How could Physician’s Perception about the “Combination Therapy” in Managing Asthma Affects its Sales Performance?

How Could Physician’s Perception about the “Combination Therapy” in managing Asthma affects its Sales performance? (Special reference to “Symbicort Turbuhaler “by AstraZeneca) Project Propsal Table of Contents ContentsPage

1. Title 3
2. Introduction 3
   1. Background of the problem 3

1. Insight to company
2. Insight to product
   2. Establishment of the problem 4
   3. Objectives of the report 5

3. Literature Review 6
   1. introduction to key concepts 6
   2. Theoretical Framework 6
   3. Analyzing finding at national level 9
4. The Approach to data collection & analysis 9
   1. Research Methodology 10
   2. Research Instruments 10
   3. Sample Technique 10
   4. Data collection 11
   5. Data analysis 11
   6. Credibility of proposal 12
5. Consideration of ethical issues 12
6. Action Plan 12
7. List of references 13

List of Figures Figure 1: Market share comparisons in combination Market 2013/2014. Figure 2: The GMS: A Broad conceptualization of Global Marketing Strategy Figure 3: Sampling Design List of Tables Table 1: Sales Volume Comparison 2012/2013/2014

1. Title

How Could Physician’s Perception about the “Combination Therapy” in managing Asthma affects its Sales performance? (Special reference to “Symbicort Turbuhaler “by AstraZeneca)

2. Introduction
   1. Background of the problem

When analyzing the background of the problem, it is important to have and comprehensive knowledge about the organization and the products.

1. Insight to the company

Astra was a former Swedish pharmaceutical company which was founded in 1913. Due to various future ambitions “Astra- PLC” and “Zeneca-PLC” of United Kingdom merged together and formed AstraZeneca-PLC in1999. As per the sales revenue of 2013 AstraZeneca holds the 6th position globally in multinational pharmaceutical industry recording a sales turnover of US $ 27.9bn (Top 20 Pharma, 2013)

2. Insight to product.

Turbuhaler is a class of a device innovated by AstraZeneca, this device is preloaded with drugs to use in asthmatic Patients. Widely used as “Symbicort Turbuhaler” (generic name of drug included Budesonide and Formetrol as a combination) Symbicort Turbuhaler as a product has been in Sri Lanka for more than 6 years. With having lots of benefits and still holds the patency for the device, it’s available at a premium price of LKR. 2516/= per device with 60 doses, and available in two strengths.

2. Establishment of the problem.

Even though “Symbicort Turbuhaler” offers more Clinical benefits over competitors, as per the internal sales data of AstraZeneca- Sri Lanka in 2014, Symbicort Turbuhaler has shown a 5% growth over 2013. Even though the growth is 5% the market share has come down by 1%. As per the internal sales in 2013 has been de- grown by 21% over 2012. (AstraZeneca-SL, 2014) Table 1. Sales Volume Comparison 2012/2013/2014

2012	2013	Growth	2014	Growth
Units	Value	Units	Value	Units	Value
18,253	38,141,957	14,357	31,413,116	79%	15,020	32,863,760	105%

But in overall Combination Market data in Sri Lanka, it is identified that total market is de-growing at -3.48% in revenue over 2013 in 2014. But as Multinational products “Seretide” by GSK (Glaxo SmithKline) also has lost their MS by 2%, on the other hand Branded generics have increased their MS by 1% (IMS, Q4-2014). On the other hand AstraZeneca allocates 10 % of “Symbicort” sales revenue as its promotional budget. That means averagely about LKR 3 Mn per annum is being used for promotions of “Symbicort”. But when “Symbicort” growth is depend on various factors in marketing, need to identify the same for its performance. However expected growth of “Symbicort” in 2014 was 15% (AstraZeneca-SL, 2014) Figure 1. Market share comparisons in combination Market 2013/2014.

3. Objectives of the Report

The main objective of this study will be identifying the perception and the prescribing patterns of physicians; will it impact the sales performance of a pharmaceutical product?

