IMPACT OF ADVERTISING ON CUSTOMER PURCHASE BEHAVIOUR IN PHARMACEUTICALS

SUBMITTED TO THE

GOVERNMENT COLLEGE UNIVERSTY OF FASILABID

(Sub-Campus Sahiwal) Department of

BUSINESS ADMINISTRATION

SUBMITTED BY:

AzharHussain

Under the Supervision of

DR .Ahmad nawaz

DEPARTMENT OF BUSINESS ADMINISTRATION

Government College University Sahiwal (sub-campus Sahiwal )

2017

DECLARATION

I hereby affirm that my research work entitled “Impact of Advertising on Customer

Purchase Behavior in Pharmaceuticals” for the award of Doctor of Philosophy from

Lahore University, Lahore is my own original work and has not been submitted for

Any assessment or degree/diploma or award at the University of Lahore or any other

University.

_________________________

Department of Business Administration

ACKNOWLEDGEMENT

It is with immense gratitude and pleasure that I acknowledge the help and support of

my supervisor Dr.Ahmad zaheer Nawaz Goodman in this thesis. He has been an

excellent guide, mentor and friend in this journey. I am so deeply grateful for his help,

professionalism, and valuable guidance throughout this research and through my entire

program of study that I do not have enough words to express my deep and sincere

appreciation.

I would like to thank to Dr. Ijaz Head of Department of Business Administration, and

all the respected teachers and staff of the Department for their constant support and

encouragement throughout my research work.

This thesis would not have been possible without the love and support of my family

and friends. I especially thankAtharHussain for his helpful insights and for standing by

me through good times and bad. I also acknowledge him for their best suggestions and

constant support.

Finally, I must express my very profound gratitude to my Mother,providing me with

unfailing support and continuous encouragement throughout my years of study and

through the process of researching and writing this thesis. This accomplishment would

not have been possible without them. Thank you.

AzharHussain

ABSTRACT

This study was conducted to develop a simple framework for finding out the impact of

the different kinds of advertisement and promotional tools offered by pharmaceutical

industry on the Consumer Purchase behavior and prescribing behavior of doctors. The

trend towards self-medication is likely to grow as consumers are becoming familiar

with OTC drugs, due to extensive advertising by companies. The present study intends

to explore advertising effectiveness of OTC drugs and Prescription drugs amongst

consumers and Doctors. Although there are different means of providing the

consumers with drug information, advertising seems to be one of the best way and a

powerful method of broadcasting information. The customer purchase behavior study

in Pharmaceutical advertisement is based on the consumer purchase behavior because

buying the medicine lies in the hand of customer (doctor) rather than final consumer

(patient). So the customer (doctor) acts as an indirect consumer. Due to this there are

two types of customers ear-marked in this study; one is doctor who is indirect

consumer and the other one is patient who is direct consumer. The advertisement of

Pharmaceutical was found to be persuasive. The study has given good insights for

marketers and advertisers of drugs and suggests including elements in the

advertisement that increase believability and trust of the advertisement. Results of

factor analysis revealed the view that the overall mean score of all the 27 items of

attitude towards prescription behavior was 2.96 and standard deviation 0.9091.This

indicates that pharmaceutical advertisement makes an impact on doctor prescription

behavior. Moreover the study also focused on whether the perception of physicians

towards variouspromotional tools is different with respect to demographic variables.

This research based on descriptive research or quantitative research. In this descriptive

research Cross-Sectional study used to compare demographical variables with attitude

of the respondent. Well-structured Questionnaires was developed for direct consumer

and doctors to identify important variables influencing Pharmaceutical advertising

effectiveness and purchase behavior towards medicine. Non probability systematic

convenient sampling technique has been followed. Survey was conducted and data was

analyzed on the basis of responses provided by 329 respondents as consumer and 150

respondents as Doctor. Researcher has applied factor analysis for data reduction and

ANOVA & Chi-Square test for hypothesis testing. Findings of the study can help the

marketing managers of pharmaceutical companies in designing their promotional

strategies especially for doctors and consumers. Construct validity and reliability of the

data were tested using Cronbach’s alpha coefficient. Descriptive statistics and Chi-

Square Tests for Independence were generated to study the relationship between

measures for each of the research questions and the demographics & miscellaneous

variables. Results show that advertisement is effective in affecting the decision process

and positive impression of the Consumer towards particular medicines and there is

significant association of medium of advertisement that gets the attention with

educational qualification, Occupation and age of the respondent as the Chi-square

value is significant. The Visual presentation of advertisement creates more attention

and makes their impacts in selection of medicine.

Contents

CHAPTER- 1................................................................................................................... 4

INTRODUCTION ........................................................................................................... 7

INTRODUCTION .......................................................................................................... 9

Factors Influencing Consumer Behavior ....................................................................... 19

Reference group: ........................................................................................................... 20

Family:........................................................................................................................... 21

Social status and role: .................................................................................................... 21

Personal Factors: ........................................................................................................... 21

Age and stage in life cycle............................................................................................. 22

Personality and self concept: ......................................................................................... 22

Psychological Factors: ................................................................................................... 22

Motivation: .................................................................................................................... 23

Perception: ..................................................................................................................... 23

Learning:........................................................................................................................ 24

Belief and Attitude: ....................................................................................................... 24

Psychographic Factor: ................................................................................................... 24

Marketing to Physicians and Consumers ...................................................................... 24

Market Characteristics That Influence Promotional Strategies ..................................... 25

CHAPTER- 2................................................................................................................. 32

REVIEW OF LITERATURE ........................................................................................ 32

CHAPTER- 3................................................................................................................. 46

RESEARCH METHODOLOGY .................................................................................. 46

Scope of the research:- .................................................................................................. 47

Research design: ............................................................................................................ 47

Selected Variables ......................................................................................................... 49

Definitions of variables ................................................................................................. 50

Hypothesis ..................................................................................................................... 53

Hypothesis ..................................................................................................................... 53

Size of sample: .............................................................................................................. 54

Sampling Technique: ..................................................................................................... 54

Survey Instrument: ........................................................................................................ 54

CHAPTER- 4................................................................................................................. 55

Data Analysis................................................................................................................. 55

Data analysis.................................................................................................................. 55

Reliability Test of Data ................................................................................................. 59

CHAPTER- 5................................................................................................................. 61

DISCUSSIONS AND CONCLUSION ......................................................................... 61

Managerial Implications for doctors: ............................................................................ 63

Conclusion: .................................................................................................................... 63

Chapterisation Scheme

The whole study has been divided into five chapters:

Chapter 1: Introduction

Chapter 1 is the Introduction presents the meaning, features and rationale of OTC

drug advertisement, role of various communication media in buying decision process,

various factor that influence consumer purchase behavior and doctor prescription

behavior. The last section consists of the rules and regulations which controls the

Indian Drug Industry in the sales and advertisement of OTC and non OTC drugs

along with the sales and growth figures of the Indian Drug industry in various years.

Chapter 2: Review of literature

Chapter 2 consists of literature review regarding various mode of advertisement,

impact of advertisement, OTC and Prescription drugs, DTCA, Brand Advertising,

How ads can influence consumer behavior and doctor prescription behavior.

Chapter 3: Research Methodology:-

Chapter 3 consist of Research Methodology presents need and scope of research, pilot

study, Data collection, discussion about questionnaires, Sampling design and brief

summary of tools used for analysis

Chapter 4: Data Analysis:-

Chapter 4 presents detailed analysis of demographic variables of doctor and consumer

that influence consumer and prescription behavior, Influence of prescription decision

with advertisement, Impact of Pharmaceutical Advertisement on doctor's Prescription

behavior, Influence of Medical Representative on doctors, Importance of medium

providing information about medicines.

