reach the rural markets, more through their FMCG expertise and network. "The biggest problem that marketers face today, is the cost of reaching the rural consumer. Rural markets tend to be far more spread out in contrast to the urban markets that are very concentrated and in compact geographies," explains Shinde.

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Absence of regional brands

As far as prescription products are concerned, there is always a trickle down effect with companies contacting the city-based specialists first, when promoting a new prescription product. After the product satisfies him, it is prescribed by the layer of General Practitioners (GP) under them. Slowly and steadily, this product then finds flavour with the GPs at the grass root level and that is how a product reaches the doctors in the class II cities and villages.

The pharma industry may be the only industry in India that cannot boast of rural or regional brands. "The pharma industry is fraught with various social and regulatory issues, in addition to various business issues. This is because human life is at stake here.

With various norms in place for quality of the product, pricing, packaging and huge investments that are needed for pharma R&D and manufacturing. It is not possible for a small regional or a rural player to come up with a standardized product for the rural as well as urban markets. Also, in these areas, chemist is the biggest influencer and plays a significant role in the purchase process as he often recommends products to consumers.

"But he is cautious about recommending any product because if something goes wrong, people will blame him. Chemist has to look at his prestige too and hence, he will not give anything that is not branded or not from a good company,". Thus, it will always be an urban to rural flow and not other way round. However, it can so happen that regional players offer products in nutraceutical or ayurvedic segment to the consumers. Yet, there will never be a situation, where a rural brand will present a threat to an MNC brand.

A different ball game

The typical Indian villager is a poor, superstitious and ignorant man. Most of the villages do not even have a health centre or a doctor. In these circumstances, The companies will have to price their products strategically keeping in mind the spending power of villagers.

All the effort and resources that go into rural marketing are appropriate as not only are rural markets big, but they also present untapped potential. The rural consumer is also highly brand loyal unlike the fickle urban consumers. The rural Indian consumer is a value conscious consumer. "For instance, if he buys crocin and it works, he will swear by it. He will not accept anything else. In case he is used to a blue crocin and a chemist gives him a white tablet, he will not accept it," says Smarta. Considering this, though it will be a mammoth task for companies to come across the right formula for success in rural areas, nonetheless, the effort and investment will not be useless as every penny spent will yield them loyal customers, who trust not just the efficacy of the brand, but also the company as a whole.

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Initiatives by different pharmaceutical companies to tap rural market

a) Novartis India Launches "Arogya Parivar" to Tap Rural Market

In a move to penetrate deep into the Indian rural market, Novartis India Limited has initiated its efforts through its new business model Arogya Parivar.

In what can be termed as a first of its kind effort by a Big Pharma in India, through this strategic initiative Novartis plans to specifically address the health needs of rural India –where about 72 per cent of the country’s population lives – by meeting the medical needs of the population.

The Arogya Parivar initiative is expected to address common diseases rampant in rural areas, including tuberculosis, respiratory infections, skin and gynaecological infections, diabetes, micro–nutrients during pregnancy and childhood, intestinal worms, acid reflux, cough and cold as well as allergies.

As part of the initiative, Novartis India would employ health educators to create awareness among the rural population on diseases, prevention and treatments. Under the system, the health educators would also refer patients to doctors, apart from making the products available in pharmacies and briefing the physicians about the programme and treatments.

The project would initially focus on 24 products from the Sandoz generics and consumer healthcare over–the–counter business unit that address tuberculosis, mother and childhood malnutrition, respiratory and gastro–intestinal problems.

“We have already launched Arogya Parivar in the states like Maharashtra, Uttar Pradesh and Madhya Pradesh. We have outsourced enough manpower to conduct health camps in rural areas to impart general health information and check–ups to rural population and prescribe branded generics to them, in an attempt to build brand image within them. We would also ensure that these branded products are available at stockists and pharmacists across the country”, said, Ranjit Shahani,vice chairman and managing director, Novartis India Ltd.

However, he made it clear that there won’t be any compromise on the cost of the drugs sold in the rural parts of India. “The medicines would be sold at the same prices in other parts of India, but packages would be made small so that the rural population need not spend a huge sum one at a time”.

Asked whether as part of Arogya Parivar, Novartis India would invest in research and development of medicines to address India specific infectious and tropical diseases, he

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quipped no, saying Novartis Institute for Tropical Diseases in Singapore would concentrate on development of medicines to address these diseases across the globe.

Though Novartis India didn’t throw light on the investments made in this project and the strength of workforce to meet the goals in tier 3 and tier 4 markets of rural India, it revealed that Arogya Parivar would be made fully operational in the country soon with the cooperation from hospitals and big NGOs.

b) Elder Pharma plans rural thrust

The Government is earmarking more than Rs 14,000 crore for the National Rural Health Mission and pharma companies are beefing up their rural marketing plans in a bid to tap into the opportunity. For example the Rs 650-crore Elder Pharmaceuticals Ltd on Tuesday said that it has set up a dedicated division called ‘Elvista’ to spread its network to villages and hinterland districts.

Mr Alok Saxena, Director, Elder Pharma, said, “Rural markets offer large potential volume growth, which has not been tapped properly by most of the pharmaceutical companies. Rising rural income levels, sops by the Government to set up health infrastructure in rural areas, thrust on rural health programmes, emergence of lifestyle diseases and penetration of medical insurance are fuelling pharma growth in rural areas.”

