TITLEFactors affecting consumers’ resistance towards a healthcare innovation.        -A study of umbilical cord Stem Cell ...
Rizvi Institute of Management Studies and                                                                       Research  ...
A                              Project Report                                    on“Factors affecting consumers’ resistanc...
DECLARATIONI declare that the project titled “Factors affecting consumers’ resistance towards a healthcareinnovation. - A ...
CERTIFICATEThis is to certify that Mr. Aviroop Banik, a student of Post Graduate Diploma in BusinessManagement (PGDBM), fr...
ACKNOWLEDGEMENTI have taken sincere efforts in this marketing research project. However, it would not have beenpossible wi...
-Table of contents-Sl. no.                                   Head                             Page no.1         Introducti...
3.6     Public v/s Private — will it survive?                            243.7     Challenges                             ...
6.5.1     Sampling plan                                                            516.5.2     Sample size                ...
List of Figures & Tables:Fig 1 ..............................................................................................
Two statistical softwares are used for data analysis
AbstractBackground: A new buzzword “STEM CELL BANKING” is slowly but continuously engulfingthe consumers’ attention in Ind...
BY AVIROOP                                                MARKETING THESIS   BANIK   1. Introduction of Stem cell bankingB...
BY AVIROOP                                                 MARKETING THESIS   BANIKa variety of cells. Stem cells serve as...
BY AVIROOP                                                 MARKETING THESIS   BANIK    1.4 The history of cord blood stem ...
BY AVIROOP                                                MARKETING THESIS   BANIK        1.7 Sources of stem cellsStem ce...
BY AVIROOP                                                MARKETING THESIS   BANIK        1.8 Stem cells functioningStem c...
BY AVIROOP                                                    MARKETING THESIS       BANIK      1.10 Advantages of cord bl...
BY AVIROOP                                                MARKETING THESIS   BANIKsystem. It is now possible to direct the...
BY AVIROOP                                                MARKETING THESIS   BANIK2.1 Why it is recommended?Stem cell bank...
BY AVIROOP                                                MARKETING THESIS   BANIKUmbilical cord blood and tissue preserva...
BY AVIROOP                                                MARKETING THESIS   BANIKThe collection process occurs after baby...
BY AVIROOP                                               MARKETING THESIS   BANIKThe stem cells from cord blood are harves...
BY AVIROOP                                 MARKETING THESIS   BANIK             Fig: 5- Storage and preservation of Stem c...
BY AVIROOP                                                 MARKETING THESIS    BANIK     2.11 Stem Cell CryopreservationTh...
BY AVIROOP                                              MARKETING THESIS   BANIK     2.12 How banked stem cells can help  ...
BY AVIROOP                                              MARKETING THESIS   BANIK      2.14 Private Banks vs Public BanksUm...
BY AVIROOP                                               MARKETING THESIS   BANIK                   2.15 Facts about stem ...
BY AVIROOP                                              MARKETING THESIS   BANIK  2.16 Stem cell treatment miracles       ...
BY AVIROOP                                    MARKETING THESIS   BANIK             Fig: 7- Stem cell potential in reducing...
BY AVIROOP                                MARKETING THESIS   BANIK             Fig: 8- Stem cell potential in treating dia...
BY AVIROOP                                               MARKETING THESIS   BANIK    3 Background of stem     cell banking...
BY AVIROOP                                                MARKETING THESIS   BANIKpublic cord blood banks like Jeevan Stem...
BY AVIROOP                                                MARKETING THESIS   BANIK    3.3 Marketing the         ConceptAmo...
BY AVIROOP                                               MARKETING THESIS   BANIKits test marketing of cryo-cord service i...
BY AVIROOP                                               MARKETING THESIS   BANIK    3.6 Public v/s Private —        who w...
BY AVIROOP                                                MARKETING THESIS   BANIK         3.7 ChallengesBesides being the...
BY AVIROOP                                              MARKETING THESIS   BANIKIncreased awareness levels among the masse...
BY AVIROOP                                               MARKETING THESIS   BANIKIntroduction:This chapter aims to introdu...
BY AVIROOP                                                     MARKETING THESIS     BANIK          4.1 Research questions1...
BY AVIROOP                                                   MARKETING THESIS    BANIK       3. What is the inter-relation...
BY AVIROOP                                               MARKETING THESIS   BANIK             4.2 PurposeThe purpose of th...
BY AVIROOP                                              MARKETING THESIS   BANIK          4.2.1 HypothesisTo answer the fi...
BY AVIROOP                                               MARKETING THESIS   BANIK        5 Frame of referenceIn this chapt...
BY AVIROOP                                               MARKETING THESIS   BANIK5.1.2 Types of Innovation:Generally there...
BY AVIROOP                                               MARKETING THESIS   BANIKResistance leads consumers response towar...
BY AVIROOP                                              MARKETING THESIS   BANIK      5.2 What is consumers’           res...
BY AVIROOP                                                MARKETING THESIS   BANIK   5.2.2 Why understanding of these     ...
BY AVIROOP                                              MARKETING THESIS   BANIKsome studies have applied these factors to...
BY AVIROOP                                              MARKETING THESIS   BANIK    5.5 Hypotheses formulationTo identify ...
BY AVIROOP                                               MARKETING THESIS   BANIK5.5.4 Perceived RiskThree kinds of risk (...
BY AVIROOP                                               MARKETING THESIS   BANIK5.5.8 Self-EfficacyConfidence in ones abi...
BY AVIROOP                                                MARKETING THESIS   BANIKdecreased as consumers ignore its defici...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a bi...
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Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a biotechnological innovation in healthcare - A study of Umbilical Stem Cell Banking in India" by Aviroop Banik (Rizvi College)

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Background: A new buzzword “STEM CELL BANKING” is slowly but continuously engulfing
the consumers’ attention in India. In India, the industry put-together has banked about >70,000
cord blood units over the last three years. This number is set to increase substantially with
increased market reach and awareness; increase in regulatory approvals for stem cells based
products and lowered resistance to private banking will together encourage more clients to
choose stem cell banking.
Problem: Like every new innovation which comes to the market faces strong resistance from
consumer side, Stem cell banking is also facing heat of resistance from Indian consumers. Many
companies (both domestic and international) have started umbilical cord stem cell banking
business, but they have not yet successful towards lowering consumer resistance towards this
service. This banking service is only limited to attract financially robust consumers (but still, not
everyone is enrolling).The other lower sections still need to be tapped to generate more
revenues.
Purpose: The purpose of this study is to identify and analyze the relationship between
consumers' resistance and different factors from innovation and consumers' characteristics.
Thereafter, important factors are identified that mainly affect/determine consumers' resistance to
stem cell banking. Moreover, the inter-relationship (correlation) among the selected factors is
found out, to know the affects of each factor on other factors.
Method: A theoretical model has been proposed from the hypotheses; and Structural Equation
Modeling has been applied, where results are estimated through Partial Least Square method
using a sample of 100 respondents from Mumbai, B’lore, Gujarat, Tripura (by sending Equestionnaires
and personal discussions). SmartPLS2.0 software has been used to estimate
results along with SPSS 12.0.
Conclusions: Four out of eight hypotheses have been supported by the empirical data, where H1
i.e. relative advantage, H3 i.e. complexity, and H4 i.e. perceived risk, are from innovation
characteristics, while H6 i.e. motivation, is from consumers' characteristics. Motivation,
Complexity, Relative Advantage, and Perceived Risk are found as important factors that
affect/determine consumers' resistance to stem cell banking. Relative Advantage & Motivation
are found as positively correlated, and Perceived Risk & Complexity are found as positively
correlated. Negative correlation has been found between Perceived Risk and Relative advantage.