Chapter 5: Summary and Conclusions

Chapter 5 includes the summary and conclusions of the study of the impact of

INTRODUCTION

Advertising is used for communicating, exchanging/delivering business information to

the present and prospective customers. It usually provides information about the

advertising firm, its product qualities, place of availability of its products, etc.

Advertisement is indispensable for both the sellers and the buyers. However, it is more

important for the sellers. In the modern age of large scale production, producers cannot

think of pushing sale of their products without advertising them. Advertisement

supplements personal selling to a great extent. Advertising has acquired great

importance in the modern world where tough competition in the market and fast

changes in technology.

This research delineates that the customer purchase behavior in Pharmaceutical

advertisement is based on the consumer purchase behavior because buying the

medicine lies in the hand of customer (doctor) rather than final consumer (patient). So

the customer (doctor) acts as an indirect consumer. Due to this there are two types of

customers ear-marked in this study, one is doctor who is indirect consumer and the

other one is patient who is direct consumer. In context to the pharmaceutical industry

in India advertisements make an impact on the prescription behavior of the customer

(doctor), along with the direct consumerwho purchase the OTC drug (Over the Counter

Drug which doesn’t requiresthe prescription of the doctors.The Pharmaceutical

marketing differs from othertypes of marketing because the consumer i.e. the patients

are not the target audience, whereas the physicians prescribing the medicines are the

target audience of the pharmaceutical companies. It is the doctor who makes the

decision on behalf of the patient. Physicians are privileged with the right of

recognizing the need of their patients and recommend medications for the well-being

of their patients. Hence, the relation between the physician and pharmaceutical

companies may create a conflict between the ethical professional interest of a doctor

and his financial self-interest. The increase in incentives to attract the doctor’s

prescription behavior reflects as a rise inthe price of prescription medicines. The

pharmaceuticals resort to many ways in marketing their product. Giving away gifts,

free lunches, sponsoring education and holidays have all been criticized as

inducements which compel a doctor to prescribe without scientific basis .

A study from Canada showed that the association with pharmaceuticals leads to less

than appropriate prescribing behavior by the doctor .Many physicians, however, do not

feel that their prescriptions are influenced by gifts and other incentives provided by

pharmaceuticals. Advertising facilitates consumer choice and it also enables consumers

to purchase goods as per their budget requirement and right choice which makes

consumer happy and satisfied. A good advertising campaign involves lots of creativity

and imagination. When the message of the advertiser matches the expectations of

consumers, such creativity makes the way for successful campaign. The advertiser

expects to create a favorable attitude which leads to a favorable action. Any advertising

process attempts at converting the prospects into customers. Thus it is an indirect

salesmanship and essentially a persuasion technique and it does not attempt at

maximizing profits by increasing the cost but by promoting the sales so in this way it

won’t lead to increase the price of the product. Thus, it has a higher sales approach

rather than the higher-cost approach.

Advertisement as a non-personal presentation is different from salesmanship as latter

is personal selling whereas advertising is non-personal in character and it does not

meant for individuals but for all. There is absence of personal appeal in advertising.

There is an Identified Sponsor who may be an individual or a firm, pays for the

advertisement and the name of a reputed company may increase sales of products. In

Pharmaceutical advertising online, in print, television or radio broadcast, direct to

consumer, or direct to physician are all variations of pharmaceutical advertising.

Advertising Campaigns can be strategic and include direct marketing, billboard design,

brochure design and development, video production, medical animations and more, to

circulate information on a new drug. Promotion in one form or another is employed by

every business irrespective of the commodity it produces. However, the

pharmaceutical industry which is regulated by drug rules and medical ethics to

communicate sophisticated information on drug usage to a critical and highly qualified

audience. As a matter of fact, pharmaceutical promotion is a vital source of technical

information and makes an important contribution towards educating the profession

also towards the right usage of the drugs. It is relevant to note at this juncture that there

are three fundamental elements in product costs in any modern industry or business,

and pharmaceutical industry is no exception. These are high technology manufacturing

costs, selling/promotion costs and research and development costs. In drug industry

particularly, the products are rather numerous and diverse, indicated for a host of

disease conditions, and each product has its own promotional requirements to suit the

needs of various specialties in medical practice which further adds to the costs which

becomes more important when the industry has to serve doctors in rural areas who are

not highly qualified and yet are called upon to treat a wide variety of diseases

prevalent in the rural community.

As said before, the unique aspect of pharmaceutical promotion is the communication of

completely prescribing information on the drugs to highly qualified medical men. In

view of the advances in drug therapy witnessed during the post independence period, it

is only natural that the members of the medical profession wish to stay abreast of the

new discoveries and developments taking place in the medical world from time to

time. For such a target audience, communication about the vital information on drugs

is more than mere promotion is a service. The job of communicating information and

promoting the pharmaceutical products to the professionals is done through Medical

Representatives who plays an important role in that. It is he who details a product

thoroughly to a practicing doctor and discusses the composition, mode of action of

each ingredient, indications, dosage, side effects, precautions, contraindications, pack

and price of the product. Doctor raises several queries concerning the use of the

product in the types of patients he sees in his day-to-day practice, and thus collects

complete information on the product and its relative advantages over similar other

products in the market.

Advertising to the General Public:-The Drug & Magic Remedies(Objectionable

Advertisement) Act & Rules mentions a list of ailments for which no advertising is

permitted. It also prohibits false or misleading advertisements which, directly or

indirectly, give false impressions regarding the true character of the drug, make false

claims, or are otherwise false or misleading in any particular respect. There is an OPPI

Code of Pharmaceutical Marketing Practices, 20101, based on the IFPMA code.

Currently, there is no specific law which prohibits the advertising of prescription

drugs.

Advertising the Products in Medical Journal: - Journal advertisementsattract

attention because they are visually appealing also see them as a way of keeping

medical practice nor up-to-date. The Ethical Criteria for Medicinal Drug Promotion

developed by the World Health Organization (WHO) suggest the types of information

that, as a minimum should be contained in a journal advertisement (WHO 1988), (see

box ). The aim is to ensure that basic information needed for prescribing decisions is

present. The medicine’s International Nonproprietary Name (INN), usually the generic

name, is a key piece of information that should always be included. Generic names

help doctors and pharmacists to identify which class a medicine belongs to and can

prevent doctors from unknowingly prescribing two medicines from the same class to a

patient.

The World Health Organization’s Ethical Criteria recommend that the following

Information be included in pharmaceutical advertisements appearing in medical

Journals.

Name(s) of the active ingredient(s) using either International Nonproprietary Name

(INN)

(INN) or the approved generic name of the medicine

Brand name

Content of active ingredient(s) per dosage form or regimen

Name of other ingredients known to cause problems

Approved therapeutic uses

Dosage form or regimen

Side effects and major adverse medicine reactions

Precautions, contraindications and warnings

Major interactions

Name and address of manufacturer or distributor

Reference to scientific literature as appropriate

Direct mailing of publicity material to doctors:-It is the sending ofpublicity material

like Textual and Audio-Visual Promotional Material to Doctor. There has been a

massive growth in direct mail campaigns over the last 5 years. Direct mail allows an

organization to use their resources more effectively by allowing them to send publicity

material to a named person within their target segment.By personalizing advertising,

response rates increase thus increasing the chance of improving sales.

Medical conferences, especially for a new product: - Companies organize medical

conference to promote new products in order to provide the information like uses, dose

regimen, contradiction & adverse effect etc. to the medical practitioner.