Elder Pharma is initially planning to target rural markets with a dedicated sales force of 240. “We plan to increase Elvista’s marketing strength to about 750 personnel or ‘product specialists’ by 2012,” said Mr Saxena.

The company has earmarked an investment of Rs 40 crore for its rural thrust. Elvista is targeting therapeutic categories, which have greater relevance in rural areas such as anti-peptic ulcerants, anti-malarials, anti-infectives and cough preparations.

Elvista has penetrated the rural markets of Uttar Pradesh, Maharashtra, Andhra Pradesh and Bihar and soon will enter the South. Before December 2012, Elvista plans to reach 1,500 villages with populations of below 40,000, 300 villages with populations of 40,000 to 100,000 and over 75 peripheral villages/towns around MMR (Mumbai Metropolitan region).

By 2012, Elvista’s target is to cover about five lac doctors, promoting health education and awareness.

Although more than 60 per cent of Indians live in rural areas, they account for 21 per cent of the total pharmaceuticals market. By 2015 rural pharma market will be around 27 per cent of the total estimated pharmaceutical sector size of Rs 90,000 crore.

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c) Sanofi-Aventis Unveils Rural Strategy

Paris-based Sanofi-Aventis intends to sell a range of generic drugs throughout India's towns,

villages and agricultural areas. The initiative has been named ' Prayas', which is a Hindi

word, derived from Sanskrit, meaning 'endeavour'. A key thrust of the strategic plan is

educating doctors on the benefits of prescribing Sanofi-Aventis products.

In the initial phase, a total of 15 products will be promoted under the label Hoechst, which is

relatively well-known to the target market. Called 'the pharmacy of the world' for its

important role in the global medicine market, Hoechst was a German chemicals then life-

sciences company that became Aventis after its merger with Rhône-Poulenc in 1999. Aventis

was then acquired by Sanofi-Synthélabo in 2004 to form Sanofi-Aventis. Hoechst Fedco

Pharma first entered the Indian market in 1956.

The affordable products will treat easy-to-diagnose conditions, such as coughs and colds,

acute pain, and non-complicated infections. Four local manufacturing firms will be

contracted to produce the medicines for Sanofi-Aventis. Through Prayas, the company is

targeting additional annual sales of INR500 crore (US$107mn) by 2014.

Several healthcare firms have recently announced plans to penetrate India's rural market.

Local companies that have expanded non-urban marketing activities include Piramal

Healthcare, Ranbaxy and Fortis Healthcare. GE Healthcare, Novartis and GlaxoSmithKline

Consumer Healthcare are among the foreign entrantsIndia's pharmaceutical market is

expected to expand by 13.2% in 2009. However, due to the weakening rupee, growth in US

dollar terms will only be 3.4%. Annual per-capita spending is just US$12.33 and market

expenditure as a percent of GDP is 1.07%. Through to 2014, we are forecasting a compound

annual growth rate (CAGR) of 11.85% for medicine sales in India.

Interview with experts

Interview -1Name – Pradeep sarkar.Designation – founder ,MART

What is rural India?

An area is defined as rural if 75% of its population is agrarian. Currently, India has more than 750 million people living in rural areas. Agriculture has dominated the Indian rural sector for decades, but lately, there has been a shift towards agricultural services and other

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sectors.

Rural India is fast emerging as a focus area in the country's economy. Especially during an economic slowdown such as the one we are experiencing now, the rural market enables a reasonable diversification to reduce the risk because of the difference between urban and rural lifestyles and consumption patterns.

Today, rural India is an unchartered territory and has not been explored by most players and industries to the fullest. In the last five years, only the Fast Moving Consumer Goods (FMCG) industry has focused on rural areas and benefited from it. The rural market remains largely under penetrated, and with the wide area covered by it, offers a great opportunity to players. Companies that have gained a strong rural foothold have been able to outperform other players in the industry.

Question. What basic factors differentiate Rural Marketing from Urban Marketing and how the Initiatives have to be different.

There are several difference between rural markets and urban markets. The first is the level of awareness about products and brands which is much lower in rural. The second is availability. Against 5000 odd town locations in urban, there are 6 lac village locations in rural, a distribution nightmare. Affordability is lower in rural as per capita incomes in rural are less than half of what they are in urban. Acceptability and usage is also a problem with some products.

The above issues are addressed by companies in many ways. Due to low penetration of electronic and print media in rural, awareness creation has to be done using Below the Line media such as haats, mandis, melas etc. Product availability has to be ensured in all feeder and mandi towns from where village retailers come to buy their stocks. Few companies like HUL and Colgate have even ensured direct availability in villages. HUL appointied 46,000 micro finance women as dealers under Project Shakti and Colgate has created the bicycle enterpreneur model where youth sell to retailers in villages and to consumers in haats. Both models were co-created by MART. Affordability is addressed by low unit packs by most FMCG brands in rural India. To ensure acceptability companies try and understand the usage habits and the ecosystem to ensure that product design is relevant for rural use.

Question. Is It ok For urban guys doing rural research? are rural guys involved in whole process?