Similarly, negative correlation has also been found between motivation and complexity. The
proposed model of consumers’ resistance to stem cell banking shows an acceptable goodness of
fit, where 90% (R-square value) of variation in consumers’ resistance is caused/explained by the
hypothesized factors

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Marketing Research Project (quantitative using SPSS and SmartPLS) on "Factors affecting consumer’s resistance towards a biotechnological innovation in healthcare - A study of Umbilical Stem Cell Banking in India" by Aviroop Banik (Rizvi College)

  1. 1. TITLEFactors affecting consumers’ resistance towards a healthcare innovation. -A study of umbilical cord Stem Cell Banking in India-
  2. 2. Rizvi Institute of Management Studies and Research Off Carter road, Bandra(W), Mumbai-400 050Marketing Thesis School of Marketing2012-01-22Factors affecting consumers’ resistance towardsa healthcare innovation - A study of umbilicalcord Stem Cell Banking in India.Aviroop BanikRizvi Institute of Management Studies and Research, aviroopbanik@gmail.comThis marketing thesis is brought to you by Mr.Aviroop Banik and is accessible to all marketing andresearch protagonists in Rizvi Institute of Management Studies and Research.It has been accepted for inclusion in marketing research omnibus.For more information, please contact aviroopbanik@gmail.com,info@rmi.rizvi.edu.in
  3. 3. A Project Report on“Factors affecting consumers’ resistance towards a healthcare innovation. -A study of umbilical cord Stem Cell Banking in India.” in partial fulfillment of the requirement of Post Graduate Diploma in Business Management (PGDBM) conducted by Rizvi Academy of Management under the Guidance of Dr. Kalim Khan Submitted by: Aviroop Banik PGDBM (MARKETING) (Batch: 2009-11)
  4. 4. DECLARATIONI declare that the project titled “Factors affecting consumers’ resistance towards a healthcareinnovation. - A study of umbilical cord Stem Cell Banking in India.” is a record of themarketing research carried out by me during the academic year 2009-2011 under the guidance ofmy guide Dr. Kalim Khan, Director, Rizvi Academy of Management.I also declare that this project is the result of my effort and has not been submitted to any otheruniversity for the award of any degree, or personal favour whatsoever. All the details and dataanalysis provided in the report hold true to the best of my knowledge. Aviroop Banik PGDBM (Marketing) (2009-2011)
  5. 5. CERTIFICATEThis is to certify that Mr. Aviroop Banik, a student of Post Graduate Diploma in BusinessManagement (PGDBM), from Rizvi Academy of Management, specializing in Marketing hassuccessfully completed the project titled “Factors affecting consumers’ resistance towards ahealthcare innovation. - A study of umbilical cord Stem Cell Banking in India.” under theguidance of Dr. Kalim Khan, Director, Rizvi Academy of Management in partial fulfillment ofthe requirement of Post Graduate Diploma in Business Management (PGDBM), by RizviAcademy of Management, for the academic year 2009-11.This is to certify that the project work is done under my guidance and supervision at RizviAcademy of Management and the same is approved by, Prof. (Dr). Kalim Khan (Project Guide)
  6. 6. ACKNOWLEDGEMENTI have taken sincere efforts in this marketing research project. However, it would not have beenpossible without the kind support and help of many individuals. I owe great many thanks to greatmany people, who helped and supported me during undertaking this project work. I would like toextend my sincere thanks to all of them. I take this opportunity to express my gratitude to thepeople who have been instrumental in the successful completion of this project.Words are inadequate in offering my sincere thanks to Dr. Kalim Khan, Director – RizviAcademy of Management, for having permitted me to carry out this project work.It was his able guidance at each step, constant feedback, encouragement, patience, cooperationand useful suggestions, which has supported me in completing the project work.I also sincerely thank all the respondents for filling up my questionnaire and thereby contributingtowards my project work.Finally, yet importantly, I would like to express my heartfelt thanks to my beloved parents fortheir blessings, my friends for their help and wishes for the successful completion of this project. Aviroop Banik PGDBM (Marketing)
  7. 7. -Table of contents-Sl. no. Head Page no.1 Introduction of Stem cells 11.2 Umbilical cord blood 11.3 What are stem cells? 1-21.4 The history of cord blood stem cells 31.5 How cord blood is collected 31.6 Types of stem cells 31.7 Sources of stem cells 41.8 Stem cells functioning 51.9 Best type of stem cells for therapy 51.10 Advantages of cord blood cells 5-61.11 Potential of stem cells 62 What is Stem Cell Banking? 72.1 Why it is recommended? 82.2 Benefits 82.3 Difference between stem cells from cord blood v/s bone marrow 82.4 Procedure of banking 8-92.5 Enrollment 92.6 Umbilical cord collection - Kit contents 92.7 Cord blood and tissue collection 9-102.8 Cord blood collection 102.9 Processing 10-112.10 Preservation 11-122.11 Stem Cell Cryopreservation 132.12 How banked stem cells can help children 142.13 Where to bank child’s stem cells in India? 142.14 Private Banks vs Public Banks 152.15 Facts about stem cell banking in India 162.16 Stem cell treatment miracles 17-193 Background of stem cell banking in India 203.1 India: A Growing Potential 203.2 The players 20-213.3 Marketing the Concept 223.4 Expanding Wings 22-233.5 Cost Dynamics 23
  8. 8. 3.6 Public v/s Private — will it survive? 243.7 Challenges 253.8 Future Prospects 25-264 Problem discussion 274.1 Research questions 28-294.2 Purpose 304.2.1 Hypothesis 314.2.2 Regression coefficients and Correlation 315 Frame of reference 325.1 Innovation 325.1.1 Technological Innovation 325.1.2 Types of Innovation 33-345.2 What is consumer resistance? 355.2.1 Factors affecting consumer resistance 355.2.2 Why understanding of these above factors is important? 365.3 Resistance models 36-375.4 Factors Affecting Consumers’ Resistance 375.4.1 Innovation Characteristics Factors 375.4.2 Consumers Characteristics Factors 375.5 Hypotheses formulation 385.5.1 Relative Advantage 385.5.2 Compatibility 385.5.3 Complexity 385.5.4 Perceived Risk 395.5.5 Expectation for better products 395.5.6 Motivation 395.5.7 Attitude towards existing products 395.5.8 Self-Efficacy 405.6 Innovation Characteristics Factors 40-435.7 Consumers Characteristics Factors 44-455.8 Theoretical Model of Consumers Resistance to stem cell banking 46-476 Quantitative Methods 486.1 Research philosophy 48-496.2 Research method 496.3 Research strategy 49-506.4 Data collection 506.5 Sampling 50-51
  9. 9. 6.5.1 Sampling plan 516.5.2 Sample size 526.5.3 Sampling procedure 526.6 Contact methods 526.7 Data analysis and tools 536.8 Statistical methods 536.8.1 Hypothesis testing 546.8.1.1 SmartPLS-Partial Least Square (PLS) 54-556.8.1.2 Correlation 557 Analysis by SmartPLS2.0 567.1 Testing hypotheses 567.1.1 Partial least square 567.1.1.1 Empirical model of consumer resistance to stem cell banking showing 57 regression coefficients and factor loadings derived from SmartPLS7.1.1.2 Factors relationship with consumer resistance represented by t-values 58 using SmartPLS7.2 Results discussion 59-627.3 Regression equation 63-647.4 Factors inter-relationship (Correlation) 65-688 Conclusion 69-718.1 Suggestions for further research 719 Descriptive statistics - Analysis by SPSS 12.0 72-10410 Cross tabulation 10510.1 Education * Rejection to adopt SCB among respondents 106-10710.2 Annual income * Rejection to adopt SCB among respondents 108-10910.3 Annual income * Opposition to adopt stem cell banking (thinking it’s a 110-111 wastage of money)11 Factors inter-relationship - Correlation using SPSS 12.0 11211.1 Positive correlation between factors 113-13311.2 Negative correlation between factors 134-14812 Regression using SPSS12.0 149-20113 Conclusion from SPSS analysis 20214 Bibliography 20315 Questionnaire 204-20816 Few success stories related to stem cell treatment in India 209-217
  10. 10. List of Figures & Tables:Fig 1 ............................................................................................................................................... 1Fig 2 ............................................................................................................................................... 2Fig 3 ................................................................................................................................................6Fig 4 ................................................................................................................................................7Fig 5 ............................................................................................................................................. 12Fig 6 ..............................................................................................................................................17Fig 7 ............................................................................................................................................. 18Fig 8 ............................................................................................................................................. 19Fig 9 ............................................................................................................................................. 30Fig 10 ............................................................................................................................................47Fig 11 ............................................................................................................................................54Fig 12 ............................................................................................................................................55Fig 13 ............................................................................................................................................57Fig 14 ............................................................................................................................................58Table 1 ..........................................................................................................................................59Table 2 ..........................................................................................................................................61Table 3 ..........................................................................................................................................65List of abbreviations used: CMPLX Complexity of understanding and using stem cell banking COMPA Compatibility of stem cell banking CR Consumer Resistance towards stem cell banking PPM Postponement to adopt stem cell banking OPPO Opposition for stem cell banking REJEC Rejection to stem cell banking EXFBS Expectation For Better Services MOTI Motivation to use stem cell banking PR Perceived Risk towards stem cell banking RA Relative Advantage of stem cell banking SE Self Efficacy of stem cell banking ATTEHS Attitude Towards Existing Healthcare Services/operation etc I.V Independent variable D.V Dependent variable PLS Partial Least Square SPSS Statistical Package for the Social SciencesNote: In this marketing thesis, stem cell banking company represents only private stem cellbanking company, NOT public.
  11. 11. Two statistical softwares are used for data analysis
  12. 12. AbstractBackground: A new buzzword “STEM CELL BANKING” is slowly but continuously engulfingthe consumers’ attention in India. In India, the industry put-together has banked about >70,000cord blood units over the last three years. This number is set to increase substantially withincreased market reach and awareness; increase in regulatory approvals for stem cells basedproducts and lowered resistance to private banking will together encourage more clients tochoose stem cell banking.Problem: Like every new innovation which comes to the market faces strong resistance fromconsumer side, Stem cell banking is also facing heat of resistance from Indian consumers. Manycompanies (both domestic and international) have started umbilical cord stem cell bankingbusiness, but they have not yet successful towards lowering consumer resistance towards thisservice. This banking service is only limited to attract financially robust consumers (but still, noteveryone is enrolling).The other lower sections still need to be tapped to generate morerevenues.Purpose: The purpose of this study is to identify and analyze the relationship betweenconsumers resistance and different factors from innovation and consumers characteristics.Thereafter, important factors are identified that mainly affect/determine consumers resistance tostem cell banking. Moreover, the inter-relationship (correlation) among the selected factors isfound out, to know the affects of each factor on other factors.Method: A theoretical model has been proposed from the hypotheses; and Structural EquationModeling has been applied, where results are estimated through Partial Least Square methodusing a sample of 100 respondents from Mumbai, B’lore, Gujarat, Tripura (by sending E-questionnaires and personal discussions). SmartPLS2.0 software has been used to estimateresults along with SPSS 12.0.Conclusions: Four out of eight hypotheses have been supported by the empirical data, where H1i.e. relative advantage, H3 i.e. complexity, and H4 i.e. perceived risk, are from innovationcharacteristics, while H6 i.e. motivation, is from consumers characteristics. Motivation,Complexity, Relative Advantage, and Perceived Risk are found as important factors thataffect/determine consumers resistance to stem cell banking. Relative Advantage & Motivationare found as positively correlated, and Perceived Risk & Complexity are found as positivelycorrelated. Negative correlation has been found between Perceived Risk and Relative advantage.Similarly, negative correlation has also been found between motivation and complexity. Theproposed model of consumers’ resistance to stem cell banking shows an acceptable goodness offit, where 90% (R-square value) of variation in consumers’ resistance is caused/explained by thehypothesized factors.
