Presentation consists of the core theory of diffusion of innovation followed by 3 case studies :
1) Diffusion of tetra cycline in the healthcare system and the effect of social factors on the same
2) Diffusion of Atorvastatin in healthcare system
3) Diffusion of Prozac in healthcare system and the dark side of pharma industry
1. Diffusion
of
Innovation
Prasad Dalvi (04)
Kamal Rajpurohit (15)
Manas Prabhudesai (20)
Siddhesh Parab (45)
2. Diffusion of Innovation
Diffusion is the process by which an innovation is communicated through certain
channels over time among the members of a social system
10-11-2014 Diffusion Of Innovation 2
3. 1
Attributes of
innovations and
their rates of
adoption
KEY ELEMENTS OF PRESENTATION
2
Adopter
categories
3
4
Change agent Stages in the
innovation-decision
making
process
5
Case study
10-11-2014 Diffusion Of Innovation 3
4. 1
Attributes of
innovations
and their
rates of
adoption
KEY ELEMENTS OF PRESENTATION
2
Adopter
categories
3
4
Change agent Stages in the
innovation-decision
making
process
5
Case study
10-11-2014 Diffusion Of Innovation 4
5. COMPLEXITY
COMPATIBILITY
OBSERVABILITY
TRIALIBILITY
INFRASTRUCTURE
COMMUNICATION CHANNELS
NORMS/ROLES/SOCIAL
NETWORKS
PACE OF INNOVATION/
REINVENTION
RELATIVE ADVANTAGE
OPINION LEADERS
10-11-2014 Diffusion Of Innovation 5
6. COMPLEXITY
COMPATIBILITY
OBSERVABILITY
TRIALIBILITY
INFRASTRUCTURE
COMMUNICATION CHANNELS
NORMS/ROLES/SOCIAL
NETWORKS
PACE OF INNOVATION/
REINVENTION
RELATIVE ADVANTAGE
OPINION LEADERS
10-11-2014 Diffusion Of Innovation 6
7. Relative advantage
Degree to which an innovation is perceived as being better than the idea it
supersedes
Factors
Economic Factors and Rate of Adoption
Status aspects of innovation
Effects of Incentives Adopter vs diffuser
Individual versus system
Positive versus negative
Cholecystectomy vs. laparascopic Monetary vs nonmonetary
cholecystectomy
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8. Trialability
Degree to which an innovation may be experimented with on a limited basis
Distribution of samples by pharma
companies
Professional association
conferences and trade shows
10-11-2014 Diffusion Of Innovation 8
9. Observability
Degree to which the results of an innovation are visible to others
Clinical Trial data to doctors Post marketing surveillance data
Youtube reviews for technological
innovations
10-11-2014 Diffusion Of Innovation 9
10. Compatibility
Degree to which an innovation is perceived as consistent with the existing values,
past experiences, and needs of potential adopters
• Compatibility with values and beliefs – Eg.Miracle rice crop
• Compatibility with previously introduced ideas
• Compatibility with needs
CT scan – X ray Thyronorm - Eltroxin
10-11-2014 Diffusion Of Innovation 10
11. Complexity
Degree to which an innovation is perceived as relatively difficult to understand and use
• The complexity of an innovation, as perceived by members of a social system, is
negatively related to its rate of adoption
Command prompt to Windows Windows 7 to Windows 8
Insulin injections to Insulin pen
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12. Over adoption
Over adoption is the adoption of an innovation by an individual when experts
feel that he or she should reject
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13. Naming of innovation
In rural areas condoms had a very negative perception as a contraceptive method
The word "Nirodh" was carefully chosen in India in 1970 as the most appropriate term
for condoms
A U.S based major soap company introduced its trademark product named CUE in
French speaking nations, where the word has an obscene connotation
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14. Positioning an innovation
Positioning research can help to identify an ideal niche for an innovation
to fill relative to existing ideas in the same field
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15. Positioning an innovation
Positioning research can help to identify an ideal niche for an innovation
to fill relative to existing ideas in the same field
10-11-2014 Diffusion Of Innovation 15
16. 1
Attributes of
innovations and
their rates of
adoption
KEY ELEMENTS OF PRESENTATION
2
Adopter
categories
3
4
Change agent Stages in the
innovation-decision
making
process
5
Case study
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17. ADOPTERS
Not all individuals in a social system adopt an innovation at the same time. Rather,
they adopt in a time sequence, and they may be classified into adopter categories on
the basis of when they first begin using a new idea
INNOVATORS
ADOPTER
CATEGORIES
EARLY ADOPTERS
EARLY MAJORITY
LATE MAJORITY
LAGGARDS
10-11-2014 Diffusion Of Innovation 17
18. INNOVATORS (venturesome)
First to adopt & display that they likely to want to be ahead
They are often not taken seriously by their peers
To be the first to own new products, well before the average consumer
They often buy products that do not make it through the early stages of
the Product Life Cycle (PLC).