There are a few Do's and Don'ts in rural research for urban researchers. Wear simple clothes so that rural people feel you are one of them and greet

them in the local manner e.g. Ram, Ram in the north

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Start by asking general questions which are of interest to villagers e.g the monsoon, crops etc

The purpose of the research should be shared with the respondent to gain their trust and get honest answers

Rural people can handle only limited information at a time. Avoid a barrage of direct questions. Intersperse subject-specific questions with some general questions to provide a mental break

If a local NGO worker can accompany it helps as he has a rapport with local people and also understands local dialect. Otherwise the researcher should consult an educated resident to familiarize him with the local language

Researcher may find it difficult to interact with villagers on a one to one basis because normally villagers gather in a crowd in front of strangers. The interviewer could make a special request to people gathered not to prompt the respondent.

In short the urban researcher should be sensitive to rural culture and practices.

Interview -2

Name – Philipe haydon

Designation – CEO , Asia Pacific , The Himalaya Drug Company

What is the reason for the company's focus on rural areas?

The Indian pharma market is regarded as one of the fastest growing pharma markets in the world. In 2007-08, this market was valued at over Rs 31000 crore. Though metros and cities account for the majority share of the Indian pharma market, it is the rural pharma market share which is increasing significantly year on year. Besides, 70 percent of the Indian population resides in rural markets. As disposable incomes increase in rural areas, people have better access to healthcare, resulting in higher demand for good quality drugs. Therefore, Class IA, II towns and rural markets hold tremendous growth opportunity for pharma companies.

Himalaya's entry into the rural market is driven by the fact that we have a vast range of products which address disease conditions and health problems widely prevalent in rural areas. We also have the required logistical and trained manpower support to expand to rural areas. Moreover, we have adopted a multi-pronged growth strategy for the pharma division which includes among other things focused promotion and wider exposure of our product range to more doctors across the country. To accomplish this we need to expand and

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divisionalise further. Therefore, entering rural areas, which have a huge growth potential, is a logical step for us.

What took you so long to target the Indian rural market in terms of a sustained brand building and marketing effort? Is it because you find the markets in the cities saturating or is it because you see a bigger potential in these geographies?

Metros and big cities will continue to be important markets for Himalaya. However, the market share of rural pharma is increasing significantly year on year. By 2015 upcoming small cities and rural centers will contribute almost as much to pharma growth as metros and top-tier towns. Hence it made sense for us to expand into rural markets.

The opportunities for Himalaya's rural expansion are huge on account of the following factors:

Many of the districts are still to be tapped by pharma companies and therefore competition in rural areas is relatively less

Product mix of Himalaya is suitable for rural markets Rural areas are susceptible to counterfeit and spurious drugs and hence there is huge

space for good quality and authentic medicines.

What is the growth potential through expansion in rural areas?

According to the McKinsey report, rural areas account for 21 percent to the country's pharma market.

Moreover, the planning commission estimates that village dwellers have started spending 12 percent of their household income on healthcare. We have witnessed that people in rural areas have a greater preference for safe, effective, economical and preferably natural products.

Can you quantify the investments that the company is making into these areas? How will these investments be funded?

The investments in HR and marketing activities are substantial and on par with our expansion plans. We plan to enter Class 1-A and 2 towns and have invested accordingly.

All investments are funded through internal sources.

At present what is the revenue that company generates through the rural markets?

The rural marketing division has been set up this fiscal year and we aim to generate between 10-15 percent of our existing turnover through this division.

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A McKinsey report published last year suggests that small towns and rural centers will be contributing as much as metros and top-tier cities in pushing the domestic pharma growth by 2015, what percentage do you think will Himalaya contribute in both these areas?

By 2015, we expect the domestic revenues of our pharma division to be split almost evenly between metros and small towns/ rural areas.

What has been your key focus and strategy for investments in pharma?

Our main focus is on R&D. Himalaya is the only herbal company to have a pharma product (Liv.52) which is amongst the top five selling drugs in India. Our advanced scientific research puts us on par with major allopathic companies and establishes credibility, safety and efficacy of our drugs. We also make substantial investments in HR, marketing and patient education.

Most of Himalaya's marketing efforts seem to be directed at repositioning herbal healthcare systems. What are you doing on the product development front? Are you looking at developing new products that are in line your with marketing direction whilst you expand in the rural areas?

We are doing advanced research on tropical diseases common to rural areas in India including dengue, malaria and infectious and viral diseases.

What are the various channels the company intends to use to grow in these markets?

Himalaya has launched a strategic business unit called 'Zera' ( Hebrew: 'seed') which will focus exclusively on expansion into Class II, III and IV towns and other rural areas. With the introduction of Zera, we will increase our total reach to more than two lakh doctors. The promotional reach would be spread across different specialties, taking us closer to our objective of achieving one product of Himalaya in each household in the country.

Tell us about the specific geographies the company has identified for expansion and how this entire initiative will benefit the masses?

Himalaya has a presence in over 300 districts and we plan to double this over the next two years. This year we will concentrate on expanding our presence in rural areas in the North. With our entry into rural markets more people will have access to safe, affordable and efficacious healthcare. This will result in higher patient compliance. We also believe in promoting health education and awareness. This will be an important part of our rural marketing initiative. Through a combination of patient information leaflets made available in local languages, medical camps and health education workshops, we intend to raise the level of health awareness in rural areas.

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Research Methodology

STUDY REQUIREMENT –To find out the different factors influencing prescribing behavior of rural medical practitioner and in – depth analysis of pharmaceutical business in rural India.