  13. 13. BY AVIROOP MARKETING THESIS BANIK 1. Introduction of Stem cell bankingBefore we understand the concept of umbilical cord blood stem cells and its banking process,first let us warm our hands with the concept of umbilical cord blood. 1.2 Umbilical cord bloodAfter a baby is born and the umbilical cord is cut, some blood remains in the blood vessels of theplacenta and the portion of the umbilical cord that remains attached to it. After birth, the baby nolonger needs this extra blood. This blood is called placental blood or umbilical cord blood: "cordblood" for short.Cord blood contains all the normal elements of blood - red blood cells, white blood cells,platelets and plasma. But it is also rich in hematopoietic (blood-forming) stem cells, similar tothose found in bone marrow. This is why cord blood can be used for transplantation as analternative to bone marrow.Cord blood is being used increasingly as a source of stem cells, as an alternative to bone marrow.Most cord blood transplants have been performed in patients with blood and immune systemdiseases. Cord Blood transplants have also been performed for patients with genetic or metabolicdiseases. More than 80 different diseases have been treated to date with unrelated cord bloodtransplants 1.3 What are stem cells?The human body has more than 200 types of cellsand they all perform designated tasks. For example,fat cells store fat, skin cells protect the skin, redblood cells carry oxygen and white blood cells fightantibodies.Stem cells: Stem cells are the "master" cells that actas building blocks of the body.Properties of stem cells: They are undifferentiated,blank cells that do not have a specific function.Characteristically, stem cells have a high capacity forself-renewal and a unique ability to differentiate into Fig: 1- Stem cell 1
  14. 14. BY AVIROOP MARKETING THESIS BANIKa variety of cells. Stem cells serve as a repair system for the body and can divide without limit toreplenish other cells.Self-regeneration is the ability of stem cells to divide and produce more stem cells. During earlydevelopment, the cell division is symmetrical i.e. each cell divides to gives rise to daughter cellseach with the same potential. Later in development, the cell divides asymmetrically with one ofthe daughter cells produced also a stem cell and the other a more differentiated cell.Stem cells are the building blocks of various organs and tissues in the body. Stem cells have theremarkable potential to develop into many different cell types in the body. Serving as a sort ofrepair system for the body, they can theoretically divide without limit to replenish other cells aslong as the person or animal is still alive. When a stem cell divides, each new cell has thepotential to either remain a stem cell or become another type of cell with a more specializedfunction, such as a muscle cell, a red blood cell, or a brain cell. Fig: 2- Functions of Stem cell 2
  15. 15. BY AVIROOP MARKETING THESIS BANIK 1.4 The history of cord blood stem cellsIn the 1970s, it was discovered that umbilical cord blood (blood that remains in the placenta andin the attached umbilical cord after childbirth) could be the source of blood-forming stem cells,cells that are capable of developing into the three types of mature blood cells present in blood;namely the red blood cells, white blood cells, and platelets.In 1988, French researchers used umbilical cord blood of a new born to treat his five-year-oldsibling who suffered from Fanconi’s anemia (a severe type of anaemia that can cause skeletaldefects); the first successful stem cell transplantation.Cord blood stem cells are also being researched in regenerative medicine given that they mayhave the potential to give rise to other cell types. Scientists are using cord blood stem cells inexperimental treatments for brain injury and juvenile diabetes. 1.5 How cord blood is collectedAt birth traditionally, the umbilical cord and placenta (the temporary organ that transfers oxygenand nutrients to the baby while in the mothers womb) are discarded. With the discovery of cordblood stem cells, parents can now opt for storing this blood.The process does not interfere with labour or delivery in any way. Cord blood can be collectedfollowing either a vaginal or a caesarean delivery. Collecting stem cells from cord blood posesno risk to mother or baby. It is collected immediately after birth (usually within 10 minutes ofdelivery) and cryopreserved. It is then stored in a cord blood bank for future transplantation. 1.6 Types of stem cellsThere are 3 main classes of stem cells: • Totipotent: It has the potential to become all other types of cells in the body. A fertilized egg is totipotent. • Multipotent: A small number of stem cells that can produce only certain types of cells. • Pluripotent: Stem cells that produce any type of cell in the body except those needed to develop a foetus. 3
  16. 16. BY AVIROOP MARKETING THESIS BANIK 1.7 Sources of stem cellsStem cells can be found in different places. But the potential sources are:1. Embryonic Stem Cells: Using a donated human embryo, scientists are able to extract theblastocyst (inner cell) from the 4-day old embryo. This is then cultured for about six months in aPetri dish until a cell line which contains millions of stem cells, is produced. Embryos are usuallyobtained from a donor who has given their informed consent that their embryos, originallycreated for IVF but are now no longer needed, may be used for stem cell research.2. Bone Marrow: Bone marrow is the spongy material you find inside your bones. Containedwithin bone marrow, however, are stem cells. In fact, aside from cord blood, bone marrow is therichest source of adult stem cells. However, bone marrow stem cells have matured and thereforeare more restricted as to what type of cells they can differentiate into. Moreover, normalenvironmental exposures and toxins have likely affected these cells. As a result, their use is morelimited. Bone marrow transplants have been used to treat blood disorders, immune systemdisorders and genetic disorders.3. Peripheral Blood Stem Cells: These stem cells also fall into the category of adult stem cells.Peripheral blood refers to the blood circulating in your system. Although this isn’t the richestsource of stem cells, peripheral blood stem cell donors can be administered growth factor drugsto help increase their number of stem cells. When donating the stem cells, blood is withdrawnfrom the body and stem cells are separated from the blood before the blood returns to the body.While this method of donation is simpler than bone marrow donation, there is a greater chancethat the recipient will have complications, like graft vs. host disease.4. Cord Blood Stem Cells: Cord blood stem cells hold great potential in treating a wide numberof diseases and disorders. Cord blood stem cells are actually much more primitive than bonemarrow or peripheral stem cells. These stem cells are taken from umbilical cord blood shortlyafter birth; once the umbilical cord has been cut, a nurse or doctor can drain the blood from thecord. This blood can then be frozen and stored privately or donated to public cord blood banks.When it is needed, the stem cells are thawed and ready to use in stem cell therapy.“Adult stem cells are found in some tissues in the adult body like the epidermis of the skin, thelining of the small intestine and the bone marrow and teeth where they serve in the regenerationof old or worn tissue. Stem cells from the umbilical cord are known as neonatal stem cells. 4
  17. 17. BY AVIROOP MARKETING THESIS BANIK 1.8 Stem cells functioningStem cells differ from other kinds of cells in the body. All stem cells regardless of their sourcehave three general properties: they are capable of dividing and renewing themselves for longperiods; they are unspecialized; and they can give rise to specialized cell types.Stem cells are unspecialized. One of the fundamental properties of a stem cell is that it does nothave any tissue-specific structures that allow it to perform specialized functions. A stem cellcannot work with its neighbors to pump blood through the body (like a heart muscle cell); itcannot carry molecules of oxygen through the bloodstream (like a red blood cell); and it cannotfire electrochemical signals to other cells that allow the body to move or speak (like a nerve cell).However, unspecialized stem cells can give rise to specialized cells, including heart muscle cells,blood cells, or nerve cells.Stem cells can give rise to specialized cells. When unspecialized stem cells give rise tospecialized cells, the process is called differentiation. 1.9 Best type of stem cells for therapyUmbilical cord stem cells are a recent innovation in science and clinical medicine, which havethe potential to define the future of proactive healthcare and stem cell science. Breakthroughmedical research has now shown that the umbilical cord and menstrual blood are amongst therichest sources of stem cells and they have the potential to treat many ailments through stem celltherapy.Transplant surgeons prefer stem cells from cord blood rather than from bone marrow ascomplications are lesser and outcomes are better. Stem cells from the umbilical cord have thehighest potential in curing diseases as against the others stem cells from bone marrow, dental ormenstrual, which have issues concerning purity and potency. 5
  18. 18. BY AVIROOP MARKETING THESIS BANIK 1.10 Advantages of cord blood cells While bone marrow, embryonic tissue, amniotic fluid and now even menstrual blood are considered sources of stem cells, umbilical cord blood stem cells are biologically younger and are considered to have qualities and advantages unique to them.• Being immediately available, they can be used for early treatment, thus minimizing disease progression.• If ever a transplant is needed, the child’s own stem cell is a perfect match and these cells may even be compatible with those of a child’s siblings.• Freezing the cord stem cells protects them from environmental damage, ageing, and common viruses that can affect stem cells in the bodies over time.• Moreover, collection of cord blood is painless, simple and safe. 1.11 Potential of stem cells Stem cells are a breakthrough in modern regenerative medicine. They have a huge potential in regenerative medicine through their ability to generate cells and tissues. Stem cells can also be directed to differentiate into specific cell types, thereby offering the possibility of a renewable source of replacement cells and tissues - to treat diseases such as Parkinsons & Alzheimers diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis and rheumatoid arthritis. Recent studies have indicated the possibility to direct differentiation of stem cells into heart muscle cells or insulin-producing pancreatic cells. For example, it is now possible to generate healthy heart muscle cells from stem cells in the Fig: 3- Diseases treated laboratory and transplant those cells into patients by Stem cell with chronic heart disease. In type I diabetes, the cells of the pancreas that normally produce insulin are destroyed by the patients own immune 6