Electronic or Broadcast Media Advertising :-Electronic or broadcastmedia consists

of (i) radio, (ii) television, (iii) motion pictures, (iv) video and (v) the internet. The

radio is audio in nature, appealing only to the sense of sound (ears). Radio advertising

is more effective in rural areas, as compared to urban regions. Television, as an

advertising medium, is more attractive and effective because it is an audio-visual

medium appealing to both the senses of sight sound (eyes and ears). Different methods,

such as spot announcements, sponsored programmes etc. are used for broadcasting

advertising messages. However, broadcasting media are very expensive form of

advertising and sometimes it also undertaken through movies, video, and the internet.

Strategies for New and Switched OTC Pharmaceutical Products:-OTCmarketing

strategies are most important and unavoidable aspect of any pharmaceutical

organization especially what happens when a pharmaceutical products losses the patent

protection, it is important to consider whether radical change is really necessary. It may

be that the pharmaceutical product is operating in a niche category that is too small to

attract challenging generic competition, at least in the short term. It could also be that

the awareness and image of the brand is so strong in patients and doctors minds that it

would retain most of its equity even after the loss of patent protection. In most cases

however, the entry of generic competitors radically alters the competitive setting and

calls for appropriate radical responses, the few major strategies available to

pharmaceutical brands facing competition from OTC and generic products are briefly

reviewed. Marketing strategies available for a prescription drug facing competition

from existing generic product involve a trade-off between brand building and price

competition.

A company can also resort to no marketing oriented strategies such as legal efforts to

extend patent protection or tactical alliances with generic makers and can

simultaneously implement different strategies, thereby creating a hybrid model. It is

nevertheless useful to review each strategy independently, starting from the most

common to the least common. Some of the strategies are discussed here

i) Low Price strategy: This strategy has the lowest potential for brand building. Onthe

other hand, narrowing the price gap with revital addresses the main problem created by

the expiry of the patent; that the equity of the brand can no longer sustain a large price

differential with what is, essentially, the same product. At the extreme, comparing the

price with the generic will make doctors, pharmacists and regulators indifferent

between the two and may force the weakest generic makers out of the business, given

their lower economies of scale. On the other hand, price competition invites retaliation

and can quickly degenerate into a price war that would kill all the profits in the

category. Another issue to be kept in mind here is that most doctors who prescribe the

drug are not aware of prices. Communicating the price to the consumers is therefore an

integral part of this strategy.

ii) Divest strategy: - It involves cutting all promotional and research

expensesonce the brand faces direct competition from revital and redirecting the

savings towards brands that are still enjoying patent protection. Sometimes, this

‘milking’ strategy actually involves price increases to take advantage of the higher

brand equity of the brand among the smaller segment of hard core loyal customers.

This strategy leads to the lowest levels of brand building as the brand is not supported

and price competition as the price advantage is not challenged. The success of this

strategy depends on the inertia of doctors, patients and the other Stakeholders. When

their motivation to switch to the newly-available generic is low, either because of low

financial incentives or strong attachment to the brand or to the value of brand equity

for funding research and development, such a strategy can deliver high profitability, at

least over the short term. As many examples have shown, it is not always easy to

convince doctors and patients to upgrade to the new patent protected drug in the

category and patenting these next-generation products is becoming increasingly hard.

One of the major drawbacks of this strategy is that it encourages generic makers to

challenge drug patents more aggressively, knowing that the market will be all theirs as

soon as they have received the green light. Introducing new and improved flavors,

packaging, or delivery systems can lead to additional emotional or functional consumer

benefits. The resulting differentiation enhances the awareness and image of the brand

and hence increases its equity. Because these innovations typically do not extend

patent life however, it is more difficult to pass the costs on to the consumer when

facing generic competition and hence, this strategy’s leads one step ahead towards

price competition. In addition, these improvements can be easily copied by generics

and thus often have only a weak impact on sales, while reducing margins. These

changes can also be perceived as marketing gimmicks and hurt the perceived scientific

integrity of the brands which Provide more value to the money.

(iii) Innovation strategysort of introducing a completely new molecule,pharmaceutical

companies can innovate by launching new forms and dosages or by demonstrating

effectiveness for new indications. They can also innovate by offering better services

for doctors and better communication on the illness and on the brand through higher

promotion by the medical representatives. Compared with the ‘Milk and Divest

strategy, this option also entails low price competition, but can improve the equity of

the off-patent brand by offering additional patent protection. On the other hand,

innovations require years of research before being authorized and, in some countries,

do not necessarily extend the duration of the patent. Provide more value for the money

introducing new and improved flavors, packaging, or delivery systems (e.g. easy to

swallow pills, or patches) can lead to additional emotional or functional consumer

benefits. The resulting differentiation enhances the awareness and image of the brand

and hence increases its equity. Because these innovations typically do not extend

patent life however, it is more difficult to pass the costs on to the consumer when

facing generic competition and hence, this strategy’s lead is one step ahead towards

price competition. In addition, these improvements can be easily copied by OTC

marketing companies and thus often have only a weak impact on sales, while reducing

margins. These changes can also be perceived as Marketing gimmicks and hurt the

perceived scientific integrity of the brand. Pharmaceutical companies can try to fight at

both ends of the market by introducing their own generic. This will reduce the

profitability of generic makers and may deter them from entering the category. On the

other hand, pharmaceutical companies have realized that producing and marketing

revival requires different skills to their traditional business and that it is difficult to be a

strong player in both business models. To overcome this difficulty, pharmaceutical

companies can license the drug before the expiry of the patent in exchange for

royalties. The new copy will typically be priced higher than a true generic, but will

benefit from first mover advantage, preferential access to raw material and

manufacturing know how, while still deterring entry from other generic makers.

Marketing approaches of Super Core Model: - In pharmaceutical marketthere has

been a significant shift from Acute towards Chronic Therapy area. Chronic segments

are driving the growth of the market as leading prescribers in these segments are

specialists as opposed to general practioners. This is evident from high growth rates

achieved by firms like anjum , Dr.Zeeshan and City pharama Ltd. who have focused

on these segments.10 Medical representatives are rearranged throughout the new

companies and more or less some of the sales representatives are afraid of losing their

job, due to the changing scenario and the possible lay offs. On the other hand, the new,

bigger, pharmaceutical companies are competing more and more with one another and

in order to stress their products might adopt a more aggressive sales strategy. For

Example: sometimes in the same geographical area there are five representatives for

just one company, or different representatives for the same drug in different settings.

As a result of the new aggressive strategy, the aggressiveness of representatives has

also been increasing, since the larger stress exerted by their companies might affect

their stay in the company. Therefore, they tend to have more frequent visits to

encourage doctors to prescribe drugs and thus increase sales. In this model medical

representatives are thekey actors. For Example: in a small oncology11 unit almost 40

sales representatives interacting with doctors, and most of them are coming for a visit

on a regular once a month basis as this is the restriction put by doctors of meeting only

once in a month that to on a fix time only, in order to stress the usefulness of their

products and push clinicians towards the use of their drugs. This means that basically

there are at least two representatives every day in busy clinic asking for a short

meeting to support their product. The pharmaceutical distribution channel is indirect

with usually three channel members i.e. depot/C&FA, stockiest and chemist and it is

shown in figure

CORE CUSTOMER

(Doctor)

END- CUSTOMER

(Patients)

NON CORE CUSTOMER

(Retailers)

CUSTOMER

(Stockiest)

CUSTOMER

(C & FA)

Fig.1.1: Pull System Working In Chronic Therapy Segment

The relationship between medical Practitioner and representatives has always been

good and pharmaceutical companies have provided and are still providing the major

economical support for customers' continuous medical education towards the new

advancements in pharmaceutical industry and it is diagrammatically represented in fig.

1.3. Something needs to be done to find a solution to this problem that takes into

account the needs of both pharmaceutical companies and their representatives on one

side and physicians on the other, for a better professional interaction so a push system

develops and in this system, doctors and retailers are the core customers and the major

thrust is given to build and retain these customers. Here retailers are also core customer

as most of the times they are substituting the products based on their own discretion.