OBJECTIVE

To study the ground realities of pharmaceutical business in rural areas. To study the prescribing behaviour of rural medical practitioner. To analyze the different aspects of pharmaceutical retail marketing in rural

India. To study the details of marketing strategies employed by different

pharmaceutical companies in order to tap the rural market.

SUB OBJECTIVE

To study and observe the different aspects of rural marketing in India. To study and analyze the different marketing trends in rural market. To study and observe the psychological aspect of buying behavior of rural

consumers. To formulate an outline of new marketing model based on the research.

Problem definition

Many pharmaceutical companies have eyed rural market but their marketing model and strategies have failed time and again.. This is because most of the companies evaluate this opportunity in a knee-jerk manner and give up when it becomes logistically unmanageable.

They often give up due to lack of skill sets, expertise and experience to reach these unexplored territories. The research will go in depth to analyze the reasons behind the failure of these strategies and will also dealt in detail with the causes that affects the prescribing behavior of rural practitioner. The research will also focus on successful and existing trends in rural pharmaceutical marketing.

Scope of the research

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The research will provide an in-depth analysis of existing trends in rural pharmaceutical business.

The research will provide different aspects of prescribing behavior of rural medical practitioner. It will help marketers to design new marketing model and strategies to penetrate rural market.

The research will provide the actual data to policy makers of the country about the scarcity of registered medical practitioner in rural India.

The research will provide an insight into the pharma retailing in rural India.

Research Design

There is a huge array of alternative research designs that can satisfy research objectives. The key is to create a design that enhances the value of the information obtained, whilst reducing the cost of obtaining it.

Marketing research can be classified one of three categories:

1. Exploratory research2. Conclusive research :

a) Descriptive researchb) Causal research

These classifications are made according to the objective of the research. In some cases the research will fall into one of these categories, but in other cases different phases of the same research project will fall into different categories.

1. Exploratory research has the goal of formulating problems more precisely, clarifying concepts, gathering explanations, gaining insight, eliminating impractical ideas, and forming hypotheses. Exploratory research can be performed using a literature search, surveying certain people about their experiences, focus groups, and case studies. When surveying people, exploratory research studies would not try to acquire a representative sample, but rather, seek to interview those who are knowledgeable and who might be able to provide insight concerning the relationship among variables. Case studies can include contrasting situations or benchmarking against an organization known for its excellence. Exploratory research may develop hypotheses, but it does not seek to test them. Exploratory research is characterized by its flexibility.

2. Conclusive research is the research design which leads us to conclusion. It is classified into:

a) Descriptive research.b) Causal research

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a) Descriptive research is more rigid than exploratory research and seeks to describe users of a product, determine the proportion of the population that uses a product, or predict future demand for a product. As opposed to exploratory research, descriptive research should define questions, people surveyed, and the method of analysis prior to beginning data collection. In other words, the who, what, where, when, why, and how aspects of the research should be defined. Such preparation allows one the opportunity to make any required changes before the costly process of data collection has begun.There are two basic types of descriptive research: longitudinal studies and cross-sectional studies. Longitudinal studies are time series analyses that make repeated measurements of the same individuals, thus allowing one to monitor behavior such as brand-switching. However, longitudinal studies are not necessarily representative since many people may refuse to participate because of the commitment required. Cross-sectional studies sample the population to make measurements at a specific point in time. A special type of cross-sectional analysis is a cohort analysis, which tracks an aggregate of individuals who experience the same event within the same time interval over time. Cohort analyses are useful for long-term forecasting of product demand.

b) Causal research seeks to find cause and affect relationships between variables. It accomplishes this goal through laboratory and field experiments.

Research Design Used in the Project-

Descriptive format of conclusive research.

Data Collection

Sampling Procedure: 600 Rural Medical Practitioners and 170 Rural Chemist were Taken as sample representative from 330 panchayats of DARBHANGA – a district situated in north Bihar. All of them were male with exception of 2 female.

Primary data: It was collected through well structured questionnaire from Rural Medical Practitioners and Chemists. The questionnaire design was such that it motivated the respondents to cooperate, become involved, and provide complete, honest and accurate answers.

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Secondary Data: it include information obtained from literature review, articles in the

newspapers, magazines and internet.

Data Presentation-it is based on statistical analysis of the feedbacks obtained.

A brief description of area where research was conducted: DARBHANGA

Darbhanga is one of the thirty-seven districts of Bihar state, India, and Darbhanga town is the administrative headquarters of this district. Darbhanga district is a part of Darbhanga Division. . The district is bounded on the north by Madhubani district, on the south by Samastipur district, on the east by Saharsa district and on the west by Sitamarhi and Muzaffarpur districts.The area of the district is 2,279 km2 .

Geography

The district has a vast alluvial plain devoid of any hills. There is a gentle slope from north to south with a depression on the centre. The District can be divided into four natural divisions. The eastern part consists of Ghanshyampur, Biraul and Kusheshwarsthan blocks. This part contains fresh silt deposited by the Kosi River. This region was under the influence of Kosi floods till the construction of Kosi embankment during the Second Five Year Plan. It contains large tracts of sandy land covered with wild marshes. The second part comprises the regions lying south of the Burhi Gandak River and is the most fertile area in the district. It is at a higher level than the other parts of the district and contains very few marshlands. This part is well suited to the rabi crops. The third natural region is the doab between the rivers, Burhi Gandak and Baghmati and consists of low-lying areas dotted over by marshes. This region gets flooded almost every year. The fourth division consists the Sadar sub-division of the district. This region is watered by numerous streams and contains some uplands.