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19. EARLY ADOPTERS(respectable)
Are also quick to buy new products and services
So are key opinion leaders (KOLs) with their neighbors and friends as
they tend to be amongst the first to get hold of items or services.
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20. EARLY MAJORITY(deliberate)
Look to the innovators and early majority to see if a new product or idea
works and begins to stand the test of time
They stand back and watch the experiences of others
Then there is a surge of mass purchases
10-11-2014 Diffusion Of Innovation 20
21. LATE MAJORITY(Skeptical)
Tends to purchase the product later than the average person.
They are slower to catch on to the popularity of new products, services,
ideas, or solutions
There is still mass consumption, but it begins to end.
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22. LAGGARDS(traditional)
These tend to very late to take on board new products and include those
that never actually adopt at all
Here there is little to be made from these consumers
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23. INNOVATORS EARLY
MAJORITY
LATE
MAJORITY
LAGGARDS
EARLY
2.5% ADOPTERS
13.5% 34% 34%
16%
Bell shaped
Diffusion Curve
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24. Diffusion effect
Cumulative degree of increasing influence upon an individual to adopt or
reject an innovation resulting from activation of peer networks about the
innovation in the social system
100%
Percentage of
adopters
0%
Time
Cumulative
No. of adopters
New adopters
Diffusion starts
to take off
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25. Sales
INTRODUCTION GROWTH MATURITY DECLINE
Product life cycle
Time
Diffusion curve
Product life cycle
Vs.
Diffusion curve
10-11-2014 Diffusion Of Innovation 25
26. Cancian Dip
Dr. Cancian also makes quite a point of the necessity to measure local socioeconomic status
rather than societal stratification; i.e socioeconomic status is measured as an individual's
status relative to other members of his or her social system, not in comparison to everyone
else in the nation
10-11-2014 Diffusion Of Innovation 26
27. Low
class
Low middle
class
High middle
class
High
class
Degree of
innovativeness
Linear
relationship
Social economic status
Of adopters
High
Low
Cancian Dip
Cancian Dip
10-11-2014 Diffusion Of Innovation 27
28. CHARACTERISTICS
OF ADOPTERS
SOCIO-ECONOMIC
STATUS
PERSONALITY
VARIABLES
COMMUNICATION
BEHAVIOUR
10-11-2014 Diffusion Of Innovation 28
29. SOCIO-ECONOMIC
STATUS
Earlier adopters have
more years of education
than later adopters have.
Earlier adopters have more specialized
operations than later adopters.
Earlier adopters are more likely to be literate
than are later adopters.
Earlier adopters have
higher social status than
later adopters.
Earlier adopters have a greater degree of
upward social mobility than later adopters
Earlier adopters
have larger-sized
units than later
adopters
Earlier adopters are more likely to have a commercial (rather than a
subsistence) economic orientation than are later
adopters.
Earlier adopters have a more favorable attitude
toward credit (borrowing money) than later adopters
10-11-2014 Diffusion Of Innovation 29
30. PERSONALITY VARIABLES
Earlier adopters have a more favourable
attitude toward science than later adopters
Earlier adopters may be
less dogmatic than
later adopters.
Earlier adopters are less fatalistic than
Earlier adopters have a greater ability
to deal with abstractions than later
Earlier adopters have a more
favorable attitude toward
education than later adopters
Earlier adopters have greater
rationality than later adopters
Earlier adopters are more able to cope with uncertainty
and risk than later adopters
Earlier adopters
have a more
favourable attitude
toward change
than later adopters
Earlier adopters have greater empathy than
later adopters.
Earlier adopters have greater intelligence than later
adopters
adopters.
later adopters.
Earlier adopters have higher levels of
achievement motivation than later adopters. Earlier adopters have higher
aspirations than later adopters.
10-11-2014 Diffusion Of Innovation 30
31. COMMUNICATION
BEHAVIOUR
Earlier adopters have more social participation
than later adopters.
Earlier adopters are more cosmopolite than
Earlier adopters have
more change agent
contact than later
adopters
Earlier adopters have greater
exposure to
mass media communication channels
than later adopters.