  19. 19. BY AVIROOP MARKETING THESIS BANIKsystem. It is now possible to direct the differentiation of stem cells in stem culture to form newinsulin producing cells that could eventually be used in transplantation therapy for diabetes. 2 What is Stem Cell Banking?A stem cell bank is a facility, which stores stem cells for future use. Umbilical cord blood isblood that remains in the placenta and in the attached umbilical cord after childbirth. Cord bloodis obtained from the umbilical cord at the time of childbirth, after the cord has been detachedfrom the newborn. Cord blood is collected because it contains stem cells, includinghematopoietic cells, which can be used to treat hematopoietic and genetic disorders. Cord bloodcontains all the normal elements of blood - red blood cells, white blood cells, platelets andplasma. But it is also rich in hematopoietic (blood-forming) stem cells, similar to those found inbone marrow. This is why cord blood can be used for transplantation as an alternative to bonemarrow. Fig: 4- Sources of Stem cells 7
  20. 20. BY AVIROOP MARKETING THESIS BANIK2.1 Why it is recommended?Stem cell banking is a simple, safe and painless procedure and happens immediately after birthafter cutting the cord. The cord blood collected is then transferred to the laboratory and frozen incryogenic storage tanks for long-term preservation. Nowadays, the umbilical cord is also stored.Stem cells represent an exciting area in medicine because of their potential to regenerate andrepair damaged tissue. Some current therapies, such as bone marrow transplantation, alreadymake use of stem cells and their potential for regeneration of damaged tissues. Other therapiesare under investigation that involves transplanting stem cells into a damaged body part anddirecting them to grow and differentiate into healthy tissue.2.2 Benefits:Storing babys umbilical cord blood stem cells is an investment towards the future health of afamily. It ensures an exact match for the child and a more likely match for another blood-relatedfamily member. Unfortunately, if a stem cell treatment is indicated, families those have notprivately banked their childs cord blood stem cells end up searching for an appropriate source ofcompatible stem cells - searches, which can take months and still, be unsuccessful. Cord bloodstem cells from a family member are much more likely to be successfully transplanted than thosefrom an unrelated donor.2.3 Difference between stem cells from cord blood v/s bone marrow:Both bone marrow and cord blood stem cell transplants are designed to replace unhealthy cellswith healthy ones. Cord blood is blood that is collected from an infants umbilical cord afterdelivery, so that it may be tested, frozen and subsequently stored in a cord blood bank for futureuse. A bone marrow transplant, on the other hand, involves the use of bone marrow that istransplanted from a donor into the recipient in order to cultivate new stem cells. Stem cells areavailable in greater proportion from the umbilical cord as compared to bone marrow. Cord bloodcells have more generative capacity as compared to bone marrow cells. Cord blood cells can beused for those with lung, heart and kidney disease where bone marrow cells are to be avoided.2.4 Procedure of banking:Umbilical cord blood & cord tissue banking is an once-in-a-lifetime opportunity for parents tocollect and preserve the stem cells from their babys umbilical cord within 10 minutes of birth ofthe baby.By preserving babys stem cells with a private bank, child and family can access to potentialtreatments for over 75 serious ailments such as leukemia (blood cancer), thalassemia, braininjury, juvenile diabetes and many more. 8
  21. 21. BY AVIROOP MARKETING THESIS BANIKUmbilical cord blood and tissue preservation is a simple, painless procedure that can take placeafter a vaginal or cesarean birth. By enrolling with a private bank, parents receive an umbilicalcord collection kit which contains all material and information for a successful collection.After your baby is born, obstetrician or paramedic staff will collect the cord blood and the cordtissue. The entire process takes less than 10 minutes and it is harmless to both the mother and thebaby. Once the cord blood and cord tissue has been collected, it will then transfer to a processingfacility through designated courier for processing and storage.2.5 Enrollment:Once parents decide to bank their baby’s stem cells with a private bank, they need to subscribefor the service, preferably a few months in advance before the expected delivery date.They can for instance contact customer support team or private bank centers nearest to them andtheir executives will assist them through the process of enrolment. The process is very simpleand parents can enroll over the phone itself. They can also make payment through easy andsimple modalities like pay online, cheque/DD, ECS as preferred by them.Upon completion of enrolment private bank will provide them the umbilical cord blood and cordtissue collection kit. But parents need to inform their doctor about their decision to preserve theirbaby’s stem cells.2.6 Umbilical cord collection - Kit contents:Gel packs need to be removed from the kit box and deep-freeze them by placing flat in thefreezer compartment of refrigerator. Proper storage of the kit in a cool, dry and well ventilatedplace at a temperature of 22 to 25 degrees centigrade is must and need to avoid exposure toexcessive temperature or humidity.When moving towards hospital, couple should inform the customer support of private bank thatthey are about to deliver. Contact information need to be provided so that private banks willguide them through the process. Couple needs to carry the kit, gel packs and all relateddocuments to the hospital / nursing home while proceeding for delivery. On reaching thehospital, gel packs need to be placed in the deep freezer immediately.2.7 Cord blood and tissue collection:Collection of cord blood is an essential part of cord blood stem cell banking. The collection kitmust be kept handy and couple must ensure that their doctor is aware of their decision to banktheir babys cord blood and willing to carry out the procedure. 9
  22. 22. BY AVIROOP MARKETING THESIS BANIKThe collection process occurs after baby is born and the umbilical cord is clamped and cut. Theblood can be collected before or after the delivery of the placenta.2.8 Cord blood collection:Cord blood is collected from the umbilical cord immediately after a baby’s birth, but generallybefore the placenta is delivered. Cord blood is drawn from the umbilical cord into the bloodcollection bag that comes in the kit. The mother’s blood will also be collected during this time tobe tested for certain infectious diseases as required by regulations. The baby’s cord blood andmother’s blood are then labeled and packaged in the kit box provided.This process is simple, safe, painless and harmless to both the child and the mother. Thisprocedure can be performed with either vaginal or cesarean section deliveries, and the entireprocess takes less than 10 minutes after the baby is born.Once the umbilical cord blood is collected a specified length of 10 to 25 cms of the umbilicalcord is cut and collected in the cord tissue collection containers.Obstetrician / gynecologist or the hospital staff shall perform the collection. In case couplerequires assistance in the collection process they would need to inform the private bank inadvance of the EDD to enable them to depute a paramedic staff for the collection.Once the blood is collected, the bag is sealed carefully to avoid contamination. The cord bloodand cord tissue samples are packed in the collection kit box as the instructions provided andsafely dispatched through designated courier service to private bank laboratory.2.9 Processing:After babys cord blood is collected, it will be safely transported to state-of-the-art processingand storage facility in India. The private bank facility is fully owned by the company and ismanaged by team of biotechnologists.Babys cord blood is processed and stored according to the stringent criteria set by the AmericanAssociations of Blood Banks (AABB). (Followed by top banking companies)On receipt of the collected sample, an array of tests is conducted on the cord blood, cord tissueand maternal sample. Depending upon the outcome of the test the samples may be quarantined orrejected. After testing, the cord blood and cord tissue are taken into a state-of-the-art technologyclean room wherein skilled technicians process the samples at utmost care adhering tointernational quality standards such as those prescribed by AABB (American Association ofBlood Banks). 10
  23. 23. BY AVIROOP MARKETING THESIS BANIKThe stem cells from cord blood are harvested using a red cell depletion method aided by achemical called ‘Hespan’ which facilitates the separation of red cells from the mononuclearwhite cells. Separation of stem cells is accomplished by further centrifuge spinning of the whitecells.The cord tissue is washed, minced put into tissue culture for extracting a pure mesenchymal stemcell population.2.10 Preservation:After the cells have been separated, the unit containing stem cells is mixed with acryopreservation solvent. This solvent protects the cells against the formation of ice crystals,which can rupture the cell membrane. The solvent most commonly used for cryopreservation ofcord blood is "DMSO" (Dimethyl Sulfoxide).To further protect cord blood cells against the formation of ice crystals, it is important that thecells freeze slowly. This is done in a special controlled-rate freezer, and then the blood istransferred to long-term storage. The final storage temperature should remain stable at -196degrees centigrade.Many private banks use special compartmentalized cryo-bags to store baby’s precious cord bloodstem cells. The bag includes a 20 ml and 5 ml portion and three segments for testing. The cordtissue stem cells are stored in two 5 ml cryo-vials, which have an integrated segment for testing.The stem cells bags and vials are overwrapped for added protection and also to avoid cross-contamination. They are housed in protective cassettes and boxes and placed in liquid nitrogenstorage vessels for cryogenic preservation at -196 degrees centigrade.Stem cells can be successfully stored for many decades in a cryo-preserved form. 11
  24. 24. BY AVIROOP MARKETING THESIS BANIK Fig: 5- Storage and preservation of Stem cell 12
  25. 25. BY AVIROOP MARKETING THESIS BANIK 2.11 Stem Cell CryopreservationThe instances of clinical storage of cord blood have increase manifold in the recent years. India isalso a fast growing destination for the Stem Cells cryopreservation fraternity. Many regionalprocessing centers have been set up to process the collected cord blood samples. Often there isconsiderable distance between the collection centers and regional processing centers whichnecessitates the development of short term as well as long term storage processes for the stem cellsderived from the umbilical cord blood. The initial work on the theory of cryopreservation wasdone by James Lovelock who suggested that the damage to the red blood cells was being causeddue to osmosis stress.The Downsides:In the cryopreservation process, the stem cells collected from umbilical cord blood samples, arefrozen to sub zero temperatures. The cryopreservation process comes with many risks. Thesolution concentration has to be correct otherwise the stem cells being preserved may be damaged.Also, if the tissue cooling process takes place slowly, the water within the tissues goes out of thetissues thus forming ice in the extracellular space. This ice may damage the cell membranesmechanically due to crushing. The water migration from the cell may also result in cellulardehydration, which again can damage the cells.How to Avoid the Downsides?Machines are used to freeze the stem cells in programmable steps before putting them into thedeep freeze stage in liquid nitrogen. The technique of Vitrification, on the other hand, claims tocryopreserve the samples while negating the damaging effects of ice crystal formation. Thetechnique uses cryoprotectants before the cooling process, which increases the viscosity. Theprocess also ensures that the solution doesn’t crystallize and turns into amorphous ice. The sameeffect can be produced through rapid cooling of water without using the cryoprotectants. 13