Rivers

Though numerous rivers originating in the Himalayas water this district, it has four major river systems, the Baghmati, the little Baghmati, the Kamla and the Tiljuga. The Bagmati, enters this district from Muzaffarpur district, forms a natural boundary between the district and Samastipur district and pursues a southeasterly course till it joins the Burhi Gandak River near Rosera. The little Bagmati enters the district from Madhubani district near Pali and turns past Darbhanga town down to Hayaghat, where it joins the Baghmati proper. The Kamla River enters the district at Singar Pandaul, and flowing east of Darbhanga town, joins the Tiljuga at the southeastern corner of Rosera block. The Tiljuga skirts the eastern boundary of the district.

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http://en.wikipedia.org/wiki/Muzaffarpur_district

http://en.wikipedia.org/wiki/Sitamarhi_district

http://en.wikipedia.org/wiki/Saharsa_district

http://en.wikipedia.org/wiki/Samastipur_district

http://en.wikipedia.org/wiki/Madhubani_district

http://en.wikipedia.org/wiki/Darbhanga_Division

http://en.wikipedia.org/wiki/Darbhanga_Division

http://en.wikipedia.org/wiki/Darbhanga

http://en.wikipedia.org/wiki/India

http://en.wikipedia.org/wiki/States_and_territories_of_India

http://en.wikipedia.org/wiki/Bihar

http://en.wikipedia.org/wiki/Districts_of_Bihar


Climate

The climate of this district is dry. There are three well-marked seasons in this district, the winter, the summer & the rainy season. The winter season starts in November and continues till February, though March is also pleasant. Westerly winds begin to blow in the second half of March and temperature rises considerably. May is the hottest month when the temperature goes up to 42ºC. Rain sets in towards the middle of June. With the advent of the rainy season, temperature drops but humidity rises. The moist heat of the rainy season is very oppressive till August. The rain continues till the middle of October. Average annual rainfall of this district is 1142.3 mm. Around 92% of the total rainfall is received during monsoon months.

Economy

Agriculture is the primary occupation of the majority of the population of this district.

Agriculture

The major crop of this district is rice. Other crops produced in this district are wheat, maize, pulses, oil seeds and sugarcane. The district also has many mango orchards.

Industry

The main industries of this district are Paper Mills, Sugar Mills and Handloom.

Demography

Population of this district as per 2001 census is 32,85,493 of which rural population is 30,18,639 and urban population is 2,66,834. According to the Census of India 2001[1], literacy rate of the distyrict is 44.32% (male 57.18%, female 30.35%). As per 1991 census, the district has 19,55,068 Hindus, 5,55,429 Muslim, 141 Christians, 198 Sikhs, 26 Buddhists and 27 Jains. The main languages spoken in this district are Hindi, Maithili and Urdu.

Divisions

The district comprises three sub-divisions which is further divided into 18 blocks. The sub-divisions are Darbhanga Sadar, Benipur and Biraul. The blocks are Darbhanga, Jale, Singhwara, Keoti, Manigachhi, Tardih, Alinagar, Benipur, Bahadurpur, Hanuman Nagar, Hayaghat, Baheri, Biraul, Ghanshyampur, Kiratpur, Gaura Bauram, Kusheswarasthan,and Kusheswarasthan East. This district has 329 Panchayats, 1269 villages & 23 Police Stations. Some of the villages are Baqui pur,Maheshpatti, Kaligaon, Kansi, Pandaol, Panchov,Rajarouly-Rampur rouly, Balbhadrapur, Gobindpur, Dharar, Koilakh, Karaj, Nehra, Sahora, Kabilpur, Bahadurpur, Anandpur, Deokuli, Rambhadrapur, Ughara, Patore,

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http://en.wikipedia.org/wiki/Urdu

http://en.wikipedia.org/wiki/Maithili

http://en.wikipedia.org/wiki/Hindi

http://en.wikipedia.org/wiki/Darbhanga_district#cite_note-0


Ghanshyampur, Mohanpur, kamtol,Kothram,Dodhiya,Balha, Dheruk, Mahinam, pahadi, Antaur and "Muraitha"

There are one Lok Sabha and 10 Vidhan Sabha constituencies in this district. Manigachhi, Bahera, Darbhanga Rural (SC), Darbhanga, Keoti and Hayaghat Vidhan Sabha constituencies are part of the lone Lok Sabha constituency of this district, Darbhanga. Jale Vidhan Sabha constituency is part of Madhubani Lok Sabha constituency while Ghanshyampur, Baheri and Singhia Vidhan Sabha constituencies are part of Rosera Lok Sabha constituency (only a part of Singhia Vidhan Sabha constituency is within this district).

Culture

This district is known for its rich tradition of folk art form,Mithila Painting. Treditional folk drama styles of Mithila region are also very popular in this district. Most prominent among them are Nautanki, Natua Nach and Sama Chakeva.

A number of fairs and melas are organised in various parts of the district. The Kartik Purnima mela, Dussehra mela, Janmashtami mela and Divali mela are most popular among them.

