The pharmaceutical market in rural India is growing rapidly due to increasing income and awareness of health issues. However, rural marketing faces several challenges including a dispersed population, lack of infrastructure and educated consumers. Elder Pharmaceuticals has launched a dedicated rural division called Elvista to target smaller towns and villages. Elvista aims to reach 1.5 million rural consumers by 2012 through dedicated sales staff and by promoting affordable medicines for common ailments. Novartis' Arogya Parivar initiative uses localized healthcare teams and adapted products to improve access to treatment in rural communities across several states. Leading companies are conducting health camps and partnering with local organizations to promote awareness and education programs tailored for rural needs.

1. Rural Marketing –Pharmaceuticals

2. The India
Pharmaceuticals
Market

3. India Pharma Market
• Total Market- 13 bill $
– Exports (bulk drug and formulation)-6.9 bill $
– Domestic formulations-6.2 bill $
• Domestic India Market
– 2006- 6.2 Bill $
• Urban-3.7 Bill $
• Rural /Small Towns ( Tier 2 cities)- 1.24 Bill $ each
• One of the fastest growing pharmaceuticals markets
in the world propelled by growth in rural markets
from 18% in 2005 to 21% in 2006.
Source: IPA, Earnest and Young analysis, 2006

4. Key Players

10. Rural Marketing- Pharmaceuticals

11. India: Rural Scenario
•About 70 percent of India resides in villages- approximately
74,26,17,747 of the whopping 1.1 billion Indian population.
•Only 30 percent of the population has access to quality medicines.
•Rural Pharma Industry only constitutes 21 % of the total Pharma
Market.
•20 million middle class households spread across 6,00,000 villages
in rural India, which is equal to the number of middle class
households in urban India.
•The disposable income in rural India is much more as compared to
urban areas. Food, shelter and primary education are virtually free
in rural areas.

12. India: Rural Scenario
• Dominated by the acute and infective therapy segment.
• Some of the prominent disease segments prevalent in the rural
markets are pain or analgesics, anti-infective and respiratory
• Most of the products that are being advertised and marketed
aggressively are the low risk-low involvement products like pain
balms, lozenges, and cough and cold syrups.
• The high risk-high involvement products like cardiac or cancer
products are not advertised or marketed through media as
regulatory guidelines prevent this.

13. Traditional Rural Marketing in
Pharma

14. • Rural marketing activities of many pharma companies have been
traditionally restricted to markets with stocks of the concerned
product; and stocking them with the chemists there
• Even today, the best and the largest of pharmaceutical companies
reach only Class 1 towns.
• Marketing in the villages-include some unplanned taxi tours or they
leave it to the stockist’s network to make the goods available without
any doctor promotion in the rural areas.

15. Advertisements in Rural Markets
• The high risk-high involvement products like cardiac or
cancer products, are not advertised or marketed through
media as regulations prevent this.
• Companies often taken the community-welfare route to
educate the rural consumers about a particular disease
segment and make them aware of the treatments
available
• Companies conduct healthcare workshops in the rural
areas by tapping the doctors there

17. Rural Marketing – Challenges
• Highly disbursed and thinly populated markets
• Reliance on local chemists /Neem Hakims and penetration of
spurious drugs
• Unavailability of stockists and skilled sales force
• Lack of Communication/language barriers
• Lack of proper distribution network/supply chain
• Storage infrastructure
• Poorly educated rural population
• Lack of adequate qualified doctors
• Lack of awareness of ailments or symptoms
• Cultural gaps in urban marketers and rural consumers
• Scant availability of market research.

18. What is making the rural market attractive
• Developing infrastructure
• Cellular operators
• Rise in rural income levels
• Sops by Govt to set up rural health care infrastructure
• Penetration of rural insurance
• Thrust on rural health care program
• Brand Loyalty
• Competition in Urban Market
• Rise in lifestyle diseases

19. Case Study
Elder Pharma’s Rural Initiative

20. Elder Pharmaceuticals- Rural Initiative
• The Rs 650 crore Elder Pharmaceuticals Limited has set up a
dedicated division called “Elvista” to spread its network to villages,
towns, sub-urban/periphery markets and hinterland districts.
• Initial target is Class II to IV towns and rural markets with a
dedicated sales force of 240. with plans to increase Elvista’s
marketing strength to about 750 personnel or “product specialists”
by 2012
• The company has earmarked an investment of Rs 40 crore for its
rural thrust.