For retaining and developing customers, the companies normally provide gifts like

sponsorship for various conferences like small gifts & sponsorship to remind the

products on daily basis.

Pharma Company

Company Depot/C&FA

Stockiest Medical Representative

Chemist

Patient Doctor

Source: GSK (Supply chain of Pakistan Pharmaceutical Industry) Fig.

Understanding Consumer Behavior:- The term consumer behavior is definedas the

behavior that consumers displays in searching, purchasing, evaluating and dispensing

of products and services that they expect will satisfy their needs. The modern day

marketing discussion centers around the need for modern marketing to be consumer

oriented and to be concerned with the needs and wishes of the consumer and thus,

studying consumer behavior is critical, for companies, in getting success of the

products in the market. The consumer is considered as king in today's scenario of

marketing. Gone are the days when manufacturers could have sold anything to the

consumers. Now a days it is consumer whose buying preferences decide what should

be manufactured, in what quantity and what should be the quality of the product more

or less it depends upon the 4p’s of marketing mix and 4c’s of consumer mix. Thus a

marketer has to take into account various factors while deciding on marketing a

product as consumers have different preferences and sometimes totally diverse

preferences. So the task of manufacture and marketer becomes onerous and therefore it

is very important to understand the consumer behavior. Understanding consumer

behavior is still arduous in the field of pharmaceuticals as the target customer is not the

end user but the influencer i.e. the doctor who generates the prescription.

Consumer Behavior in Pharma Sector: - Unlike direct 'seller to user sales'pharma

selling is a multiple tier process. Here the consumer/user is not in direct contact with

the salesman. Here the medical practitioner decides on the behalf of patient/consumer,

which product needs to be bought, in what quantity, when to be consumed and how

long to consume. Hence regular, continuous study of prescribing behavior of

physicians is very important for pharmaceutical

Medical Practioner

Influence Feed back Feed back Influence

Salesman

Consumer

Buys from

Sells to

Sells to

Buys from

Distributor

Whole seller

Retailer

The Distribution Chain

18

Consumer Pyramid:

This is a very efficient tool in the hand of the marketer to study consumer behaviour even

more closely. This pyramid has four tiers:

1. Platinum tier: - It includes heavy users/prescribes who not price sensitive areand who are

willing to try new offerings.

2. Gold tier:- They are also heavy users but are more prices sensitive. They askfor more

discounts, free samples etc. and are likely to prescribe several brands.

3. Iron tier: - It consists of customers who are spending volumes; profitabilityand prescribing

pattern do not merit special treatment from the company.

Lead tier: - It consists of customers who actually cost the company moneybecause they

claim more attention than is merited by their spending, tie up company resources and

spread negative work of mouth The four tiers described above can be compared with

traditional New Product Adoption Process. The first tier, platinum tier can be compared

with the "Innovators" as these customers are trying to experiment and accept new offering

from the companies. The next tier i.e. gold tier can be compared with "Early adopters and

Early Majority" as these customers are responsible for growth phase of a product life

cycle due to substantial use of the products. The third tier i.e. the iron tier can be

compared with "Late Majority" who have adopted the product very late in the product life

cycle and are very cautious while using the products and the brands. And the last tier i.e.

lead tier can be match up with the "Laggards" who would hardly try the product and

actually drains out the companies resources.

(Source: Consumer Behavior in Pharmaceutical Marketing)

Fig 1.8 New Product Adoption Process

19

Factors Influencing Consumer Behavior

The various factors influencing consumer behavior are: -

1. Cultural factors

2. Social factors

3. Personal factors

4. Psychological factors

5. Psychographic factors

Cultural Factors: - Culture is the fundamental determinant of aperson’s want and

behavior. Companies often design specialized marketing programs to serve each

subculture. This programme is called diversity marketing. The effect of culture upon a

consumer’s behavior is considerable, and culture is a factor which has the greatest

influence. Culture creates the foundation of the individual’s values, opinions and behavior,

and is learnt from the other members of society or from school and institutions that play a

significant part of one’s environment and these traits constitute what the consumer values,

wants are and therefore do affect the way consumer acts. Culture also consists of different

subcultures that group people by their nationality, ethnicity, geographic location, religious

views or by their set of shared values. By targeting members of a specific culture or sub-

culture, businesses can tailor their marketing mix to match the needs and values of that

segment. Consumers are more prone to accept products that are in line with the values,

preferences, customs and norms of their culture. None the-less, a culture is constantly

evolving and the values, social structures, worldviews and other cornerstones of the

culture change through time. Society is divided in social classes which group members of

society that have a similar social status and a comparable behavior and these social classes

display the hierarchy of society, and are characterized by a set of factors. A common way

to determine a consumer’s social class is through the income, occupation and education

but these are only factors that influence how the person is ranked in society. To determine

the accurate social class is not always easy or obvious as the social classes can also change

through time when people climb up the corporate ladder or even change to an occupation

of a lower rank. Also, new family relationships can have a rapid change on someone’s

status and social class. For Example: The people of Germany pronounce the letter 'V' as 'F'

so while pronouncing word VICKS they call it FIX, rather than VICKS so the marketing

of VICKS in Germany led its name to be changed to suit the German Culture. Pakistani’s

are much more oriented towards ayurvedic or herbal medicines. It is in thePakistaniculture

20

to use Neem, Tulsi and Haldi etc. So, it's much easier to position non - allopathic drugs in

Pakistan because of its cultural set up.

Social Factors: - A consumers buying behavior is also affected bythe people around.

Family is a strong entity that has an influence on buying behavior. This includes both the

parents, as well as the spouse/husband and kids with whom the consumer might regularly

spend his time. Through the upbringing, parents teach their children about love, self-

esteem, economics, politics and so forth. With this guidance the influence of the parents

does not cease to affect the child even after the child no longer lives with the parents, and

therefore can have an influence on the consumers behavior throughout life. The opinion of

a spouse and kids can directly affect and guide the purchasing decision. According to

Kotler et.al. (2005) there is however, a big difference of influence by a spouse depending

on the product category, and there are several buying roles that a per-son can take on. The

buyer is not always the user, and thus the purchase may be made for someone else keeping

that person’s opinions in mind. The initiator is the one who comes up with the idea of

buying a certain product or service, whereas the influencer is the one who’s opinion matter

and is taken into consideration when making a purchasing decision. The final decision

about whether or not to buy, and how, when and what to buy is made by the decider.

The social factors which influence consumer behavior are:

i. Reference group

ii. Family

iii. Social status and role

Reference group: - A reference group consists of all the groups thathave a direct (face to

face) or indirect influence on the person's attitudes or behavior. Now these reference

groups have an opinion leader and they are the persons who offer advice or information

about a specific product or product category and suggest which brand is best. A marketer

should know how to reach and influence these opinion leaders in order to influence

consumer purchase behavior. For Example: In pharmaceutical field while marketing a

product, it is important to identify certain Key Opinion Leaders (KOL) who have

influence on the prescription pattern of other doctors in specific areas or have wider

geographical reach. If these KOL's start prescribing the product, many doctors also

prescribe the product.

21

Family: - Family is an important determinant of social factor. If thereis a physician whose

father is also a physician it is natural that he will have a liking for the same drug that his

father used to have

Social status and role: - The person’s position is defined in terms ofrole and status.

People choose products that communicate their role and status. A physician depending on

its specialty, experience and social status will go for the drug that will match his social

status. A well known renowned physician will surely go for the branded drugs rather than

generic drugs. Further prescribing pattern will also have influence depending on the types

of patient a doctor treats. For rich patients a doctor may prescribe costly products while

for a poor patient he may not do so. This means that buying capacity of patient also

influence’s the doctor’s in their prescription.