Two of the prominent and popular Artistic groups of this district are Mithila Chetna Parishad & Adarsh Kala Manch. Mithila Chetna Parishad is a professionally managed conglomarate of artistic activities of Mithila region. They also conduct stage shows all over India and abroad to spread the ethos of Maithili art and culture. Adarsh Kala Manch, Madanpur(in Bahadurpur Block)is run by a group of amateur artists and activists of the villages in this region. This group is immensely popular due to the depth and style of presentation of local Maithili Natak ( based on religious and social themes). However off late, the scarcity of funds has forced this club to reduce its activities and limit it within the village during Festivals like Chhat & Chitragupt Puja.

Questionnaire for doctors

1. What factors do you consider while prescribing a brand?A) Company’s image.B) Brand name.C) Medical representativeD) Prescription pattern of key opinion leaders.E) Cost factorF) Better availability

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http://en.wikipedia.org/wiki/Madanpur

http://en.wikipedia.org/wiki/Mithila


2. Do you shift from one brand to another?A) YesB) No

3. If yes, then reasons might be:-A) Medical representativeB) Better product (cost, formulation)C) Less patient compliance

4. Do you consider patient while prescribing a brand?A) YesB) No

5. If yes, which among the following influences your prescribing behavior:-A) EducationB) IncomeC) LocationD) Profession

6. Do you like to prescribe extended version of a brand? (Ex. Becasule - Becasule- Z)A) YesB) No

7. What services among the following is being provided by pharmaceutical companies?A) Education materialB) Provide sample for poor patient C) Both A & B.

8. How much time do you spent for a Market Representative?A) 0-3 minB) 3-5 minC) 5-10 minD) More than 10 min

9. What qualities of Market Representative do you appreciate?A) RegularityB) Updated product knowledge C) Commitment fulfillment on their partD) Communication10. How frequently do you use an internet?A) DailyB) WeeklyC) RarelyD) I don’t use internet

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Questionnaire for chemist

1. What affect sales of drug at your store?A) Prescription PatternB) Sales promotion schemeC) Expiry return

2. Why do you keep stock of particular company?A) Prescription PatternB) Better productC) Image of company D) Expiry ReturnE) Credit period

3. What motivates you to stock a new product?A) Company’s nameB) Relation with M.RC) Relation with wholesaler and stockiestD) Flow of prescriptionE) Brand name

4. Do you sell alternate medicine to patients? A) YesB) No

5. Why do you substitute a brand?A) MarginB) SchemeC) I don’t substitute

6. How much time you Give to M.R.?A) 0-3 minB) 3-5 minC) 5-10 minD) More than 10 minE) No visit by M.R

7. Are you satisfied with performance of wholesaler?A) YesB) No

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8. If No, why?A) Do not disclose the company scheme.B) Their attitude C) DiscountD) Payment pressureE) All above

DATA ANALYSIS

Sample details 600 Rural Medical Practitioners and 170 Rural Chemist were taken as sample representative.

All of them were males except two..

I was in dilemma to include mid - wives as prescriber or not and at last decided to omit them from the list of rural medical practitioner.

Most of them don’t seem acquainted with common medical terminologies like drug interaction, contraindication etc.

The working hours of most of them were between 7am -11 am in morning and 4pm-8pm in evening.

Around half of them were engaged in other works apart from prescribing medicines.

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RURAL PRACTITIONERS : DATA ANALYSIS

1. Factors affecting prescribing behavior of Rural Practitioner

Companys image

Brand name

M.R

Prescription pattern

cost

availability

0% 5% 10% 15% 20% 25% 30% 35% 40%

19%

37%

21%

9%

5%

9%

Factors affecting prescribing behavior

Findings: The most important factor that influenced the prescribing behavior was brand name. Ex- becosule of Pfizer was found in remote villages without any promotion activity

by pharma major. The same was applicable in case of crocin of GSK, flygyl of Piramal and grilinctus syrup.

About 21% of them admitted being influenced by regular visit of M.R.This implies the importance of regular detailing in pharma industry.

About 19% of rural practitioner said that the company’s name and image matters to them. But most of them named Indian majors like Cipla, Ranbaxy, Alkem, Aristo etc as big company instead of international big wigs.

Only 9% of doctors said that they go by prescription pattern and availability. Most surprisingly only 5% of them considered cost as important factor influencing

prescribing behavior.

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2. Shifting from one brand to another

77%

23%

Shifting of brand

YesNo

Findings:

77% agreed that they do change the brands depending upon various factors ranging from profit margin, drug availability, consistent detailing to the quality of drug.

These 77% doctors can easily switch from one brand to another and can be target customer for pharmaceutical companies aiming at rural penetration.

23% of them said they are using same medicines and combination from the time they came into business. Some of them were using same medicines for last 25 yrs.

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3. Reasons behind shifting of one brand to another

M.R Better product less patient compliance

0%5%

10%15%20%25%30%35%40%45%

39%33%

28%

Reasons behind shifting of brand

Findings:

Most of the practitioner admitted shifting of brand due to regular visit of medical representatives.

Medical representatives provide free samples to practitioners which act as push factor for switching of medicines.

Good products in terms of quality and money are also an important reason behind switching of one brand of another.

Patient non compliance was also one of the factors for switching of brands.

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4. Shifting of prescribing behavior patient wise

44%

56%

Patient influencing prescribing behavior

YesNo

Findings: The opinion was almost equally divided on this question.