1. To identify the key drivers that affects the sales performance of “Combination therapy”
2. To identify effective way of increasing sales volume of “Symbicort” and secure the market share.
3. To Increase the financial contribution to R&D and strengthen the product pipeline of AstraZeneca.
4. To provide suitable suggestions and recommendations to the management of AstraZeneca to overcome above problems.

3. Literature Review 3.1 introductions to key concept In this context of study it is really need to be understood that the variations of trends in sales impact is due to marketing concepts are used to meet the objectives. To arrive at organizational expectations, a marketing plan or a conceptual frame work of marketing is meant by marketing mix (Palmer, 2007). According to Ala’Eddin Mohammad Khalaf Ahmad (2013) marketing mix refers to a set of tools that offers customer which in return to an organization to achieve their objectives. Marketing mix 4ps consist of product, price, place, and promotion. When a product performance is declining and variations in performance in certain period of time, it is right to analyze the marketing mix which includes the perception of the customers towards the product, the promotion strategies and the targeted customer base is covered. Which also have a positive or negative impact on performance? Since “Symbicort Turbuhaler” is a tangible product conventional 4ps Marketing Mix has been taken as the concept to explore. 3.2 Theoretical Framework to the Project The study that has been heavily emphasized that marketing mix is increasing being adopted by in virtually all the sectors of the economy. Hence as per Aremu, M.A. and Bemiduro, J.A., (2012) marketing mix has been a major determinant of the organizations short term and long term success. Furthermore this study emphasizes that adopting marketing mix by an entrepreneur will able to gain competitive advantage as well. Since this study states that organization success can achieve with marketing mix, it will be an interesting opportunity to find out more in-depth what kind of elements will impact the same. Marketing mix is a great tool to gain competitive advantage over other marketed products (Ibidunni, O.S., 2011). As per this study it is proven that in Nigerian multinational companies and indigenous food and beverage companies have utilized marketing mix elements to arrive at a competitive advantage. And it is also clearly identified and mentioned the variables could influence the perception of the consumer towards companies achieving its performance level in the market place. This study strongly recommends indigenous companies to follow relevant marketing mix. Hence this study emphasize on marketing mix as a tool of gaining competitive advantage over other markets, will be considered as a supportive study and will be explored for further information to do this research. As the above mentioned studies Shaoming Zou and S. Tamer Cavusgil (2002) has clearly stated that the relationship between global marketing strategies has an impact on organizational performance. Global Marketing Strategies (GMS) that integrates three major perspectives which includes standardization, configuration- coordination, and integration perspectives. Since AstraZeneca Pharmaceutical is a Multinational Company implementing global marketing strategies can have an impact on organizational performance. The below shown Figure 2. Explains eight dimensions which global marketing strategy at which degree that is implemented to market products across other country markets. Source: Journal of marketing, Vol. 66, Page 43. This study will be further explored deeply to get information for the research. As followed by the previous study, article published in Brazilian Administration Review by Brei, V.A., D’avila, L., Camargo, L.F and Engels, J., (2011) has done a meta-analysis on the influence of adaptation and standardization of marketing mix on performance in international context. The results of this analysis have shown it has a positive impact on its performance. If its adaptation, it is suggested to adapt price and followed by promotions, product and place. Since it is proven that marketing mix has a positive impact on its performance, referring this study will help to find out more information. Elaborating further more would like to explore more about, will prescribing patterns of physicians due to promotional strategies implemented companies through promotional staff? According to the study done by, Serhat, Vancelik. , (2007) it has been proven the promotions done by promotion staff, academic content (knowledge) which is shared with the physicians has made an impact on their prescribing pattern. This study can be explored to identify that any promotion strategies by AstraZeneca- SL will Impact the Physician prescribing Pattern. Pharmaceutical companies use scientific and educational information to physicians in giving the best treatment to their patients. But in Sri Lankan Health sector it is found to be different due to several factors. According to Geoffrey, K. Spurling, (2010) have done a systemic review to identify information from pharmaceutical companies and the quality, quantity, and cost of physicians prescribing. The results of this study have shown that the investment cost on promotion by the companies is competitively high and it has an impact on influencing physicians prescribing pattern. This study can be explore further to get information and will be supportive in identifying the factors in Sri Lankan Market. According to Saito S, Mukohara K, Bito S (2010), has done a survey in japan physicians to identify the relationship between the pharmaceutical Representatives or companies. The results have shown that the attitude of several physicians has an impact or influence in prescribing pattern and at a risk in long term. This is a clear identification and will be the same scenario which has impacted in srilankan market due to no regulation in controlling. Fusun. F. Gonul., (2001) has found that promotion of prescription drugs will impact on physician choice behavior. In this study not only price the promotions (detailing and sampling) have an impact on physician behavior which is positive in most cases. And physicians in this study have been categorized by fairly limited price sensitivity. This study will be deeply analyze and get further information to this research. Specially to develop questionnaires effectively. 3.3 Analyzing the findings at national level. Customer (Physicians) Perception impact on marketing mix which can be positive or negative in performance in a product or in an organization will be analyzed locally, and globally through reviewing the studies, articles, and journals stated in the theoretical frame work above in this research.