Earlier adopters are
more highly
interconnected
in the social system
than later adopters
Earlier adopters are more likely to belong to
highly interconnected systems than are later adopters
Earlier adopters seek
information about innovations
more actively than later
adopters
Earlier adopters have a higher
degree of opinion
leadership than later adopters
Earlier adopters have greater exposure to interpersonal
communication channels than later adopters
later adopters.
Earlier adopters have greater knowledge of
innovations than later adopters.
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32. OPINION LEADERSHIP
&
DIFFUSION NETWORKS
‘ Every heard of wild cattle has its leaders, its influential heads ‘
- Gabriel Tarde (1903),
The Laws of Imitation
10-11-2014 Diffusion Of Innovation 32
33. Opinion Leadership
The degree to which an individual is able to informally influence other individuals'
attitudes or overt behaviour in desired way with relative frequency
External communication
Characteristics of
opinion leader
Accessibility
Socio-economic Status
Innovativeness
“Invention can start from the lowest ranks
of the people, but its extension depends
upon the existence of some lofty social
elevation”
-Tarde(1903)
10-11-2014 Diffusion Of Innovation 33
34. Diffusion network
These subjective evaluations of an innovation mainly flow through interpersonal
networks. For this reason, we must understand the nature of networks if we are to
comprehend the diffusion of innovations fully
Communication proximity
Degree to which two individuals in a network have personal communication
networks that overlap
By Granovette (1973)
10-11-2014 Diffusion Of Innovation 34
35. A B
Low communication proximity
C D
High communication proximity
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36. Communication flow
Model of mass
communication
flow
Hypodermic Needle Model
The Two-Step Flow Model
Homophily-Heterophily and the
Flow of Communication
10-11-2014 Diffusion Of Innovation 36
37. Homophily-Heterophily
A fundamental principle of human communication is that the transfer of ideas occurs most
frequently between individuals who are alike, or homophilous. Homophily is the degree to
which pairs of individuals who interact are similar in certain attributes, such as beliefs,
education, social status, and the like.
10-11-2014 Diffusion Of Innovation 37
38. A
B
D C
E
X
Y
Strong ties
Weak ties
V U
W
The communication link plays a crucial
function in the flow of information in this
network; if it were removed, the network
would collapse into two unconnected cliques
According to Granovetter's (1973) theory of the-strength-of-weak-ties, the low proximity
B-X link is "strong" in its potential for carrying information between the two unalike
cliques, thus playing a crucial role in the diffusion of innovativeness
10-11-2014 Diffusion Of Innovation 38
39. Homophily-Heterophily
When interpersonal diffusion networks are heterophilous,
followers seek opinion leaders with more education
When interpersonal diffusion networks are
heterophilous, followers seek opinion leaders
who are more cosmopolite
When interpersonal diffusion networks are
heterophilous, followers seek opinion
When interpersonal diffusion networks are
heterophilous, followers seek opinion leaders with greater change
agent contact.
leaders with greater mass media
exposure.
When interpersonal diffusion networks are
heterophilous, followers seek opinion leaders
of higher socioeconomic status.
When interpersonal diffusion networks are
heterophilous, followers seek opinion
leaders who are more innovative.