Personal Factors: - Consumers can furthermore be segmentedaccording to their personal

characteristics and personality type that shape their consumer behavior. Research can

bring out per- sonality traits that are common for users of certain products, and thus

describe and group consumers that hold specific characteristics. Consumers can for

instance be grouped depending on if they are social, confident, aggressive or adaptable

because they may portrait similarities in behavior due to these characteristic. Not only are

personality and personal traits affecting the consumer’s behavior but also the consumer’s

self-concept. The self-concept stands for the way the consumer does see himself and the

way he evaluates his own attributes. The self concept is related to the buying behavior

seeing that an individual’s belongings often demonstrate what the person is like or how

the person is? Nevertheless, there are three types of self concepts to take into account

when drafting a marketing strategy or seeking to understand consumer behavior. The

actual self-concept does display how a person sees himself. In addition the person has an

ideal self-concept which reflects how he would ideally like to see himself. Additionally

there is the self-concept of others which shows how the person thinks that other people see

him. Thus the consumers behavior can be influenced by any of these three self-concepts

and the consumer can either act according to what he thinks he is, what he wants to be or

according to what he believes that others think he is. (Kotler et.al 2005). Depending on

how positive a consumer’s actual self concept is the better is his self-esteem.

Advertisement can have great influence and shape the consumer’s self-concept and self-

esteem as consumers compare them to what they see in advertisements. Consumers can

create a link between the advertised product and the person displayed in the

advertisement, and form their personal image of the product brand accordingly. This brand

image can then influence the decisions, the consumer makes when choosing between

available products and the level of influence

The various personal factors which influence consumer behavior are:

22

i. Age and stage in the life cycle

ii. Occupation and economic circumstances

iii. Life Style

iv. Personality and self concept

Age and stage in life cycle: - The choice of product and brand differswith age. With the

increase in age and experience of physicians, their prescribing behavior changes as they

behave as laggards in new product adoption process. Younger physicians can easily go for

new drugs or brands. Whereas the experienced doctors mostly go for renowned, well

established or well known drugs or brands. It may be easier to convince a younger doctor

to try a new product or a brand as compared to an experienced doctor as they are early

adopters. The most important determinant factor is the place of work i.e. whether he works

in a government hospital, general hospital, and private hospital or in a private clinic and

accordingly to that doctors used to prescribe drugs of different brands.

Personality and self-concept: - Personality is the individualcharacteristic that makes a

person unique as well as consistent in adjustments to the changing environment. It is an

integrated system that holds attitude, motivation and perception together. Further a doctor

that has learnt in his early stages, For Example: during study or internship, is likely to be

loyal to a particular brand rather than switching to other brand and companies should

focus on developing a self concept among doctors about a company’s products and I had

studied during my field research that the young doctors or interns, residents only prescribe

those drugs which are recommended by their seniors or by professors.

Psychological Factors: - Motivation can be used to describe one’sbehaviour and it can be

seen as the reason behind one’s actions. Motivation is what drives individuals to attain a

certain goal. When the consumer feels a need, there is tension that the consumer wants to

eliminate by satisfying that particular need. If the drive to reach that goal is strong enough

the consumer will possess a motivation that drives and pushes him towards its realization.

In accordance to a theory outlined by Sigmund Freud, consumers are not fully aware of

their true motivations and are not always able to explain them. Freud’s theory points out

that unconscious motive which have their roots in the individual’s childhood affect the

consumer’s choices. The theory also acclaims that consumers may base their product

choice on a product’s symbolic meaning, in order to be able to satisfy a desire that is not

acceptable but which the consumer can find symbolized in an acceptable product.

On the other hand, explains motivation through his hierarchic pyramid where consumers

are motivated by needs that have a different classification and that are part of a hierarchy.

With the help of the five senses; taste, smell, sight, touch and hearing, consumers interpret

23

their surroundings. With the process of choosing, organizing and interpreting stimuli

consumers create their own perception. Because the perception of a person differs to one

another, the buying behavior does as well. Consumers are drawn to products not only by

their practical function but also by the hedonic features of the product. The added value

that a competitor’s product has can simply be the emotional value that it has for the

customers.

The major physiological factors are:

i. Motivation

ii. Perception

iii. Learning

iv. Beliefs

v. Attitudes

Motivation:- A motive is an internal emerging force that orients aperson's activities

towards satisfying a need or achieving a goal. The motives may be rational or non rational.

E.g. rational motives for a doctor are price, efficacy, patient compliance and economy of a

medicine while prescribing. Non rational are prestige, comfort and pleasure. Convenience

is the factor which is both rational and non rational at the same time. Motives often

operate at subconscious level, hence are difficult to measure. For example, Nutriment is a

product marketed by big apple to be used as an additional energy supply after exercise and

play etc. as a fitness drink. But it was found that this product was heavily used by drug

addicts, as they were not able to digest a regular meal. So, the motivation to purchase

nutriment was completely different from the thinking of the company.

Perception: - It is the process by which an individual selects,organizes and interprets

information inputs to create a meaningful picture of the world. It varies from individual to

individual. One doctor might perceive a fast talking medical representative as aggressive

and insincere, another as intelligent and helpful. While prescribing a product one doctor

may not feel so.

24

Learning: - Learning involves changes in an individual's behaviorarising from

experience. Learning reflects and individual's capability to comprehend new things based

on experience .It is important that doctors learn about new products and new treatment

therapy. Pharmaceutical companies have to make a doctor learn about new therapy and

treatment options by providing relevant literature and apprising doctors about advances in

pharmaceutical sciences. For Example: Biogen used multi paged advertorials to launch

and position their product called Amevine for treatment of psoriasis. They used the

learning psychology of physicians to position their product. Some of the physicians who

are techno-savvy are also attracted by themedical representatives as they use e-Detailing

technique which is a broad and continually evolving term describing the use of electronic,

interactive media to facilitate sales presentations to physicians. Some of the

pharmaceutical companies are using this method to communicate key marketing messages

to physicians. But how many physicians want to use e-marketing as a learning tool also

attributes the success of a pharmaceutical company in adopting new methodologies of

product promotion. If doctors are not willing to adapt to evolving techniques and so the

efforts spent by a pharmaceutical company would go waste and thus understanding the

learning curve of customers is also important.

Belief and Attitude: - A belief is a descriptive thought that a personholds about

something. People's belief about a product or brand influences their buying and

prescribing decisions. If a physician has belief in the product of one company, he will

prescribe it in spite of equivalent products available from competitors. Customers begin

service experiences with some level of trust, but the quality of the delivered service

determines whether the trust level rises or falls. The customer's confidence in the service is

especially important in healthcare but whenever if a customer is unhappy with the service

offered by the sales officer of one company, he is likely to have a negative view about the

company.

Psychographic Factor:It is much more important to know what sortof patient has a

disease. This is the kind of thinking a marketer needs to have while dealing with

psychographic behavior of the consumer (Psychograph is the science of using psychology

and demographics to better understand consumer behavior). Here marketers believe that

positioning occurs not in the market place, but in the customer's mind. Psychographic

studies are mainly based on VALS (Value, Attitudes and Life Style survey).

Marketing to Physicians and Consumers :- Drug companies use advertisingand

promotions in much the same way that producers of other goods do to inform consumers

about an advertised products existence and uses and, if alternatives are available, to

persuade consumers that the advertised product is better than competing products. If

successful, advertising can spur demand for the good and therefore boost its producer’s

25

sales and profits. Pharmaceutical manufacturers incur most of the costs of producing a

drug during the research and development phases and during the process of gaining the

FDA approval to put the drug on the market. Any additional sales that advertising

generates can be highly profitable because the prices that manufacturers receive for their

products generally exceed the cost to manufacture and distribute those additional units.