  26. 26. BY AVIROOP MARKETING THESIS BANIK 2.12 How banked stem cells can help childrenStem cells are used today to treat various cancers and blood disorders. They may hold the key torepairing brain or spinal cord damage, or regenerating heart tissue in those who have suffered aheart attack.Other factors that may be an incentive for families to save their babies’ cord blood are a familyhistory of disease; having a baby of mixed ethnicity or an ethnic minority, where it may be moredifficult to find stem cell donors, or when a newborn is adopted, it may serve as a valuablegenetic source of stem cells for the adopted baby.However, for inherited genetic conditions, the childs own cord blood cannot be used and here amatched sibling’s stem cells would be the first choice.Planning for the health of the new addition to the family starts at birth. Cord blood bankingoffers the security of knowing that there is a feasible option to overcoming life-threateningdiseases in future. 2.13 Where to bank child’s stem cells in India?In India, a parent has three options:1. They may privately bank, which means they pay a company to collect, process, and store theirbabys stem cells in a private stem cell banking company,2. They may store it in a public bank,3. They may simply choose to discard them. If they make no decision at all, these potentiallylifesaving cells will be discarded. 14
  27. 27. BY AVIROOP MARKETING THESIS BANIK 2.14 Private Banks vs Public BanksUmbilical cord blood stem cells can be banked in either a private bank or a public bank. Theprimary difference between a private and public cord blood bank is that, in a private bank theexpectant family pays to bank the umbilical cord blood for their private use, while a public cordblood bank collects umbilical cord blood free of cost from anyone who wishes to donate andstores it for the benefit of the general public. 15
  28. 28. BY AVIROOP MARKETING THESIS BANIK 2.15 Facts about stem cell banking in India: from media Young couples are getting tuned with the innovation in their cities: Young parents are flocking to banks to create savings accounts for their newborns. Less than 1 in 30,000 people withdraws these cells. Its now just a blind faith in science. Medical research is focusing on using stem cells in conditions such as Parkinsons disease, Alzheimers, diabetes and a growing list of debilitating and incurable diseases. At least 100 couples from across the country have banked stem cells with Lifecell every month. What if couple misses the chance of storing their baby’s cord blood stem cell: For couples who missed the chance during deliveries, the bank offers an alternative. Women can bank their menstrual blood, which is also rich in stem cells. The women are given a collection kit comprising a menstrual cup and collection tubes. Like the cord blood, it is processed and preserved in liquid nitrogen at extremely low temperatures. Stemade opened the citys first dental stem cell bank. The bank will store the stem cells drawn from the childrens milk teeth or adult wisdom tooth. Its something people would anyway throw out. Its an opportunity for people who have missed out on banking their cord blood cells as dental stem cells can be extracted at any stage. (Source: Times of India, April’11) Eight years ago, when a handful of companies started offering expecting parents the option of preserving their newborn childs stem cells for future use, the response was tepid. Most women simply chose to get on with the birthing process and welcome their child into the world. By 2010, however, urban India had cottoned on to the potential life-saving power of stem cells carefully extracted from the blood of the umbilical cord. According to estimates from the medical community, an average of 24,000 couples opts for the procedure every year across India. This is a far cry from the initial years when the annual figure averaged just about 300. With a shelf life of 21 years, stem cells are seen as a form of health insurance. A majority of couples opting for this treatment are the educated middle-class, who are willing to bear the monetary pinch. (Source: Times of India, Dec’10) 16
  29. 29. BY AVIROOP MARKETING THESIS BANIK 2.16 Stem cell treatment miracles Fig: 6- Stem cell potential in treating cardiac and Parkinson’s disease 17
  30. 30. BY AVIROOP MARKETING THESIS BANIK Fig: 7- Stem cell potential in reducing tumor mass and recovering of eyesight 18
  31. 31. BY AVIROOP MARKETING THESIS BANIK Fig: 8- Stem cell potential in treating diabetes 19
  32. 32. BY AVIROOP MARKETING THESIS BANIK 3 Background of stem cell banking in IndiaA new buzzword “STEM CELL BANKING” is slowly but continuously engulfing theconsumers’ attention in India. Stem cells were in the limelight when recently US President BarakObama lifted an eight-year-old ban on Government-supported funding for embryonic stem cellresearch, opening floodgates for millions of dollars in research.In the Indian research turf too, stem cell banking is gaining momentum. In India the industry put-together has banked about >70,000 cord blood units over the last three years. This number is setto increase substantially with increased market reach and awareness; increase in regulatoryapprovals for stem cells based products and lowered resistance to private banking will togetherencourage more clients to choose stem cell banking. 3.1 India: A Growing PotentialWith more than >80,000 births a day or >26 million births a year, India is poised to be the largestsource for umbilical cord blood in the world. Its no surprise then that leading stem cell bankingcompanies are keenly eyeing India. The investments are considerable and mostly run intomillions of dollars. Analysts estimate that an Indian stem cell bank, which is currently at Rs 100crore, would generate Rs 2,700 crore in revenues by 2012, accounting for 17 per cent of theworld market. Companies with foreign funding are entering the market and are planning tocapture at least 21 per cent of the total market.As of now, there are more than ten players in this eight-year-old market. Most of these cordblood banking companies are having an overseas parent company which is responsible for theinitial investment. 3.2 The playersLeading private players in area of cord blood banking are Lifecell International, CryobanksInternational India, Cryo Stemcell Karnataka, Reliance Life Sciences, Cordlife SciencesIndia, Cryo-Save India and many others. This segment also includes nominal presence of 20
  33. 33. BY AVIROOP MARKETING THESIS BANIKpublic cord blood banks like Jeevan Stem Cell Blood Bank which is a not-for-profit stem cellbank.Lifecell, launched in November 2004 through a technology tie-up with Cryo-Cell International(CCI) US, was one of the first entrants in the Indian cord blood banking segment and therefore issaid to be the biggest umblilical cord blood banking company in India. Lifecell made use of itsfirst mover advantage and has created a customer base of >25,000 parents. Another homegrownventure that emerged in the early days of stem cell banking in India was Cryo StemcellKarnataka. Started around five years ago by Dr S.G.A Rao, this company thrives on makingtherapeutics as the future for stem cell banking. The company treated over 60 patients forBeurgers disease (limb ischemia), with adult stem cells. On similar lines, it has completed trialson spinal cord injury, chronic liver failure, myocardial infraction and osteoarthritis.Cryobanks International India, started in 2006, is a joint venture between CryobanksInternational, a US body, and RJ Corporation headed by Ravi Jaipuria. The company invested Rsone billion to build the seven repositories in metro cities.Cordlife Limited, a Singapore-based cord blood banking group, recently entered this segmentopening the first cord life facility in India, with a storage capacity of up to 1, 50,000 cord bloodunits. This unit has been set up at Bishnupur area on the outskirts of Kolkata. The company plansto invest Rs 300 million in 18-24 months to set-up similar facilities across India.Another European stem cell banking company, Cryo-Save launched its operation in India inDecember 2008. The company has set 10 stem cell storage banks in the country at a cost of Rs10 million. 21
  34. 34. BY AVIROOP MARKETING THESIS BANIK 3.3 Marketing the ConceptAmongst the six existent players, Lifecell and Reliance Biotech both have partners withexperience in pharma industry. These companies have established sales force wherein trainedmedical representatives visit the prospective clients home and explain the concept, collectionand processing, and provide confidence on the storage facilities. They are aware of the fact thatin India if any medical concept has to be rolled out, the doctors have to be taken into the loop.Therefore, private players have set up a marketing and sales force structure which is just like apharma company that gets in touch with the obstetrician, gynecologist on regular basis and getpregnant patient population from them.The smaller companies are making some headway in creating infrastructure through privatefunding. There are companies who are directly approaching prospective customers for conceptselling. Cryobanks International India has been following a model of increasing direct client anddoctor awareness. They are offering their services in more than 75 towns, which they plan toincrease to 250 plus towns. They are also conveying information on the concept throughadvertisements, advertorials in magazines and papers. Further, they conduct direct mass outreachprogrammes which are aimed at increasing mass awareness about stem cells. The company hasalso on offer the public banking services to its clients who wish to bank their stem cells in publicbanks and intends to cater to all towns with population of more than a lakh in the coming threeyears. 3.4 Expanding WingsThe investments from the cord blood banks in India are mainly focused on the facility building,technology development fees and its day-to-day operations. The industry is expecting at least 10more new players in the next few years including global players who are keen to leverage theIndia opportunity. With everyday advancements in stem cell technology from the research andclinical perspective, stem cells do promise a healthy future for the coming generations in India.Some companies launched new banking services (like collection of stem cells from menstrualblood, cord tissue, and adipose tissue). This will increase the customer base significantly as thisopportunity is not restricted to expectant parents alone.Cryo-Save India has plans to offer more value added services like cord and stem cells fromadipose tissues besides offering the elementary service of cord blood banking. It has just started 22