21. Categories/Areas Targeted
• Elvista is targeting therapeutic categories which have greater relevance
in rural areas and are preferred by doctors like Anti-peptic Ulcerants,
Anti-Malarials, Anti-infectives, NSAIDS, Quinolones, Cough
preparations, etc.
• Division has been launched with the support of 16 brands which
included a big brand like Eldervit injection. And few niche brands like
Mucodyne, Mucobron, Protocream and Venex too have been launched
in these towns.
• Elvista has already penetrated the rural markets of UP, Maharashtra,
Andhra and Bihar and soon will enter the South.
• Going ahead the company will be looking at smaller pack sizes for rural
markets. For example, plans are already made to launch topical pain
reliever called Ontac Gel in a small blister sachet pack.
• Outreach techniques to target rural audience would include Mobile
Health Clinics

22. Plan for 2012
• Before Dec 2012, Elvista plans to reach 1500 villages with
populations of below 40,000, 300 villages with populations of 40,000
to 100,000 and over 75 peripheral villages/towns around MMR
(Mumbai Metropolitan region).
• By 2012, Elvista’s target is to cover about five lakh doctors
promoting health education and awareness.
• Elder has over 350 products with focus of generics, women’s
healthcare, pain management lifestyle diseases etc which are
planned to be taken to the rural markets by 2012 by which time
Elvista is expected to contribute about 15 percent of Elder’s total
turnover.

23. Case Study-
Arogya Parivar Yojana

24. Arogya Parivar
• Novartis ‘social business’ model for rural India- awarded
prestigious award for "Best long-term rural marketing
initiative" from the Rural Marketing Association of India (RMAI).
• Sandoz and Consumer Health began piloting this model 2006. to
address following challenges :
– Lack of healthcare infrastructure,
– Lack of diagnosis - non awareness of the symptoms of diseases.
– Tendency to go to visiting a doctor whena disease becomes
critical, due to the cost and time involved.

25. Aim of the scheme
• The initiative a mix of aims to build a sustainable, profitable
business that improves access to healthcare among the
underserved millions in rural India by :
– Creating awareness,
– Enhancing local availability,
– Designing appealing and affordable health solutions.
– Innovative direct approach to make villagers aware of prevalent
diseases and encourage them to seek treatment.

26. Field force and product lines adapt to
rural needs
• Model-decentralized- the field force is in autonomous cells (170
cells by year-end 2008). Each cell has health educators and
supervisors who collaborate with local health professionals,
pharmacy chains and NGOs to address the whole "patient flow,"
including education, diagnosis, treatment, delivery, and availability
and accessibility of medicines.
• Novartis India has also adapted its organization and product offering
to the rural markets.
• A key differentiator is offering patients integrated solutions to health
problems rather than mainly selling products to health professionals.
• Products selected for the initiative are simple to use and packages
are reduced in size to keep out-of-pocket costs low.

27. • Arogya Parivar focused on diseases where Novartis could offer
solutions with Sandoz and OTC products. These included
tuberculosis and other respiratory infections, cough, cold, allergies,
skin and genital infections, mother and child malnutrition, diabetes,
intestinal worms and digestive problems - important challenges in
rural communities.
• Late 2006, the Arogya Parivar initiative was launched in the northern
state of U. P. and the western Maharashtra which inc. to a population
of around 25 million villagers across seven states by end 2008. The
objective is to double it by 2010.
• The company target is to reach 50 million rural patients by February
2010.