Drug companies face a different task in making sales than do the producers of most

consumer goods, however because several separate actors must be persuaded that a

prescription drug merits purchasing. First, a consumer must perceive that visiting a doctor

to seek diagnosis and treatment offers a benefit. Then, following an examination to

diagnose the patient’s condition, the doctor must determine an appropriate treatment and

when warranted write a prescription. Finally, the consumer must fill that prescription for

the manufacturer to make a sale. (In many cases, the individual’s insurer can also

influence prescription drug purchases by determining whether or not to include a drug on

the formulary of drugs it covers and by deciding how large a copayment to assign to it.

Recognizing that both consumers and physicians take part in the decision to purchase a

drug, pharmaceutical manufacturers adopt different marketing strategies for reaching each

group. Direct-to-consumer advertising appears in magazines and newspapers, on

television and radio, on outdoor billboards, and increasingly online. Drug companies also

promote their products to physicians in a variety of ways. They send sales representatives

to meet with physicians, nurse practitioners, and physicians assistants in a practice called

detailing. During those sales calls, the representatives discuss drugs manufactured by their

company that are relevant to the physician’s specialties, and they may provide product

samples and reprints of academic literature that discuss their company’s products. In

addition to detailing, pharmaceutical manufacturers purchase advertisements for their

drugs in medical journals. They also sponsor professional meetings and events, both in

person and online, including some that offer physicians credit for continuing medical

education.

Market Characteristics That Influence Promotional Strategies :- Apharmaceutical

manufacturer’s decision to use DTC advertising or other types of marketing tools depends

on the potential size of the market for a given prescription drug, the current competition in

that market, and the amount of time that has elapsed since the drug received FDA

approval. Manufacturers may also choose to alter their marketing mix over time,

especially as new competitors enter the market, the manufacturer faces the end of a drugs

patent protection and the entry of generic versions on the market, or the manufacturer

introduces new dosage forms, extended release versions of a drug, or new combination

drugs. The balance of this brief focuses on those issues for the two largest components of

pharmaceutical manufacturers promotional expenditures detailing and DTC advertising.

Centered around the doctors as an important source of communication for consumers.

Found that older segments have greater faith in doctors and are less skeptical towards

26

healthcare. Regardless of whether prescription or OTCs are concerned, medical

practitioners have a unique and often multiple roles in the purchasing process of

pharmaceutical products. They may be the deciders who make the buying decision for

their patients when prescribing drugs or they may play the role of influencer or

gatekeepers in the case of OTCs or hospitals dispensaries.

The purchasing process: - The consumer evaluates different alternatives that areavailable

in the market before a consumer makes a choice of a product. During this process various

product attributes to which a consumer is associated with each product option can be

evaluated and its importance determined .The evaluation of alternatives can either be very

extensive at times and rather narrow and fast at others. Consumers can create different

rules that help and facilitate their decision making, and decreases the amount of

information that they will process. The consumer narrows down the alternatives by the

help of his or her personal heuristic rules. These rules can be of various natures and can

represent different assumptions or mindsets. They can be related to their personal beliefs

about products and companies, if they associate product familiarity with product quality,

or how they interpret product quality based on indications that they obtain from a

product’s visual appearance. Some consumers tend to judge a book by its cover and it is

common to associate high price with good quality, or to form beliefs of product attributes

based on the country of origin. Companies occasionally use advertisement to connect their

products with feeling of nostalgia, sometimes even sad longing of the past, because these

feelings that arise can influence the consumer to choose a certain product over another .In

some cases the buying behavior can turn into a habit where the consumer does not need to

put effort into making a decision. Such a buying habit can stem from a brand loyalty

where the consumer feels strongly and positively about a certain brand and thus makes

consciously a choice to buy a product of that particular brand. A personal connection to

the brand can be developed over time and reinforces the habitual buying behavior and

makes the consumer less prone to switch to any other brand. For other consumers the

habitual buying behavior does often come from inertia when the consumer is reluctant to

put effort into the decision making process. As a result the consumer develops behavior of

buying a product out of habit. Because there is not a strong personal connection to the

product or the brand itself, the consumer is prone to switch to other brand. The reason for

a change of product can be the opportunity to easily buy another product due to better

availability or price. All product purchases are not planned and the purchasing

environment can influence the consumer to buy products that the consumer was not

intended to buy. Consumers sometimes shop by impulse when they cannot resist buying a

product that they all of a sudden feel a strong desire for. The purchasing can likewise be

spontaneous, where the purchase is not planned upon but the consumer is led to buy the

product because of a re-minder in the store, because the consumer is in hurry or any other

reason that incite the consumer to buy. To measure how well advertisements affect

consumer behavior and therefore sales is not an easy task. The expenditure on

27

advertisement as well as sales results can be compared to previous experience, or different

amounts of money can be spent on advertisement in similar locations to measure

variations in the sales results that each location generates. It is known that many

consumers are unable to recall advertisements that they have been exposed to. This does

raise a concern for the advertising company, since there is reason to assume that the

consumer may not remember the product or the advertised message at point of purchase.

However, the influence on the buying behavior of a consumer that is able to recall an

advertisement is not positive in every case. Consumers tend to not only remember

advertisements that they like, that raise strong emotions or that communicate a message

that they believe in, but also advertisements that do the opposite. Those recalled

advertisements may have an unwanted effect and makes the consumer avoid that product.

The purchasing process: - The consumer evaluates different alternatives that areavailable

in the market before a consumer makes a choice of a product. During this process various

product attributes to which a consumer is associated with each product option can be

evaluated and its importance determined (Kotler et.al, 2005). The evaluation of

alternatives can either be very extensive at times and rather narrow and fast at others.

Consumers can create different rules that help and facilitate their decision making, and

decreases the amount of information that they will process. The consumer narrows down

the alternatives by the help of his or her personal heuristic rules. These rules can be of

various natures and can represent different assumptions or mindsets. They can be related

to their personal beliefs about products and companies, if they associate product

familiarity with product quality, or how they interpret product quality based on indications

that they obtain from a product’s visual appearance. Some consumers tend to judge a book

by its cover and it is common to associate high price with good quality, or to form beliefs

of product attributes based on the country of origin (Solomon et.al., 1999). Companies

occasionally use advertisement to connect their products with feeling of nostalgia,

sometimes even sad longing of the past, because these feelings that arise can influence the

consumer to choose a certain product over another (Solomon et.al., 1999). In some cases

the buying behavior can turn into a habit where the consumer does not need to put effort

into making a decision. Such a buying habit can stem from a brand loyalty where the

consumer feels strongly and positively about a certain brand and thus makes consciously a

choice to buy a product of that particular brand. A personal connection to the brand can be

developed over time and reinforces the habitual buying behaviour and makes the

consumer less prone to switch to any other brand. For other consumers the habitual buying

behavior does often come from inertia when the consumer is reluctant to put effort into the

decision making process. As a result the consumer develops behaviour of buying a

product out of habit. Because there is not a strong personal connection to the product or

the brand itself, the consumer is prone to switch to other brand. The reason for a change of

product can be the opportunity to easily buy another product due to better availability or

price (Solomon et.al., 1999). All product purchases are not planned and the purchasing

28

environment can influence the consumer to buy products that the consumer was not

intended to buy. Consumers sometimes shop by impulse when they cannot resist buying a

product that they all of a sudden feel a strong desire for. The purchasing can likewise be

spontaneous, where the purchase is not planned upon but the consumer is led to buy the

product because of a re-minder in the store, because the consumer is in hurry or any other

reason that incite the consumer to buy (Solomon et.al., 1999). To measure how well

advertisements affect consumer behavior and therefore sales is not an easy task. The

expenditure on advertisement as well as sales results can be compared to previous

experience, or different amounts of

money can be spent on advertisement in similar locations to measure variations in the

sales results that each location generates (Kotler et.al., 2005). It is known that many

consumers are unable to recall advertisements that they have been exposed to. This does

raise a concern for the advertising company, since there is reason to assume that the

consumer may not remember the product or the advertised message at point of purchase.