44% of the practitioner said that they consider patients while prescribing medicine.

56% of the practitioner said that they did not consider patients while prescribing medicines.

They prescribe most of the medicine which is available to the patients irrespective of their income level, education, profession etc.

5. Patients influencing prescribing behavior

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EducationIncome

LocationProfession

0%

10%

20%

30%

40%

50% 44%

32%

2%

22%

Patients influencing prescribing behavior

Findings: 44% of Practitioner admitted that there prescribing behavior changes as per the

educational qualification of patient.

32% of practitioner said income of the patient was influencing factor in prescribing a drug.

It clearly implies that prescribing behavior changes with change in income of patients.

Profession of patient has an affect on the prescribing behavior was agreed by 22% of prescriber.

Only 2% of practitioner said that location of patients influences their prescribing behavior.

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6. Do practitioner prescribe extended version of a drug or brand?

16%

84%

Prescribing extended version of a drug

YesNo

Findings: 84% of the practitioners were not acquainted with the term extended version of a drug

or brand.

This clearly shows the lack of product knowledge and other related technicalities in rural practitioners.

The pharmaceutical companies having rural penetration rarely provide literature related to product and are only interested in promoting their traditional brands.

16% of them admitted prescribing and knowing about the extended version of a drug.

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7. The services provided by pharmaceutical companies to rural practitioners

Education material sample for

poor Both A& B

0%

20%

40%

60%

80%

4%

67%

29%

Services provided by pharmaceutical companies

Findings: Majority of doctors get physician samples for poor.

They are provided free samples to treat poor at the same test the efficacy of drug.

Only 4% acknowledged that supportive education material is being provided by pharmaceutical companies.

29% admitted that they get both service i.e education material as well as free samples.

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8. Time spent on medical representative by rural practitioners

0-3 min 3-5 min 5-10 min more then 10 min

0%5%

10%15%20%25%30%35%40%45%

18%

27%

42%

13%

Time spent on medical representative

Findings: The study resulted in shocking results.

Majority of rural doctors spent between 5-10 minutes per M.R as compare to 1-2 min by their urban counterparts.

27% of rural practitioner said that they spend around 3-5 minute per M.R .

13% admitted that M.R rarely visits them. So, they spend more then 10 minutes whenever they visit them.

Only 18% admitted that they have fixed time for M.R visits and they did not spent more then 3 minute on M.R.

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9. Qualities of M.R most appreciated by rural practitioners

Regularity

Update knowledge

Commitment

Communication

0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

38%

9%

39%

14%

Qualities of market representative

Findings:

Commitment and regularity were the attributes of M.R most liked and appreciated by Rural Practitioners.

14% of rural practitioners said that they appreciate a M.R because of communication skill.

Only 9% of Practitioners admitted that they appreciate up to date knowledge of M.R.

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10. Rural practitioners as internet user

Daily weekly Rarely Never

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

0.16% 4.64%

45.80% 49.40%

Use of internet by Practitioner

Findings:

Majority of practitioners are not internet user.

Most of them just know internet by name.

Most of them don’t have even their mail address.

45% of practitioners used internet rarely.

Only 4.64% of practitioners are weekly user.

Only 1 practitioner of the whole study admitted using internet every day.

RURAL CHEMISTS: DATA ANALYSIS

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1. What affect sales of drug at your store?


Sales promotion

Expiry return

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

82%

18%

0%

Factors affecting sales

Findings: 82% of chemist said prescription of doctors plays most important role in affecting the

sales of drugs.

Most of the rural chemist admitted stocking the drug as per the prescription pattern of nearby Practitioner.

It clearly shows that retail pharma marketing is almost same as urban pharma retail marketing.

Only 18% of retailers admitted that sales promotion also affects the sale of drugs at their store.

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2. Reasons for stocking medicine of a particular company by rural retailers


Better product

Companys Image

Expiry return

Credit period

0% 10% 20% 30% 40% 50% 60% 70%

62%

7%

4%

0%

27%

Reasons for stocking medicine of a particular company

Findings: Prescription pattern is main factor behind stocking of drug of a particular company.

27% of rural retailer admitted that credit period is also one of the important factors behind stocking of drug of a particular company.

Only 7% supported the statement that better quality of product is one of the reasons behind stocking of drug of a particular company.

4% of rural retailers said that company’s image is the factor behind stocking drug of a particular company.

Not even a single retailer admitted that companies provide them the service of expiry return.

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3. Motivating factors behind stock of a new product by rural retailers

0%20%40%60%

11%2% 4%

58%

25%

Factors motivating for new stocks

Findings: Flow of prescription was foremost motivating factor in stocking of new drug by rural

chemist.

25% of chemist said that brand name was motivation behind stock of new drug.

11% of chemist said that company’s name was motivation behind stock of new drug.

Only few of them said that relationship with M.R and with whole seller and stockiest Were the motivations behind stock of new drug.

4. Substitution of brand by rural retailer

49


69%

31%

Substitution of brand

YesNo

Findings:

69% of retailers admitted that they substitute the brand.

Substitution may be because of many factors.

Only 31% of retailer said that they do not substitute.

5. Reasons behind substitution of brand by retailers

50


Margin

Scheme

I don’t substitute

0% 10% 20% 30% 40% 50% 60% 70%

63%

28%

9%

Reasons behind substitution of brand

Findings: 63% of rural chemist admitted that they substitute brand because of high profit

margin.