10-11-2014 Diffusion Of Innovation 39
40. 1
Attributes of
innovations and
their rates of
adoption
KEY ELEMENTS OF PRESENTATION
2
Adopter
categories
3
Change
agent
4
Stages in the
innovation-decision
making
process
5
Case study
10-11-2014 Diffusion Of Innovation 40
42. Change Agent
An individual who influences clients'
innovation decisions in a direction deemed
desirable by a change agency
10-11-2014 Diffusion Of Innovation 42
43. Change agent
linkage
‘ One of the main roles of a change agent is to facilitate the flow of innovations from a
change agency to an audience of clients ’
Client’s
needs and
feedback
Innovation
Flow to
clients
Change
agency
Client
system
10-11-2014 Diffusion Of Innovation 43
44. Sequence of
change
Agent roles
LOADING…
10-11-2014 Diffusion Of Innovation 44
45. Develop need for
change
1
2
3
5 4
6
7
8
Sequence of
change
Agent roles
10-11-2014 Diffusion Of Innovation 45
46. 1
2
3
5 4
6
7
8
Sequence of
change
Agent roles
Develop need for
change
Establish an
info exchange
relationship
10-11-2014 Diffusion Of Innovation 46
47. 1
2
3
5 4
6
7
8
Sequence of
Develop need for
change
Establish an
info exchange
relationship
change
Agent roles Diagnose the
problems of
clients
10-11-2014 Diffusion Of Innovation 47
48. 1
2
3
5 4
6
7
8
Sequence of
change
Agent roles
Develop need for
change
Establish an
info exchange
relationship
Diagnose the
problems of
clients
Create intent to
change in client
10-11-2014 Diffusion Of Innovation 48
49. Translate
intent into
action
1
2
3
5 4
6
7
8
Sequence of
change
Agent roles
Develop need for
change
Establish an
info exchange
relationship
Diagnose the
problems of
clients
Create intent to
change in client
10-11-2014 Diffusion Of Innovation 49
50. Stabilize adoption
1
2
3
5 4
6
7
8
Sequence of
change
Agent roles
Translate intent
into action
Develop need for
change
Establish an
info exchange
relationship
Diagnose the
problems of
clients
Create intent to
change in client
10-11-2014 Diffusion Of Innovation 50
51. Prevent
discontinuance
1
2
3
5 4
6
7
8
Sequence of
change
Agent roles
Stabilize adoption
Translate intent
into action
Develop need for
change
Establish an
info exchange
relationship
Diagnose the
problems of
clients
Create intent to
change in client
10-11-2014 Diffusion Of Innovation 51
52. Achieve a terminal
relationship
1
2
3
5 4
6
7
8
Sequence of
change
Agent roles
Prevent
discontinuance
Stabilize adoption
Translate intent
into action
Develop need for
change
Establish an
info exchange
relationship
Diagnose the
problems of
clients
Create intent to
change in client
10-11-2014 Diffusion Of Innovation 52
53. Para professional aides
An aide is a less than fully professional change agent who intensively contacts
low level socially backward clients to influence their innovation decisions
Less technically Expert
But
Low cost per client
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54. Competence credibility
The degree to which a communication source or channel is perceived as
knowledgeable and expert
Safety credibility
The degree to which a communication source or channel is perceived
as trustworthy
10-11-2014 Diffusion Of Innovation 54
55. Competence credibility
The degree to which a communication source or channel is perceived as
knowledgeable and expert
Safety credibility
The degree to which a communication source or channel is perceived
as trustworthy
Safety
credibility
Competence
credibility
10-11-2014 Diffusion Of Innovation 55
56. Barefoot Doctors
They are actually part-time doctors trained to diagnose and treat common
diseases without professional assistance. It might be expected that such a
radical idea would face stiff opposition from the medical profession, but
in China Mao had virtually wiped out the Ministry of Health in 1966
during the Cultural Revolution. So the medical profession was essentially
by passed in establishing the new rural health system
Socially very close to the villagers - Homophily
Refer difficult cases to the community hospital
50
10-11-2014 Diffusion Of Innovation 56
57. Set Fractured Bones Deliver Babies
Vaccinations
Emergency Appendectomy
Perform Abortions Insert IUDs Suture Lacerations
10-11-2014 Diffusion Of Innovation 57
59. 1
Attributes of
innovations and
their rates of
adoption
KEY ELEMENTS OF PRESENTATION
2
Adopter
categories
3
4
Change agent Stages in the
innovation-decision
making
process
5
Case study
10-11-2014 Diffusion Of Innovation 59
60. Types of innovation decisions
Collective—decide as a group, consensus
Optional—voluntary, individual choice
Authoritative—top down decision, must do it!
10-11-2014 Diffusion Of Innovation 60
61. Innovation decision process
An information-seeking and information-processing activity in which
an individual is motivated to reduce uncertainty with the advantages
and disadvantages of the innovation
10-11-2014 Diffusion Of Innovation 61
62. STAGES OF DECISION PROCESS
Knowledg
e
One is exposed to an innovation’s existence
and gains an understanding of how it functions.
Persuasio
n
One forms a favorable or unfavorable attitude toward the innovation.
Decision
One engages in activities that lead to a choice to adopt or reject.
Implementatio
n One put an innovation to use.
Confirmation
One seeks reinforcement of their decision.