However, the influence on the buying behaviour of a consumer that is able to recall an

advertisement is not positive in every case. Consumers tend to not only remember

advertisements that they like, that raise strong emotions or that communicate a message

that they believe in, but also advertisements that do the opposite. Those recalled

advertisements may have an unwanted effect and makes the consumer avoid that product

(Solomon et.al., 1999).

The Role of the Consumer (Patient):- Physicians have traditionally treatedpatients

largely as passive participants in a process that affects patients’ health outcomes. This

model is appropriate for diseases that are acute (For Example: a broken leg) and for

patients who believe that the doctor knows best. However, patients now have access to

detailed information about diseases and medications, and are increasingly inclined to

assert their perspectives especially for chronic diseases. This suggests a multi agent

prescription decision and follow up process that includes compliance with the prescribed

course of therapy.

The Prescription Decision: - Given that many diseases are chronic in nature,

theassumption that there exists a single agent (Physician or Consumer) maximizing their

utility seems strong. There exists some research that demonstrates that the tradeoffs made

by physicians in prescribing a course for a patient do not necessarily align themselves with

patient preferences (Fraenkelet.al., 2004). An open area of research therefore is the

development and testing of models that incorporate the utilities of both the physician and

patient in arriving at the prescription decision. For example: Misra (2004) allows two

types of physicians those who strongly value patient utility and those who value it less and

for two types of patients new and continuing. He then specifies a model that maximizes

utility for the physician-patient combination. The design of systems that allow patients to

have a bigger say in the choice of therapy is another open area of research. A system like

29

this should be based around a model that is able to elicit patient preferences for various

attributes of a therapy in real time, quantify the tradeoffs and suggest the most preferred

treatment for a patient based on a patient/disease/time specific utility function (methods to

calibrate such functions are well known in the medical and marketing literatures).

The Role of Price: - The increased expenditure for drug promotion will affect theprice of

the prescription drugs and this in turn will have an adverse impact on the expenses on

health care. In India same molecules are sold by different pharmaceuticals under different

brand names. To cite an example: there are over hundred and forty brands of omeprazole a

proton pump inhibitor available in India used for stomach ulcer. How does a doctor select

a brand? What are the factors that influence the prescription behavior of the doctor? What

is the influence of pharmaceutical marketing on prescription behavior? There are no

recently published studies that have addressed the factors that influence the prescription

behavior of physicians in Pakistan.

This study also aims to identify the factors that influence the prescription behavior of

physicians.

Branding in Pharmaceutical Marketing:- Branding is a key issue in thepharmaceutical

industry; product managers have evolved into brand managers and are beginning to

understand the dynamics of brand equity that lie at the heart of product development and

marketing. However, with no established 'best practices' in brand management, those

tasked with steering brands around the various hurdles and challenges presented by

pharmaceutical markets must use all available learning and experience to help in building

the leading brands of the future. Branding in pharmaceutical industry largely depends on

the type of product. Branding strategies for Over-the-Counter (OTC) drugs would differ

from branding strategies for Prescription drugs. Pharmaceutical products are no longer just

drugs, they are brands. Though as a brand, it is possible to communicate a promise, an

essence, and aspiration which build loyalty. In the past and even today, pharmaceutical

industry branding is not prominent compared with the business-to-business and in

consumer segments but largely by choice. For decades, a pharmaceutical Companies

brand

Branding in Pharmaceutical Marketing:- Branding is a key issue in thepharmaceutical

industry; product managers have evolved into brand managers and are beginning to

understand the dynamics of brand equity that lie at the heart of product development and

marketing. However, with no established 'best practices' in brand management, those

tasked with steering brands around the various hurdles and challenges presented by

pharmaceutical markets must use all available learning and experience to help in building

the leading brands of the future. Branding in pharmaceutical industry largely depends on

the type of product. Branding strategies for Over-the-Counter (OTC) drugs would differ

from branding strategies for Prescription drugs. Pharmaceutical products are no longer just

drugs, they are brands. Though as a brand, it is possible to communicate a promise, an

essence, and aspiration which build loyalty. In the past and even today, pharmaceutical

30

industry branding is not prominent compared with the business-to-business and in

consumer segments but largely by choice. For decades, a pharmaceutical Companies

brand.Thus a marketer has to take into account various factors while deciding on

marketing a product as consumers have different preferences and sometimes totally

diverse preferences. So the task of manufacture and marketer becomes onerous and

therefore it is very important to understand the consumer behavior. Understanding

consumer behavior is still arduous in the field of pharmaceuticals as the target customer is

not the end user but the influencer i.e. the doctor who generates the prescription.

Marketing to Physicians and Consumers: - Drug companies use advertisingand

promotions in much the same way that producers of other goods do to informconsumers

about an advertised products existence and uses and, if alternatives are available, to

persuade consumers that the advertised product is better than competing products. If

successful, advertising can spur demand for the good and therefore boost its producer’s

sales and profits. Pharmaceutical manufacturers incur most of the costs of producing a

drug during the research and development phases and during the process of gaining the

FDA approval to put the drug on the market. Any additional sales that advertising

generates can be highly profitable because the prices that manufacturers receive for their

products generally exceed the cost to manufacture and distribute those additional units.

Drug companies face a different task in making sales than do the producers of most

consumer goods, however because several separate actors must be persuaded that a

prescription drug merits purchasing. First, a consumer must perceive that visiting a doctor

to seek diagnosis and treatment offers a benefit. Then, following an examination to

diagnose the patients condition, the doctor must determine an appropriate treatment and

when warranted write a prescription. Finally, the consumer must fill that prescription for

the manufacturer to make a sale. (In many cases, the individual’s insurer can also

influence prescription drug purchases by determining whether or not to include a drug on

the formulary of drugs it covers and by deciding how large a copayment to assign to it.

Recognizing that both consumers and physicians take part in the decision to purchase a

drug, pharmaceutical manufacturers adopt different marketing strategies for reaching

each group. Direct-to-consumer advertising appears in magazines and newspapers, on

television and radio, on outdoor billboards, and increasingly online. Drug companies also

promote their products to physicians in a variety of ways. They send sales representatives

to meet with physicians, nurse practitioners, and physicians assistants in a practice called

detailing. During those sales calls, the representatives discuss drugs manufactured by

their company that are relevant to the physician’s specialties, and they may provide

product samples and reprints of academic literature that discuss their companies products.

In addition to detailing, pharmaceutical manufacturers purchase advertisements for their

drugs in medical journals. They also sponsor professional meetings and events, both in

31

person and online, including some that offer physicians credit for continuing medical

education.

1.16 Different Marketing Strategies for Different Drugs:-

Pharmaceuticalmanufacturers use different marketing strategies for the drugs they

produce. Many drugs are promoted solely to physicians, with no attempt to reach

consumers. Others are heavily promoted to consumers and, in varying degrees, to

physicians as well. That different marketing strategies are used for different drugs is not

surprising because there is no consensus among experts about the effects of such

strategies on the sales or prices of prescription drugs. For DTC advertising, studies that

have analyzed the effects for a few specific drugs or classes of drugs have shown mixed

results; the writing and filling of prescriptions increased for some advertised drugs but

not for others. For detailing, some analyses have found positive effects on the number of

prescriptions written for the targeted drug, but others suggest that detailing’s effects are

unclear.