4. The Approach to data collection & analysis.

In order to selecting the methodology will be looked at the possibility of accessing to primary and secondary data in terms of getting permissions. And also specifically apply theories that learned in an appropriate manner, research methods, research instruments, sample technique, data collection, and data analysis will be elaborated in this topic and will give the credibility of doing this research.

1. Research Methodology

According to Naresh, K. Malhotra., (2008) it is identified that to formulate successful marketing strategies with rich insights, will get from both qualitative and quantitative approaches in combination. In this research Quantitative approach will be used to understand the relationship of the variables. Mainly quantitative approaches such as questionnaires will be used with physicians as they are very busy and less open for lengthy or in-depth discussions. But qualitative approach may be used for measuring the medical representative’s product knowledge by using secondary data available at Company.

2. Research instrument

According to Naresh, K. Malhotra., (2008) an instrument of research questionnaires have three specific objectives, first the respondents can and will answer which must translate the information in to a set of specific questions. This is a challenging objective. Second, a questionnaire must motivate and encourage getting involved in the interview. Third, it should minimize response error. So in this research Main instrument will be the questionnaire given to physicians. It’s a self-administrative questionnaire.

3. Sample Technique

Judgmental sampling (typical case sampling) will be used as a sample technique. There are few reasons to use judgmental sampling.

• Pharmaceutical industry is an academic and informative area
• Data saturation could be essential
• Difficulty of approaching elements
• Relatively low cost

Figure 3. Sample Design. Above sample of 35 elements will include following.

• 10 physicians
• 2 Chest Physicians
• 15 General Practitioners
• 8 Medical Officers

4. Data Collection

1. Primary data collection methods

Questionnaires will be distributed through medical representative. Medical representatives will be educated in obtaining answers to questionnaires.

2. Secondary data collection methods

• Annual Reports
• Territory sales reports
• IMS data
• Company internal Evaluation Reports ( Medical Representatives)

5. Data Analysis

Collection of data will be analyzed by using MS-Excel and also will be presented through bar charts, tables, and line graphs.

6. Credibility of this proposal.

This research is practical and achievable study. All sample and elements will be selected from current customer base of AstraZeneca Sri Lanka hence all customers are accessible. Since the total sample elements are restricted to 35 doctors. Completion of this research in given time frame is possible. Furthermore, financial liability is within the acceptable range.

5. Consideration of Ethical issues.

• Confidentiality of collected data will be secured.
• Access to hospital premises will be requested before collecting data