10-11-2014 Diffusion Of Innovation 62
63. INNOVATION DECISION
PROCESS
Knowledge Persuasion
Interpersonal
Attitude
Adoption
Decision
Uncertainty
Reduction
Rejection
Perceived
Characteristics
of Innovation
Re-invention
Institutionalization
Implementation
Confirmatio
n
Continue
d
Adoption
Dissonance
Discontinuanc
e
Replacement
Disenchantment
Later Adoption
Dissonance
Continue
d
Rejection
10-11-2014 Diffusion Of Innovation 63
64. Knowledge implementation Persuasion Decision Confirmation
Decision Process
and types of
decisions
The decision leads to
adoption or rejection
Of these methods
Optional
Collective
Authority
Perceived
attributes of
innovation
Rate of
Adoption of
innovation
Social system
Relative
advantage
Compatibility
Observability
Complexity
Trialability
Extent of Change agent’s
promotional efforts
Communication
Channel
10-11-2014 Diffusion Of Innovation 64
66. Characteristics
of diffusion system Centralized diffusion system De-centralized diffusion system
1.Degree of
centralization
In decision making
and power
Over all decision by national
Government administration and
technical subjects expert
Wide sharing of power
and control among the
members
2.Direction of
diffusion
Top down diffusion from experts
To local users of innovation
Peer diffusion of innovation
throughhorizontal networks
3.Sources of
innovation
Innovation come from formal
R & D conducted by technical
expert
Innovation comes from
local experimentation
By no experts, who often
are users
4.Who decides which
innovation to diffuse?
Decision about which innovations
Should be diffused are made by
top administration and technical
subject
Local units decide which
innovations should diffuse
on the basis of thir informal
evaluations of innovation
5.How important are
clients’ needs in
driving the diffusion
process?
An innovation-centred approach:
technology -push, emphasizing
needs created by availability of
The innovation
A problem centred approach :
technology –pull, created by
Locally perceived needs
and problem
6.Amount of
re-invention?
A low degree of local adoption
& re-invention of the innovation
as they diffuse among adopters
A high degree of local adaption
& re-invention of innovations
as they diffuse among adopters
10-11-2014 Diffusion Of Innovation 66
67. 1
Attributes of
innovations and
their rates of
adoption
KEY ELEMENTS OF PRESENTATION
2
Adopter
categories
3
4
Change agent Stages in the
innovation-decision
making
process
5
Case study
10-11-2014 Diffusion Of Innovation 67
68. Case Study
Guess the molecule ?
10-11-2014 Diffusion Of Innovation 68
69. To find out the social processes which intervened
between the initial trials of the drug by a few local
innovators and its final use by virtually the whole medical
community
RESEARCH
OBJECTIVE
The study focused on the ongoing social processes which
finally led to widespread adoption of the drug by
physicians
FOCUS
Data were collected 15 months after a new drug with wide potential use,
here called “tetracycline" had been placed on the market
10-11-2014 Diffusion Of Innovation 69
70. 3 Sociometric Questions
1
With whom did
he most often
discuss his cases
in the course of
an ordinary
week?
2
Who were the
friends, among
his colleagues,
whom he saw
most often
socially?
3
With whom did
he most often
discuss his
cases in the
course of an
ordinary week?
The "others" named by each doctor in answer to the sociometric questions were
included in the sample, so that it became possible to characterize pairs or chains of
socially connected doctors
124
10-11-2014 Diffusion Of Innovation 70
71. Month during which each doctor first used the drug.
DEPENDENT
VARIABLE
This information was obtained through a search of the
prescription records of the local pharmacies for three-day
sampling periods at approximately monthly intervals
over the 15 months following the release date of the
drug
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72. Data about the informal
social structure of the
medical community
The month of each
doctor's first prescription
for the new drug
Individual
attributes of
each doctor
10-11-2014 Diffusion Of Innovation 72
73. The doctor's relative orientation to his professional colleagues and to patients,
inferred from his answer to the following question:
How would you rank the importance of these characteristics in recognizing a good
doctor in a town like this?
The respect in which he is
held by his own patients
The recognition given him
by his local colleagues
His general standing in
the community
The research and publications he
has to his credit
67 57
Profession oriented Patient oriented
A
B
C
D
CDAB, CADB, CBDA, CABD ABCD, ACBD, ACDB, ABDC
10-11-2014 Diffusion Of Innovation 73
74. Fig.1
Relationship of the resulting classification to
the date of introduction of the new drug
Observation :
Profession- oriented doctors generally used
the drug earlier than the less profession-oriented
ones
Profession-oriented doctors in Figure 1 differed
from the patient-oriented from the very start
almost as much as later on
The constant difference between the
profession-oriented and patient- oriented
doctors suggests that they differ individually in
their receptivity to new developments in
medicine
10-11-2014 Diffusion Of Innovation 74
75. Fig.2
The results with regard to the network of
friendships
Observation :
The "integrated" doctors-those named as
"friends" by three or more of their colleagues-were
much faster to introduce tetracycline
The integrated doctors were little different
from their isolated colleagues at the very
beginning; but then their rate accelerated to
produce an increasing gap between the curves
The accelerating difference between the
integrated and isolated doctors suggests a kind
of "'snowball" or "chain-reaction' process for
the integrated
10-11-2014 Diffusion Of Innovation 75
76. 2
Fig.3
Social connection
2
Professional orientation
Observation :
Vs.