High profit margin has opened the door of sub standard drugs in rural market.

Only 9% of retailer said that they don’t substitute.

6. Time spent on medical representative by retailers

51


0-3 min 3-5 min 5-10 min more then 10

minNo visit by M.R

0%5%

10%15%20%25%30%35%40%45%

9%

22%

44%

18%

7%

Time spent on market representative

Findings:

44% of retailers said they spend between 5-10 minutes of their time on M.R.


18% of retailers said they spend between more then 10 minutes of their time on M.R.


7% of retailers admitted that M.R never visited their shop.

7. Satisfaction with performance of whole seller

52


96%

4%

Performance of wholeseller

YesNo

Findings:

Almost all of retailer said that they are not satisfied with the whole seller.

They said that whole seller didn’t respect them and treat them badly.

Only 4% of them admitted that their relationship with hole seller is fair and they are satisfied with performance of whole seller.

8. Reasons for dissatisfaction with whole seller

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Do not disclose scheme

Attitude discount Payment pressure

All of above0%

10%20%30%40%50%60%70%80%90%

100%

2.00% 2.50% 3.00% 4.50%

88.00%Reasons for dissatisfaction with whole seller

Findings:

Most of the rural retailers were not satisfied with the whole seller.

The whole sellers did not behaved good with rural retailers mainly because they are not big buyers as compare to urban chemists.

Majority of the whole seller do not credit to rural retailers.

The whole sellers do not disclose company’s gifting and other benefit schemes to rural retailers.

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Limitations of the study

India is inhabited by people of different culture, religion and traditions. The language and tradition changes here after every 10 km. Any kind of research on Indian population and its buying behavior cannot be accurate

because of its diverse population with more diverse living style and culture. This is the reason why many market model and strategies employed by several

companies in rural India did not yield expected result. The research on prescribing behavior of rural practitioner was done on practitioners

from a district of Bihar. The culture and tradition of Bihar may match the tradition and culture of other Hindi

speaking state but it differs from south India or north east states or other non-Hindi states.

So, the conclusion or findings of research may vary if done on a district of south India or any non-Hindi state.

The questionnaire does not include any question to measure the psychological behavior of rural practitioner.

So, the result may not be as accurate due to lack of measurement of psychological behavior of rural prescriber.

The findings of the research are not sufficient to formulate any new rural marketing model or strategy because :

a) The questionnaire is only confined to prescribing aspect of rural practitioner.

b) The questionnaire does not include any question to measure the psychological aspect of rural practitioners.

c) The questionnaire does not include any question related to demography of region.

d) The samples of the research were confined to one region of country.

Conclusion of the study

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Rural pharmaceutical market has huge potential and is untapped market with huge promises in coming years.

Most of the rural practitioners do not have proper education and there practice is basically based on experience.

Both rural practitioners and end users are loyal to brands. Brand name and company’s image are the important factors affecting the prescribing

behavior of rural practitioners. Generics or low quality drugs are also making space in rural market because of its

low cost and good distribution channel. The prescribing behavior of rural practitioners basically includes 1-2 branded drugs

along with 3-5 generic or low quality drugs. Regular detailing of drugs by Medical Representatives plays an important role in

shifting brand loyalty of rural practitioners. Prescribing behavior in rural areas also changes with income, profession and

education of patients. Most of the rural practitioners spent good amount of time on interacting with Medical

Representatives. Rural practitioners are not internet users. Prescription flow is major factor behind stocking and selling of drugs by rural

chemists. Substitution of brand is done by rural chemists and it’s mainly due to high profit

margins. The whole sellers at nearby town or city do not disclose company’s schemes to rural

retailers. The retailers are not at all satisfied with whole sellers.

Recommendations

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The government of India should take appropriate steps to establish primary healthcare centers at each and every village of country.

The regulatory bodies should act strictly and new laws should be made to stop the flow of sub-standard drugs in rural areas.

The training program should be designed from time to time for rural medical practitioners (RMP) in order to train them as per standard norms of medical science.

The RURAL MBBS program planned by government should be implemented as soon as possible because of scarcity of qualified practitioners in rural India.

The pharmaceutical companies planning for rural penetration should play dual role of educator and provider.

The pharmaceutical companies should apply different strategies for different rural areas because each area has different ethnicity, values and cultures.

The pharmaceutical companies should design a new rural distribution strategy instead of traditional one for deeper penetration into the rural market.

Bibliography

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Kolassa .M.Euqene ,Perkins .G.James ,Siecker.R.Bruce: Pharmaceutical Marketing- Principles, Environment, and Practice

Chatangi.R.Subba: Pharmaceutical Marketing in India.

Smith.Mickey : Pharmaceutical Marketing – Strategy and Cases.

www.express pharma online.com

pharma mkting.blogspot.com

www.the pharmamarketing .com

en.wikipedia.org/wiki/ Rural _markets

www. rural relations.com

www.ibef.org/economy/ rural market.aspx

Bijapurkar.Rama: we are like that only

Rao .G.Srinivas:Rural Marketing in India-A Case Study

Kashyap .Pradeep , Raut.siddhartha : Rural Marketing

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http://www.ibef.org/economy/ruralmarket.aspx

http://www.ruralrelations.com/

http://www.thepharmamarketing.com/

http://www.expresspharmaonline.com/

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