  35. 35. BY AVIROOP MARKETING THESIS BANIKits test marketing of cryo-cord service in India. Menstrual blood contains extremely large numberof mesenchymal stem cells and several thousand fold high concentration of stem cell growthfactors. Because of these properties research has shown that these menstrual cells multiplyrapidly and can also form other types of specialized cells including those of the heart, nerve,bone, cartilage and fat. 3.5 Cost DynamicsEvery year out of around 26 million births in India, 6, 00,000 are potential clients, given thepricing of approximately Rs 79,000 per umbilical cord banked for 21 years. In recent times,companies are driving the prices to almost 50 per cent of the initial cost, forcing other companiesto match the price. Markets have been reduced to bargaining battlegrounds controlled by theaspirations of marketing personnel, who are looking to maximize their role in this drive, oftenresulting in giving the client biased banking solutions options.Private players are now increasingly offering EMI schemes of payments to help clients choosebetter and easier payment options for banking. Lifecell provides its services in two packages.With Lifecells Baby Cord plan, the interested parents can enroll and store their babys cordblood stem cells and cord tissue for 21 years by paying Rs 3,500 as a monthly EMI for twoyears. Other options available are one-time storage fee of Rs 79,000 or initial processing fee ofRs 44,600 with an annual storage fee of Rs 3500.CordLife Sciences India offers private banking for an initial upfront fee of Rs 38,000 andsubsequent annual storage fees of Rs 3,600. The critical factor which is affecting business in thefield of stem cell banking is the cost of processing and storing the stem cells. The processinvolves usage and procurement of items not manufactured in the country (so a huge amount ispaid in duties and taxes) and this increases the cost of the process significantly.Banking would naturally increase if reductions in prices are made for banking, Stem cellbanking is hugely capex intensive and is in itself an entry barrier.Even though it is a well-known concept in the Western world, public cord blood banking has justtaken off in India a few months ago. Chennai-based Jeevan Stem Cell Bank has launched publicbanking service recently. Jeevan Stem Cell Bank is a unit of Jeevan Blood Bank and ResearchCentre, a 14 year old not for profit organisation. Bangaluru-based Narayana Health City alsorecently came up with a public stem cell bank named the Rotary Narayana Tissue Bank and StemCell Research Centre. 23
  36. 36. BY AVIROOP MARKETING THESIS BANIK 3.6 Public v/s Private — who will survive?Public stem cell banking is different from private stem cell banking in the fact that the clientdoes not need to pay for the banking and that the right of the sample is not with the client whichis so in private banking. Moreover, there is a raging debate on whether public stem cell bankingas a concept will survive on the Indian healthcare grounds in the long run. The need of the houris public stem cell banking which anyone who needs transplant can access. Possibility of use ofstored stem cells within the family or by the same child is very limited. When one donates thecord blood to a public bank, the donor need not make any payment and the processing cost is metby the public bank with community donations.It is best suited for treatment of hematological disorders; whereas autologous stem cells fail toresult in a beneficial outcome in such cases. Public banking system must be in place forhematological disorders, whereas, autologous banking is more appropriate for treatingdiseases in the regenerative mode.Public cord blood banking is a novel concept of making an otherwise biological waste availableas a therapeutic tool but this is however fraught with multiple issues. The source material isfreely available, what with nearly 80,000 births happening everyday in India. The issues startwith the cost of collection systems, couriering to the processing centre, testing, throughprocessing and finally storage. All these come at a prohibitively expensive financial liability.Testing itself would involve all infective markers like the HIV, Hepatitis B, C, Syphilis, CMVapart from sterility issues to detect contamination of the blood or tissue.Nevertheless, cord blood stem cells stored in a public cord blood bank are available for publicuse and often, chances of finding a match are low. If a match is found, the charges to retrievethese stem cells can cost as high as $26,000.Public cord blood banking works only when the repository is huge and this requires extra largeshares of the financial pie. This money has to come from Governmental organizations, NGOs,philanthropists or open-ended research schemes, funded by foreign funds. A global teaming upwith other stem cell repositories across the world may make the public banking feasible, in termsof funding and revenues from therapies. 24
  37. 37. BY AVIROOP MARKETING THESIS BANIK 3.7 ChallengesBesides being the richest source of cord blood, there are few other factors which have madeIndia both preferable as well as a risky destination for prospective stem cell banking players toenter and survive in this segment. However, as in every nascent industry, the issue of regulationis rearing its head in stem cells. While the Indian Council of Medical Research had issuedstringent guidelines for stem cell research and therapy, they are yet to be legislated. The UnionHealth Ministry is planning a law to regulate this sector. The guidelines have to become law in astrict sense to attract global attention.Currently, umbilical cord blood and cord-tissue banking are more popular amongst theaffluent clients. The uptake of this concept would be faster in the upper class and tier III citieswith comparatively higher disposable incomes.With stem cell therapy proving to be an emerging treatment for the future, cord blood banking isone of the cheapest alternatives. Stem cell transplantation facilities are increasing in India, butfor optimal utilization of these facilities, it is important to create concept awareness. It is stillconsidered an ultimate preventive healthcare luxury due to high cost barriers.At present, lack of awareness among the common people about the huge potential to be gainedfrom the storage of cord blood stem cells and highly technical nature of the process is the keyreason for a small customer base in the country. However, the market has tremendous potentialthat could be tapped by initiating an awareness campaign and a customized marketing plan. Toovercome this challenge, companies like Cryo Banks India intend to involve doctors practicingin the towns. 3.8 Future ProspectsIn 2003 less than 30 diseases were able to get cured or supported with stem cells help, but, todayover 85 diseases can be cured or supported. In India the Department of Biotechnology is takinginitiatives to create Centers of Excellence in 35 medical teaching colleges to foster research inboth adult and embryonic stem cells. The success observed in other countries such as China,Taiwan and Korea is a yardstick to indicate that the concept of stem cell banking will also workin India. 25
  38. 38. BY AVIROOP MARKETING THESIS BANIKIncreased awareness levels among the masses about the concept and a strong legalized and lesscommercialized environment can work positively towards making stem cell banking an integralpart of Indian healthcare.After understanding the current status of stem cell banking in India, it leads me towardsanother important and often ignored perspective of innovation challenges, i.e. consumers’resistance. As stem cell banking represents “radical innovation” which faces considerablymore consumers resistance. Consumer (or end user) adoption and purchase decision make asignificant difference in the success of innovative healthcare service, so consumers resistanceis one of the important factors in the success of innovation. It can certainly inhibit and/ordelay the diffusion of an innovation and thus has important implications for the managementof firms. Consumers, who resist innovation, are most of the time non-adopters and represent amajor part of consumers.These consumers have strong potential for providing valuable information necessary for thedevelopment, implementation, and marketing of innovation, and should be given moreattention in research studies. From managerial perspective, studying consumers resistance toinnovation is very important and useful. Understanding resistance will help firmsdesign/develop new products/services so as to ensure market success, and high product/servicefailure rate that is prevalent today, can be reduced. Once firms face consumers’ resistance totheir innovations, they can analyze the underlying causes of resistance, and better be able todesign strategies to deal with critical & important resisting factors.Studying the factors affecting consumer resistance to stem cell banking can provide itsmarketers with useful information about these important factors that affects consumersbehavior towards innovation. 26
  39. 39. BY AVIROOP MARKETING THESIS BANIKIntroduction:This chapter aims to introduce the reader to the background of the study topic, the problemarea and a brief discussion of related studies. The research questions are formulated, followedby the purpose and hypothesis. 4 Problem discussionIntroduction: Innovation is a key factor for companies to survive and grow in the long run andhas been called as the lifeblood of most organization especially in the dynamic & complexmarkets, and uncertain economic circumstances. Despite the successful outcome of innovations,inhibition or delay in the diffusion of innovation may translate this success in to market failure.The cobweb: One of the main reasons for inhibiting or delaying the innovation diffusion isconsumers’ resistance, which appears to have been neglected in the academic literature. Eventhough the innovative products/services may provide extensive benefits and improvedfunctionalities, researchers have found that consumers often convey less than enthusiasticresponse to a number of new products/services. 27
  40. 40. BY AVIROOP MARKETING THESIS BANIK 4.1 Research questions1. What are the causal relationships between INNOVATION CHARACTERISTICS (Factors like Relativeadvantage, Compatibility, Complexity, Perceived risks and Expectation for better services) on consumer’s resistance to stem cell banking? INNOVATION CHARACTERISTICS Relative advantage of Stem cell banking Causal Compatibility of Stem cell banking relationships Complexity of Stem cell banking Consumer’s resistance towards stem cell banking? Perceived risks of Stem cell banking Expectation for better services2. What are the causal relationships between CONSUMER CHARACTERISTICS (Factors like Motivation, Attitude towards existing services & Self-efficacy) on consumer’s resistance to stem cell banking? CONSUMER CHARACTERISTICS Motivation to adopt Stem cell banking Consumer’s resistance towards stem cell Attitude towards existing healthcare services banking? Self-efficacy to use Stem cell banking service 28