1
Faster rate of diffusion is observed
between the doctors with high social
connectivity than those who simply
maintained their intrinsically different
receptivity as the time went on
Thus, the communication channels have
a greater influence on the adoption of
innovation than the individual attributes
leading to adoption of innovation
1
10-11-2014 Diffusion Of Innovation 76
77. s
t l
o
e r
B
Saga
k c b
u
10-11-2014 Diffusion Of Innovation 77
78. Whose brain child ? From which year D2C marketing was permitted in US ?
LIPITOR
“Merck and Bristol-Myers spent 10 years educating doctors to get them to
use their drugs, but Lipitor, at lower doses, is a much better deal. It's kind
of a marketing coup”
-- Kevin Graham
(Cardiologist at Minneapolis Heart Institute, Minneapolis)
10-11-2014 Diffusion Of Innovation 78
79. 1997
th
Mevacor
Zocor
Pravachol
Lescol
TURBOSTATIN
>60% increased
Efficacy
"Those other companies didn't even take us seriously. They didn't think we could
be a viable contender"
-- Adele Gulfo,
(Head of cardiovascular marketing at Warner-Lambert Co.)
10-11-2014 Diffusion Of Innovation 79
80. Warner Pfizer
lambert
Consumer health Listerine
Benadryl allergy pills
Halls cough drops
Sales approach : Saturation strategy
PARKE DAVIS Atorvastatin
10-11-2014 Diffusion Of Innovation 80
81. Positioning
Reduce heart attacks and death through
cholesterol lowering capabilities
Ease of use ( no need / ease of dose
titration)
72%
10-11-2014 Diffusion Of Innovation 81
82. The beauty of Lipitor’s positioning is that physicians can remain ‘lazy’ by using the
starting dose and then forgetting about it, but the goals achieved with Lipitor will be
greater than with any other statin
-- Carl Seiden,
(Analyst from J.P.Morgan)
10-11-2014 Diffusion Of Innovation 82
83. Promotion
National cholesterol education program in association
with AMA
Lipitor was publicized in medical journals and at major
medical conventions with pre-market comparative
efficacy data
Free sampling to KOL after drug approval but before
official launch
Pre marketing
promotions
Warner-Lambert and Pfizer implemented an aggressive sampling
program, distributing 7.3 million samples to physicians in the first
year of launch for a share of voice of slightly over 23%
10-11-2014 Diffusion Of Innovation 83
90. The company was forced to purchase a fully operational manufacturing
facility just months after Lipitor launched in an effort to keep up with
In my two decades of experience within the pharmaceutical industry, I have never
witnessed the launch of a fifth comparable drug to treat a non-symptomatic disease
take off as rapidly as Lipitor has
Hemant Shah
President of HKS & Company
demand
Manufacturing executives admitted that the market demand was so
strong that they exhausted what they thought was a 3-month drug supply
virtually overnight.
10-11-2014 Diffusion Of Innovation 90
91. Many observers think Lipitor succeeded because Pfizer sold it hard to the public on
television and print. In fact, that is not true. Lipitor had the number one new Rx share
of about 34 before Pfizer launched the campaign in 1999
The national advertising created by Bates Advertising worked and Lipitor continued
to grow into the $7.6 billion brand it became in the U.S. and achieved $12.8 billion
worldwide at its peak. Over the course of its patent life Lipitor sold $131 billion, the
largest in drug history
10-11-2014 Diffusion Of Innovation 91
92. PATIENT POURING STRATEGIES
Health groups kept lowering the cholesterol
targets in national guidelines
New research showed the link between
cholesterol levels and consequences such
as heart attacks
MRs repeatedly visited family doctors as well as cardiologists,
and blanketed patients with data showing that Lipitor was best
at lowering cholesterol
MRs stressed to doctors nervous about
safety that Lipitor's lowest dose worked as
well as rivals' highest doses.