6. Action Plan

7. List of reference

1. Roger A.Plamer, Juanita Cockton, Graham Cooper (2007) Managing Marketing [Online] Available at: https://books.google.lk/books?hl=en&lr=&id=xc3LMeik5wwC&oi=fnd&pg=PR3&dq=introduction+on+marketing+mix+4ps+palmer+2004&ots=mJ2-YoHddh&sig=5-f6nj8z2BF4iteWorQBRMp_XLM&redir_esc=y#v=onepage&q=marketing mix&f=false (Accessed: 29 March 2015)
2. Ala'Eddin Mohammad Khalaf Ahmad (2013) the impact of Marketing Mix Strategy on hospitals performance measured by patient satisfaction: an empirical investigation on Jeddah Private Sector Hospital senior manager’s perspective, International Journal of Marketing Studies; Vol. 5, No. 6; 2013 [Online] Available at: https://www.ccsenet.org/journal/index.php/ijms/article/view/31968/18600. (Accessed: 29 March 2015)
3. Aremu, M.A. and Bemiduro, J.A., (2012). Marketing mix practice as a determinant of entrepreneurial business performance. International Journal of Business and Management Vol. 7, No. 1; January 2012
4. Ibidunni, O.S., (2011) marketing mix as tools for achieving competitive advantage in Nigerian market place: Multi-National and indigenous companies in perspective. Journal of Marketing Development and Competitiveness, 5(7), pp.81-94.

5. Shaoming Zou and S. Tamer Cavusgil (2002). The GMS: A broad conceptualization of global marketing strategy and its effect on firm performance in journal of marketing, Vol. 66, No. 4 (Oct., 2002) pp. 40-56 [Online] Available at: https://www.jstor.org/discover/10.2307/3203357?sid=21106316350763&uid=70&uid=385054361&uid=385054351&uid=3&uid=2134&uid=60&uid=2 (Accessed: 30 March 2015)

6. AstraZeneca – SL, 2014. Internal Secondary sales data. [Excel] December 2014, Colombo: AstraZeneca Pharmaceuticals.
7. IMS Q-4, 2014. Sri Lankan Pharmaceutical industry market statistics, software version 2014, IMS: Colombo.

8. Top 20 Pharma, (2013). Top 20 pharmaceutical companies. [Online] Available at: https://www.contractpharma.com/heaps/view/542. (Accessed 30 March 2015)

9. Brei, V.A., D’avila, L., Camargo, L.F and Engels, J., (2011). The influence of adaptation and standardization of the marketing mix on performance: a meta-analysis in Brazilian Administration Review. [Online] Available at: https://www.scielo.br/scielo.php?pid=S1807-76922011000300004&script=sci_arttext (Accessed 30 March 2015).

10. Serhat, Vancelik. , (2007). Impact on pharmaceutical promotion on prescribing decisions of General practitioners in Eastern Turkey in BMC Public Health.[Online] Available at: https://www.biomedcentral.com/1471-2458/7/122. (Accessed 30 March 2015)

11. Geoffrey, K. Spurling, (2010). Information from pharmaceutical companies and the quality, quantity, and cost of physicians prescribing: a systemic review. [Online] Available at: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000352#pmed-1000352-g002. (Accessed 31 March 2015)

12. Saito S, Mukohara K, Bito S (2010) Japanese Practicing Physicians' Relationships with Pharmaceutical Representatives: A National Survey. PLOS ONE 5(8): e12193. Doi: 10.1371/journal.pone.0012193 Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0012193. ( Accessed 31March 2015)

13. Fusun. F. Gonul., Franklin, carter., (2001). Promotion of prescription drugs and its impact on physician choice behavior in journal of marketing. Vol. 65, No. 3 (Jul., 2001), pp. 79-90[Online] Available at: https://www.jstor.org/discover/10.2307/3203468?sid=21105863286271&uid=385054361&uid=70&uid=385054351&uid=2134&uid=60&uid=2&uid=3. (Accessed 1 April 2015).

14. Naresh, K. Malhotra., (2008). Marketing Research: An Applied Orientation, 5/E, Person education India. [Online] Available at: https://books.google.lk/books?hl=en&lr=&id=TKb8iORscegC&oi=fnd&pg=PR19&dq=using+quantitative+and+qualitative++research+methodology+for+a+product+to+identify+customer+perception&ots=xUpZFRQ9eX&sig=TCTEBR33I9V4egJ8OwvQoFITEPc&redir_esc=y#v=onepage&q=quantitative and qualitative&f=false. (Accessed 2 April 2015).

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