  41. 41. BY AVIROOP MARKETING THESIS BANIK 3. What is the inter-relationship among the innovation and consumer characteristics factors? INNOVATION CHARACTERISTICS CONSUMER CHARACTERISTICS Relative advantage of Stem cell banking Inter- relationship Motivation to adopt Stem cell banking Compatibility of Stem cell banking Complexity of Stem cell banking Attitude towards existing healthcare services Perceived risks of Stem cell banking Self-efficacy to use Stem cell banking service Expectation for better services4. Which factors of INNOVATION CHARACTERISTICS and CONSUMER CHARACTERISTICS mainly affect/determine consumer’s resistance to Stem cell banking? INNOVATION CHARACTERISTICS CONSUMER CHARACTERISTICS Relative advantage of Stem cell banking Motivation to adopt Stem cell banking Compatibility of Stem cell banking Complexity of Stem cell banking Attitude towards existing healthcare services Perceived risks of Stem cell banking Self-efficacy to use Stem cell banking service Expectation for better services 29
  42. 42. BY AVIROOP MARKETING THESIS BANIK 4.2 PurposeThe purpose of this study is to identify and analyze the relationship between consumersresistance and different factors from innovation and consumers characteristics. Thereafter,important factors are identified which mainly affect/determine consumers resistance to stem cellbanking. Moreover, the inter-relationship (correlation) among the selected factors is found out, toknow the affect of each factor on other factors. Fig: 9- Dependent and Independent variables 30
  43. 43. BY AVIROOP MARKETING THESIS BANIK 4.2.1 HypothesisTo answer the first research question, a theoretical model of consumers resistance to stem cellbanking has been proposed and eight hypotheses (each for one factor) are constructed to find thecausal relationships.This theoretical model is based on some models (Ram’s, Yu and Lee Model, & TAM) andempirical results from different studies (discussed in the frame of reference). Based on themodels and different studies on consumers behavior towards innovation, I propose that;consumers resistance to adoption of stem cell banking is mostly determined by innovationcharacteristics; relative advantage, compatibility, perceived risk, complexity, & expectation forbetter products, and consumers characteristics; motivation, attitude towards existing products,& self-efficacy.The eight hypotheses are presented as follow:H1= Lower the Relative Advantage, higher the consumers resistance to stem cell bankingH2= Lower the Compatibility, higher the consumers resistance to stem cell bankingH3= Higher the Complexity, higher the consumers resistance to stem cell bankingH4= Higher the Perceived Risk, higher the consumers resistance to stem cell bankingH5= Lower the Expectation for Better/extended service (genetic testing along with storing stemcells), higher the consumers resistance to stem cell bankingH6= Lower the motivation, higher the consumers resistance to stem cell bankingH7= The more favorable/positive consumers Attitude towards existing healthcare services, thehigher the consumers resistance to stem cell bankingH8= Lower the Self-efficacy, higher the consumers resistance to stem cell banking4.2.2 Regression coefficients and Correlation:The first and second research questions will be answered from the results of regressioncoefficients and third and forth research questions will be answered from the results ofcorrelation, and will be performed on the same empirical data collected for hypotheses testing. 31
  44. 44. BY AVIROOP MARKETING THESIS BANIK 5 Frame of referenceIn this chapter, I have discussed relevant theories and models. These theories and model areused to build a theoretical framework and propose a model to be applied on our empiricaldata; that has enabled me to test the hypotheses and fulfill the desired purpose of the study.5.1 Innovation:An innovation is "an idea, practice, or object that is perceived as new by an individual or otherunit of adoption". An innovation may be composed of advancement in existing features, orestablishment of new features to an existing product/service, or it might be a totallynew/innovative product/service introduced in the (same or new) market.5.1.1 Technological Innovation:Technological Innovation is an iterative process started by the perception of a new market and/ornew opportunity for an invention (technological) which directs to development/improvement,manufacturing, and then marketing tasks essential for the commercial accomplishment of theinvention. This reveals two important perspectives, first, the innovation process comprises thetechnological development of an invention with addition to the commercial introduction of thatinvention to consumers, and secondly, the innovation process is iterative and hence, instinctivelyincludes the first opening of a new product and the re-opening of an enhanced and developedinnovation.The commercialization of new product/service has been termed as the most critical and alsocrucial activity that renders its accomplishment. 32
  45. 45. BY AVIROOP MARKETING THESIS BANIK5.1.2 Types of Innovation:Generally there are two types of innovation; incremental and radical innovation.In this study we deal with radical innovation. A radical innovation is “a product, process orservice with either unprecedented performance features or familiar features that offer significantimprovements in performance or cost that transform existing markets or create new ones”. It canalso be defined as an “innovation that breaks with traditions in the field”. They can also belabeled as radical, discontinuous, generational or breakthrough, and also disruptive innovation.Radical innovations are essential and eminent for manufacturers/marketers because of theircapabilities to bring new means of competitive advantage; on the other hand they are necessaryfor consumers as they are the main source of social and economic change in everyday lives. Theadoptions of radical innovations require much more commitment and entail higher expenditureand risks (including learning costs and psychological effort) than the adoption of incrementalinnovations.Innovation Resistance:Innovation resistance is consumers reaction towards an innovation, either because it createpotential changes from a satisfactory status quo or because it is in conflict with their beliefstructure.Ram and Sheth (1989) discovered that, the causes of innovation resistance stem from one ormore of the adoption barriers. These barriers are usage, value, risk, image, and traditionalbarriers. The usage barrier comes when the innovation is not compatible with consumersexisting workflow, practices, or habits. The value barrier is based on the economic value of aninnovation that the innovation does not offer strong performance-to-price compared to itsalternative products/services. Risk barrier is the degree of potential risks an innovation mayentail. Traditional barrier generally involve the changes an innovation may cause in dailyroutines, also it “a preference for existing, familiar products/services and behaviors over novelones”. The image barrier is associated with the innovations identity (from its origin) like theproduct category, brand, or the country of origin. Different researchers have found that, even forsuccessful new products/services, most of the time consumers respond in less than enthusiasticway, this less enthusiasm is often termed as consumers resistance. Consumers’ resistance playsan important role in the success of innovation, as it can certainly inhibit or delay the consumeradoption, and has been termed as one of the major causes for market failure of innovations. 33
  46. 46. BY AVIROOP MARKETING THESIS BANIKResistance leads consumers response towards three forms, it may take the form of rejection,postponement or opposition. Postponement Resistance Opposition Innovation RejectionPostponement occurs when consumers delay the adoption of an innovation. It simply “refers topushing the adoption decision to future. Even though the innovation may be acceptable to them,but usually it is caused by situational factors, like e.g. waiting for the right time, to becomecapable, or to make sure the product/service works effectively. Postponement may take the formof acceptance or rejection after a certain time period.Opposition refers to “protesting the innovation or searching for further information after thetrial”. It is a kind of rejection, but the consumer is willing to test/check the innovation beforefinally rejecting it. The causes of opposition vary and can be many, e.g. habit resistance,situational factors, and consumers cognitive style might direct them to reject innovations. Mostimportantly, an opposition might lead the consumers to search for adequate information whichcan direct them to acceptance.On the other hand consumers might reject an innovation on the basis of existing awarenessabout the innovation when they understand that it is not suitable for them. Consumers maydirectly reject an innovation, which is the most extreme form of resistance. When a mass ofconsumers reject an innovation, manufacturers usually change or iterate/modify it appropriatelyand then re-introduce it in the market. Rejection may occur if the innovation does not offer anyvaluable advantage, is complex or risky, etc. Rejection can be of two types, passive and activerejection; where passive rejection occur when the innovation is never really adopted orimplemented, and active rejection occur when the innovation has been considered but laterrejected. 34
  47. 47. BY AVIROOP MARKETING THESIS BANIK 5.2 What is consumers’ resistance?Consumers resistance has been defined as “Innovation resistance” is the resistance offered byconsumers to an innovation, either because it poses potential changes from a satisfactory statusquo or because it conflicts with their belief structure”.If the resistance cannot be broken down, adoption slows down, and the innovation is likely tofail. Firms need to understand consumers’ resistance, its reasons, and influencing factors; inorder to become much more efficient in their improvement efforts, and to identify ways toimprove competitiveness, productivity, and profitability. 5.2.1 Factors affecting consumers’ resistanceConsumer adoption of innovation depends upon several factors >> the most important of whichare specified as1. Consumers’ characteristics (psychological characteristics of consumers; how they view theinnovativeness with respect to that particular product/service), and2. Innovation characteristics (outcome and effects of innovation) Innovation characteristicsresearch represents the relationship among the attributes or characteristics of an innovation andthe adoption, use, or implementation of that innovation. 35