MRs gave free samples of the white pills and sometimes bought
lunch for the office staff
10-11-2014 Diffusion Of Innovation 92
93. MARKETING
OF
MADNESS
Show me a sane man and I shall cure him for you
-Dr.Carl Gustav Jung
(Psychiatrist and Psychotherapist)
10-11-2014 Diffusion Of Innovation 93
95. Life Problems As Medical
Disorders
SHYNESS SOCIAL ANXIETY DISORDER PAXIL
LOSS OF A LOVED ONE MAJOR DEPRESSIVE DISORDER PROZAC
HOME SICKNESS SEPARATION ANXIETY DISORDER LEXAPRO
SUSPECTION PARANOID PERSONALITY DISORDER ZOLOFT
HAVING UPS AND DOWNS BIPOLAR DISORDER ABILIFY
DISTRACTABILITY ADHD RITALIN/ADDERALL
10-11-2014 Diffusion Of Innovation 95
96. Pharma companies convincing
doctors to write their brands….
How to drive patients to the doctors
clinics and make them believe that
they are sick…
Product theatres in psychiatry conferences
KOL’s then convinence fellow psychiatrists
Psychiatrists in turn influence GP’s for writing
the prescriptions
Funding of prominent medical journals and
Sampling
ghost writing
Catch physicians young in the medical
institutes.Groom them into speakers for your
drugs
Generate so called KOL’s
10-11-2014 Diffusion Of Innovation 96
97. 10-11-2014
Direct to Consumer advertising Using internet as a channel
Mental health screening concepts
Diffusion Of Innovation 97
Children magazines
Disease Mongering
Pharma companies convincing
doctors to write their brands….
How to drive patients to the doctors
clinics and make them believe that
they are sick…
98. API of PROZAC ? Whose molecule ?
PROZAC
10-11-2014 Diffusion Of Innovation 98
99. The diffusion curve in the US was
strongly influenced by the debates
surrounding Prozac
The debates about Prozac played some role in
creating a resistance to the drug in the UK
10-11-2014 Diffusion Of Innovation 99
100. 1980s
ORAFLEX
Diet control CNS Chronic diseases
10-11-2014 Diffusion Of Innovation 100
101. 1980s
Diet control CNS Chronic diseases
Depression
Fluoxetine
Incidental
Weight loss
10-11-2014 Diffusion Of Innovation 101
102. 60%
Dieting
st
Company to release side effects
free anti obesity drug would rule
the US and UK market
10-11-2014 Diffusion Of Innovation 102
103. Diet Pill
Anti Depressant
10-11-2014 Diffusion Of Innovation 103
104. Less common Chills or fever
convulsions (seizures)
purple or red spots on the skin
racing heartbeat
excessive hunger
overactive reflexes mood or behavior changes
unusual tiredness or weakness difficulty with concentration
cool pale skin
trouble with breathing
lack of energy
shivering or shaking shakiness or unsteady walk
headache
increased thirst
Drowsiness Dizziness Feeling nervous
Sneezing
Sore throat
Side effects
Nausea
Upset stomach
Constipation
increased sweating
Sleep problems
dark urine
Decreased sex drive
Weight changes
Impotence
Increased appetite
Dry mouth
restlessness
Hives
itching
bleeding gums
inability to sit still
confusion
skin rash
diarrhea
Rare Anxiety
cold sweats
dryness of the mouth
unusual or incomplete body or facial
movements
talking, feeling, and acting with
excitement and activity you cannot
control
fast or irregular heartbeat
back or leg pains
chest pain or discomfort
blood in the urine or stools
difficulty with swallowing
blindness
bloody, black, or tarry stools
continuing vomiting
blistering, peeling, or loosening of the skin
bloating
cough or dry cough
decreased urine output
decreased vision
constipation
depression
severe sleepiness
clay-colored stools
blurred vision
difficulty with breathing
slurred speech
rapid weight gain
blue-yellow color blindness dizziness or lightheadedness pinpoint red spots on the skin
redness, tenderness, itching, burning,
or peeling of the skin
sores, ulcers, or white spots on the lips
or in the mouth pain in the ankles severe muscle stiffness
10-11-2014 Diffusion Of Innovation 104
105. Diffusion Communication
Channels
Heterophily Homophily
Dr. - Dr.
Co. – Dr. C - C
Co. - C
Dr. - C
10-11-2014 Diffusion Of Innovation 105
106. MARKETING CAMPAIGN FOR
DOCTORS
The kind of positioning Eli Lilly did for Prozac,
shifted Prozac,
from Psychiatrist’s inpatient dept. to GP’s outpatient dept.