28. Some Other Initiatives by leading Pharma
companies in Rural Markets

29. Some Major Initiatives
• Novo Nordisk Education Foundation launched 'The Changing
Diabetes Barometer project' in Goa last year under the banner of
Global Changing Diabetes Leadership forum in association with the
Goa Government.
• Through this project the company aims through its mobile clinics
undertake a massive diabetes control programme, which includes
• Creating mass awareness of diabetes,
• conducting diabetes screening programmes,
• enabling practical training camps for medical professionals,
• improving treatment of diabetes with focus on reducing
complications related to diabetes and
• working towards making Goa free from diabetes related amputation,
blindness, nephropathy and other complications.

30. • In another initiative, the company conducts training for
anganwadi workers.
• This education programme covers various aspects of
diabetes including early symptoms of diabetes, diagnosis
complications and unlearning myths about diabetes.
Anganwadi workers are trained health workers in various
aspects of preventive health, nutrition and child
development covering rural areas.
• Through this programme, 74 anganwadi workers
responsible for maintaining health records of 1,000 to
1,500 people in their area were trained.

31. Company Initiative
Nicholas Piramal
(NPIL)
It has tied up with Sorento Healthcare
Communications for an Epilepsy Outreach
Programme launched under the banner 'Reach
More, Teach More'.
Strepsils lozenges It builds brand awareness in villages through
billboards at bus stands, branding buses, hoardings,
promotions at village haats, jatras and melas, road
shows etc.
Ajanta Pharma It uses stalls at fairs, slides in cinema halls, moving
vans. It also educates tertiary health workers, who
work in smaller villages.
Eli Lilly It works with the Self-Employed Women's
Association (SEWA) in Ahmedabad to educate
people on tuberculosis and encourage them to seek
treatment
A group of Pharma companies under leadership of Nicholas Piramal has asked govt to allow them to
use post offices as a channel to sell life saving drugs

32. Case Study
RW Promotions and Marketing

33. • RW promotions – advertising agency focusing on rural markets has
over 50 stage vans which have been driving campaigns in rural
markets for corporate across sectors ranging from FMCG to
banking, television channels, telecom companies etc for the last 15
years.
• It is a big success in Pharma as it promotes brands by conducting
medical camps which help in increasing the number of prescriptions
of the brand for the next four weeks once the van leaves the town.
• It also helps the pharma client build awareness about the ailment for
which the drug is being promoted.

34. • "The modus operandi of the medical camp being conducted is the
brand being promoted aggressively with the entire sales chain
getting touched starting from the MR to the distributor to the local
retail chemist.
• It has already conducted a few medical camps including
GlaxoSmithKline's Parivar Swasthya Parikshan Shibir, in Uttar
Pradesh, to create awareness for calcium intake in body through a
basket of drugs mainly Osteo Calcium along with Zentel, Zevit and
Becadexamin. This in return added 9,000 new prescriptions which in
turn resulted in almost about 95 percent of it getting converted into
sales.

35. • ‘Hame Jeetna Hai’ in Uttar Pradesh by Piramal Healthcare was an
18 month long activity, - creating general awareness for epileptic
patients through free medical check-up camps with readily available
medicines like Garoin and Gardenal, which . This helped them in
generating additional prescriptions of about 10,000 patients.
• An average medical camp campaign over a 30 day route cycle
would costs between Rs 4.5-5 lakh depending upon the drug being
promoted.
• The van ideally has a 30 day route cycle conducting about 70 to 80
medical camps with an average medical camp touching around 100
to 200 people.

36. Recommendations & Strategy for Rural Market
• Dedicated focus on rural separate divisions ( like Elder. )
• Focus on education with emphasis on primary health.
• Availability of medicines at primary health centers.
• Involvement of people for early diagnosis through camps.
• Training to selected villagers in paramedics (will help in
communication and overcoming prejudices).
• Training of Dai’s, local chemists at training camps.
• Pooled warehouses (with cold storage etc.)

37. Recommendations & Strategy for Rural Market
• Use of post offices as a distribution channel for life saving basic
drugs.
• Propagate happy user experience in communication.
• Use of folk artists and folk songs to communicate effectively and
interestingly.
• Join hands with NGO’s and self help groups.
• Emphasis on rural insurance

38. Thanks