  48. 48. BY AVIROOP MARKETING THESIS BANIK 5.2.2 Why understanding of these above factors is important?There is a need to identify and understand the factors that seem to most influence customersresistance to innovative products. It is important to study the effects of important factors (relatedto consumers characteristics and innovation characteristics) on consumers resistance that willreveal the importance of each factor, the intensity of their effect and their relationship. On theother hand, understanding the key factors of consumers and innovation characteristics that affectcustomers resistance is crucial for firms project team to improve its chances of making the rightdecisions throughout the design and development efforts argues that, the reasons for innovationresistance vary across different consumers, which affects the adoption processes of eachconsumer.These variances suggest that firms need to explore the different factors affecting consumerresistance to innovations in order to minimize the possibility of product failure. Part of theproblem is that consumers may not understand the characteristics of the innovation in the sameway as the manufacturers/marketers. Stem cell banking companies should consider the factorsinfluencing user’s adoption and resistance to banking their baby’s cord blood stem cells. 5.3 Resistance modelsThe concept of innovation resistance was presented by Sheth (1981) as the "less developedconcept" in diffusion research. He researched psychology of innovation resistance and proposedtwo psychological constructs which seems very useful in understanding the psychology ofinnovation resistance. These psychological constructs are; habit/behavior towards existingproducts and perceived risks associated with innovation adoption. Following this model, Ram(1987) discussed innovation resistance in more details and proposed a detailed model ofinnovation resistance, based on this model; innovation resistance can be viewed as dependent onthree sets of factors: Perceived Innovation Characteristics, Consumer Characteristics, and,Characteristics of Propagation Mechanisms.Ram’s model was later modified by Lee and Yu (1994), with the argument that consumersresistance is not dependent on propagation mechanism, as propagation mechanism can onlyinfluence innovation diffusion. Numerous studies have applied factors from consumerscharacteristics and innovation characteristics to assess consumer adoption of innovation, while 36
  49. 49. BY AVIROOP MARKETING THESIS BANIKsome studies have applied these factors to assess consumers resistance. Below is a briefdiscussion to mention these studies. 5.4 Factors Affecting Consumers’ ResistanceThere are two kinds of factors that affect consumers’ resistance, and are based on consumers’characteristics and innovation characteristics.5.4.1 Innovation characteristics factors are related to the outcome and the affect of newproducts on consumers, which determine the amount of resistance generated and has the powerto predict consumer adoption and expected resistance. It has been found by some researchers thatinnovation characteristics provide greater explanation to consumers behavior towardsinnovation. Innovation characteristics research describes the relationship between the attributesor characteristics of an innovation and the adoption or implementation of that innovation.5.4.2 Consumers characteristics factors are the psychological characteristics of consumerse.g. how they view the innovativeness with respect to that particular product. Innovationresistance is dependent on the psychological characteristics of the consumer. The importantfactors that have been identified as relevant to consumer behavior in innovations context are:Personality, Attitudes, Value Orientation, Previous Innovative Experience, Perception, andMotivation. 37
  50. 50. BY AVIROOP MARKETING THESIS BANIK 5.5 Hypotheses formulationTo identify the causal relationship among consumers resistance to stem cell banking and theabove discussed eight factors, I set up hypotheses based on the models of innovation resistanceand previous research findings. Following the above discussed literature on eight factors, apositivistic research paradigm was adopted and eight hypotheses have been constructed.5.5.1 Relative AdvantageRelative advantage is hypothesized to have negative effect on consumers resistance to stem cellbanking.Hypothesis 1: Lower the Relative Advantage, higher the consumers resistance to stem cellbanking.5.5.2 CompatibilityBased on the definition of compatibility in innovation perspective, stem cell bankingcompatibility is checked with consumers needs and life/work style. Following the past researchon compatibility, I hypothesize compatibility to have negative effect on consumers resistance tostem cell banking.Hypothesis 2: Lower the Compatibility, higher the consumers resistance to stem cell banking.5.5.3 ComplexityMost of the researchers have found complexity to have negative effect on consumers adoptionand positive effect on resistance so I hypothesize complexity to have positive effect onconsumers resistance to stem cell banking.Hypothesis 3: Higher the Complexity, higher the consumers resistance to stem cell banking. 38
  51. 51. BY AVIROOP MARKETING THESIS BANIK5.5.4 Perceived RiskThree kinds of risk (financial, performance, and security risk) have been found as important incase of stem cell banking. Following the past research on perceived risk and consumers behaviortowards innovation, I hypothesize perceived risk to have positive effects on consumersresistance to stem cell banking.Hypothesis 4: Higher the Perceived Risk, higher the consumers resistance to stem cellbanking.5.5.5 Expectation for better products/healthcare servicesIt is measured by consumers expectation for “more convenient & useful healthcare services” andwith “lower prices”. I hypothesize expectations to have negative effect on consumers resistanceto stem cell banking.Hypothesis 5: Higher the expectation for better services, higher the consumers resistance tostem cell banking.5.5.6 MotivationMotivation drives consumers needs and intentions to adopt innovation. I hypothesize motivationto have negative effects on consumers resistance to stem cell banking.Hypothesis 6: Lower the Motivation, higher the consumers resistance to stem cell banking.5.5.7 Attitude towards existing products/servicesThis factor is used to find consumers satisfaction from existing products/services and it plays animportant role in driving consumers behavior toward innovations. This factor has been found tohave positive effect on consumers resistance towards innovation, and therefore I hypothesizeconsumers favorable attitude towards existing healthcare services have positive effect onconsumers resistance to stem cell banking.Hypothesis 7: The more favorable/positive consumers attitude towards existing healthcareservices, higher the consumers resistance to stem cell banking. 39
  52. 52. BY AVIROOP MARKETING THESIS BANIK5.5.8 Self-EfficacyConfidence in ones ability to use/understand stem cell banking without any difficulty, mayincrease the chances of adoption, and will have negative effect on consumers resistance.Different researchers have found self-efficacy to have negative effect on consumer resistance andpositive effect on consumers adoption of innovative products, based on which I hypothesizeconsumers self-efficacy to have negative effect on resistance to stem cell banking.Hypothesis 8: Lower the Self-efficacy, higher the consumers resistance to stem cell banking. 5.6 Innovation Characteristics FactorsAccording to Ram, Kelly, and Kranzberg, innovation characteristics can be divided into twocontexts, first is consumer-independent context and second is consumers-dependent. Thefactors of consumer-independent context can be expected to create the same type of resistanceacross all consumers, and is thus out of the scope of this study. On the other hand, the affects ofConsumer-dependent factors vary across different consumers. Innovation characteristics(consumer-dependent) factors effect consumers’ decision making to adopt a new product, thesefactors are; relative advantage, compatibility, risk, complexity, and expectations for betterproducts (inhibitory effect on adoption of other innovations). Understanding these factors andtheir affect on consumers resistance is crucial for increasing the chances of innovation success.Following is the detailed discussion about each factor.Relative Advantage:The relative advantage of an innovation is the “degree to which an innovation is perceived asbeing better/superior than the idea it supersedes. Relative advantage can be presented ineconomic profitability, social benefits, time saved, hazards removed, and also perceivedusefulness (PU). Tornatzky and Klein (1982) found relative advantage to be an important factorin determining adoption of innovations, affecting consumers’ resistance negatively. Relativeadvantage as the dominant factor that predicts consumers’ intention to adopt or resist innovation.In general, perceived relative advantage of an innovation is positively related to its rate ofadoption and negatively related to consumers resistance. Relative advantage, in addition to itsdirect and negative effect on consumers resistance, has indirect impact on perceived risk. Ifconsiderable advantages are provided with a new product/service, the expected risk maybe 40
  53. 53. BY AVIROOP MARKETING THESIS BANIKdecreased as consumers ignore its deficiencies/flaws. Moreover, relative advantage is positivelyrelated to compatibility and negatively related to complexity as compatible product can beutilized effectively and may increase its relative advantage, but relative advantage may decreaseif the new product/service is complex and consumers are unable to utilize it effectively.Compatibility:Compatibility is the degree to which prospective consumers believe that the new product fitswith their socio-cultural norms or is consistent with existing values, past experiences, style,behavior patterns, and needs. It has been regarded as an important component included inattitude development and is of special importance in technological markets. A general causeexpressed by different consumers for resisting or not adopting new product/service is "no need",even though all technological innovations usually bring about a number of benefits/advantagesfor consumers. Compatibility (or simply "congruence"), in prior research has been found as acrucial factor than can predict consumers adoption and resistance behavior. There are twoaspects of innovation compatibility: (1) it may refer to compatibility with the values or norms ofthe potential adopters or (2) may represent congruence with the existing practices of theadopters. The first is a kind of psychological or cognitive compatibility (e.g. compatibility withwhat people feel or think about a technology) while the second is a more practical/operationalcompatibility (e.g. compatibility with people practices). Culture and previous experience withproducts can determine (to some extent) consumers sense of security with innovation.Compatibility may lead the innovation evaluative process due to its direct affect on purchaseintention and other attributes. Research suggests that compatibility has a large and direct positiveeffect on purchase intentions; as if an innovation is perceived compatible, it is most probable thatconsumers will learn and get information about the innovation. On the other hand, the adoptionrate is affected by the old/existing products, the more compatible the old/existing products are,the less consumers intentions to adopt new products and hence more consumers resistance.Complexity:Complexity can be defined as “the degree to which the innovation is perceived as relativelydifficult to understand, use or comprehend. This definition has been followed by some otherresearchers.Different researchers have found complexity as negatively related to the innovation diffusion andpositively related to innovation resistance. An innovative product/service with considerablecomplexity demand more skills and efforts (to implement and use innovation) to increase itsadoption and decrease the possibility of consumers resistance. It is generally believed thatinnovative products that are less complex are easily adopted by consumers. There exist anegative relationship between complexity and relative advantage, as if a product/service isperceived as complex, it will be difficult for consumers to try it and hence cannot be utilized for 41

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