10-11-2014 Diffusion Of Innovation 106
108. 96 hr. of CME Depression = Chronic disease
DSM produced for GP
Samples
Prozac = alternative for Talk therapy
GP
10-11-2014 Diffusion Of Innovation 108
109. 96 hr. of CME Depression = Chronic disease
DSM produced for GP
Samples
Prozac = alternative for Talk therapy
Top of the mind recall
New patients poured in
Continue therapy to avoid relapse
GP
2/3rd of total prescriptions
10-11-2014 Diffusion Of Innovation 109
110. Off label uses
Diabetics and migraine
Generalised Anxiety disorder Dysthymia
Personality disorders
Stage fright
Social phobia
Premenstrual
Syndrome
Eating disorders
Borderline personality disorder
“You can give Prozac to anyone you want, in fact, I have even added it to my
watering can and found geraniums grow better on it.”
- Mauro and Breggin 1994:47
10-11-2014 Diffusion Of Innovation 110
111. Off label uses
New indications
Diabetics and migraine
Generalised Anxiety disorder Dysthymia
Personality disorders
Stage fright
Social phobia
Premenstrual
Syndrome
Eating disorders
Borderline personality disorder
OCD
Bulimia
“You can give Prozac to anyone you want, in fact, I have even added it to my
watering can and found geraniums grow better on it.”
- Mauro and Breggin 1994:47
10-11-2014 Diffusion Of Innovation 111
113. Ecstasy
API Of Ectasy ?
Mood is a light bulb and serotonin is the voltage which keeps it glowing.
Prozac restores the voltage and brightens to normal. Ecstasy produces
blinding flash as bulb burns out
-Dr. Simpson (Medical Director, Eli Lilly)
10-11-2014 Diffusion Of Innovation 113
114. D2C
Company makes Products
People make Brands
10-11-2014 Diffusion Of Innovation 114
115. TV advertisement slots were increased from 2hrs. P.a to 16hrs.p.a
You have a problem ?
We have a solution
Talk to your Dr.
10-11-2014 Diffusion Of Innovation 115
116. Teen Screen camp
School Children American Soldiers
Camp in Malls
Foster
Children
E-Forms
10-11-2014 Diffusion Of Innovation 116
118. A fashionable accessory designer drug, for trend highfliers,
seeking to ease the anxiety of modern living
Brand Personality
A ‘Go for it’ drug for
individualistic and
independent personality
people in 1990s
• Self confidence
• Social poise
• Energy
• Assertiveness
• Independent
10-11-2014 Diffusion Of Innovation 118
119. Recognise the person?
Madness was the new Sexy
Kurt Cobain got a wider fame as a suicide victim than a
musician at that time
10-11-2014 Diffusion Of Innovation 119
120. Prozac : Emblem of vigour and
emotional individualism
Prozac : Just another antidepressant
And a mind deadening American fadd
10-11-2014 Diffusion Of Innovation 120
122. Dr.Peter D. Kramer
(Psychiatrist)
Prozac is not a drug and did not induce false synthetic experiences,
but merely removed obstacles to feeling more content and relaxed
10-11-2014 Diffusion Of Innovation 122
123. Dr.Peter D. Kramer
(Psychiatrist)
Prozac has become a feminist drug as it’s major users are women for
the main reason being, it frees women from inhibiting consequences
of trauma
10-11-2014 Diffusion Of Innovation 123
124. Prozac thus slotted neatly into a classic
elixir paradigm, thus being viewed as a
drug which enabled people to realize their
aspirations painlessly
Eli Lilly criticized Dr.Kramer for creating
unrealistic expectations(to be on safe side)
by describing him as a part time psychiatrist
and part time writer, and his book being
based on personal observations and not on a
controlled study
10-11-2014 Diffusion Of Innovation 124
125. But by this time, Prozac was diffused
extensively in the society pouring a lot of
profit to Eli Lilly
10-11-2014 Diffusion Of Innovation 125
126. REFFERENCES
• The Diffusion of an Innovation Among PhysiciansAuthor(s): James
Coleman, Elihu Katz and Herbert MenzelSource: Sociometry, Vol. 20, No.
4 (Dec., 1957), pp. 253-270
• Lipitor: At the Heart of Warner-Lambert – university of Michigan
business school
• Diffusion of innovation – Everett Rogers
• The University of Hull - Managing the Diffusion of Medical Technologies
10-11-2014 Diffusion Of Innovation 126
But results of larger studies vindicated Dr. Black's strategy. In October 1994, he and his colleagues made the first public presentation of human trial data of the compound -- now known as atorvastatin -- at a scientific conference in Montreal. The results were so stunning a senior Merck official stood up to suggest the drug be called "turbostatin."