32

CHAPTER- 2

REVIEW OF LITERATURE

The broad reviews of literatures are:

1. Shweta Vats (2014):- A study on “impact of direct to consumer advertising

through interactive internet media on working youth”. This research paper analyzes the

effect of social media promotion of prescription medicine on behavior of working youth.

It also studies the adoption of social media by working youth for collecting information on

Prescription drugs. This study also aims at getting an insight into correlation between

demographic factors and attitude and perception for social media based prescription drug

advertisement.

2. RavindraGoyal and PranavPareek (2013) - A study on “A Review Article on

Prescription Behavior of Doctors, Influenced by The Medical Representative In

Rajasthan, India”. This study examines that Medical representatives provide incomplete

medical information to influence prescribing practices; they also offer incentives

including conference, Seminars, national and aboard sponsorship. Doctors also demand

for gifts and other incentives, they look to every medical representative as a blank cheque

for themselves, as when doctors' associations threaten to boycott companies that do not

comply with their demands for sponsorship. Manufacturers, chemists and medical

representatives use various unethical trade practices of particular interest was the finding

that chemists are major players in this system, providing drug information directly to

patients.

3. Mahmoud Abdullah Al-Areefi, Mohamed AzmiHassali, Mohamed Izham and

Mohamed Ibrahim (2013):- A study on “Physicians’ perceptions of medical representative

visits in Yemen: a qualitative study”. This paper concluded thatphysicians are aware that

the medical representatives could influence their prescribing decision; they welcome

representatives to visit them and consider receiving free samples, gifts and various kinds

of support as a normal practice. The findings provide insight into possible target areas for

educational interventions concerning pharmaceutical marketing. Such a finding will

provide the basis for policymakers in the public and private health sector in Yemen to

develop a suitable policy and regulations in terms of drug promotion. Support as a normal

practice. The findings provided insight into possible target areas for educational

interventions concerning pharmaceutical marketing. The present qualitative study found

33

that the majority of the physicians had positive interactions with medical representatives.

The physicians main reasons stated for allowing medical representatives’ visits are the

social contacts and mutual benefits they will gain from these representatives. They also

emphasized that the meeting with representatives provides educational and scientific

benefits. A few physicians stated that the main reasons behind refusing the meeting with

medical representatives were lack of conviction about the product and obligation to

prescribe medicine from the representative company. Most of the physicians believed that

they were under marketing pressure to prescribe certain Medicines.

4. Chintan H Rajani (2012):- Another study to “A study to explore scope of direct to

consumer advertisement (DTCA) of prescription drugs in India”. This study explorer the

scope of direct to consumer advertising of prescription drugs in Indian market. This study

also concluded that there are certain benefits and harm associated with DTCA. Key

benefits of DTCA are preventive care for under diagnosed conditions and patient’s

psychological confidence for improving treatments which must be balanced against

adverse factors like self medication, rising drug costs, confusion and fear of side effects

5. Lau, A., Fernandez-Luque, L. and Armayones, M. (2012): A study report on

"Social media in health what are the safety concerns for health consumers ".This paper

presented possible harm that social media can inflict on consumers when misused. Social

media has the potential to overcome many of the reading and writing barriers in health

literacy. However, due to the salient nature of social media and the social influences

surrounding its use, consumers and patients are likely to be subjected to greater risks when

unsafe content is consumed than in the pre-social media world.

6. Mackey,K. and Liang,A. (2012): A study report on "Globalization, evolution and

emergence of direct-to consumer advertising: Are emerging markets the next

pharmaceutical marketing frontier? " concluded that Pharmaceutical advertising

hasundergone a rapid evolution due to Globalization, changing patient-provider

relationships, emerging health-related technologies, growing importance and expanding

“business” of global health. Yet, pharmaceutical marketing can have adverse health and

economic outcomes, especially if left unregulated and allowed to proliferate and cross

geopolitical borders in the uncontrolled digital environment. Emerging markets may

represent the next logical step for digital DTCA proliferation, given their untapped market

potential and explosive growth, but they are especially at risk given the ambiguous

regulatory treatment of digital DTCA.

7. Myers, D. S. (2012): A study report on " Face book and Pharmaceutical

Companies: An Industry in Need of Guidance " concluded that Delayed guidance has not

stopped many of the world’s largest pharmaceutical companies from establishing a

presence on Face book. These pharmaceutical companies have been cautious in the use of

34

social media concentrating on science or social responsibility while keeping away from

user-generated content and specific product information. These companies do not

currently have Face book pages relating to any specific drug therapies. This is likely to

change if the FDA guidance provides companies the assurance that such an activity is not

a violation.

8. Zain-Ul-Abideen and Salman Saleem (2011):- A study on "Effective advertising and its

influence on consumer buying behavior”. This study investigates the relationship between

independent variables which are environmental response and emotional response with

attitudinal and behavioral aspect of consumer buying behavior, by tapping the responses

of 200 respondents using telecommunication services and indicate that there exits a weak

association between environmental response with the consumer buying behavior including

the attitudinal as well as behavioral aspects of the consumers buying behavior.

9. Gu,Williams., Aslani and Chaar (2011): A study report on " Direct–to– Consumer

Advertising of Prescription Medicines on the Internet: An Australian Consumer

Perspective " .The study aimed to investigate the DTCA encountered by Australian

consumers when searching the Internet for common health- or medicine-related questions.

The results confirmed that Australian consumers were exposed to DTCA of prescription

medicines on the Internet. Although Australia is a DTCA-restricted country, consumers

are not exempt from exposure to advertising of pharmaceutical products, including

prescription medicines, on the Internet.

10. Montoya Ricardo, OdedNetzer, and KamelJedidi (2010) - Another study on“Dynamic

Allocation of Pharmaceutical Detailing and Sampling for Long-Term Profitability". This

present a two-stage approach for dynamically allocating detailing and sampling activities

across physicians to maximize long-run profitability. In the first stage, he estimate a

hierarchical Bayesian, non homogeneous hidden Markov model to assess the short- and

long-term effects of pharmaceutical marketing activities.

11. Dhaval Dave and Henry Saffer (2010):- A study to "The impact of direct-to-

consumer advertising on pharmaceutical prices and demand". This study investigates the

separate effects of broadcast and non-broadcast DTCA on price and demand, utilizing an

extended time series of monthly records for all advertised and non-advertised drugs in

four major therapeutic classes spanning 1994-2005, a period which enveloped the shifts in

FDA guidelines and the large expansions in DTCA. The costs of DTCA result from

increased drug prices and increased use of more expensive drugs in place of equally

effective lower-priced drugs.

12. Glinert, L. (2010): A study report on " Prescription drug brand Web sites:

Guidance where none exists " .This study shows that use of the social media is a fast-

growing part of this picture. The credibility that users have been attributing to Internet

35

health information has been consistently high. Majority of the health-seekers said they

believed all or most online health information, and that they had not seen any wrong or

misleading health information on the Internet.

13. Vanessa Khim (2009):- A study on “Pharmaceutical Direct-to-Consumer

Advertising and Print Media". This study examined which type of pharmaceutical direct-

to consumer (DTC) advertising would be the best marketing strategy for pharmaceutical

companies to use. The main argument was that one-to-one marketing in the forms of print

media and the Internet was the best strategy over mass media marketing in the forms of

television and radio. In this study the Results showed that the best method for DTC

advertisements is one-to-one marketing through magazines and websites. Through this

method consumers can be targeted by pharmaceutical companies. In addition these

advertisements offer clear information that a consumer and understand and retain. If

consumers can retain information about a DTC advertisement they have a better chance of

purchasing the medication.

14. Pantelic, D. (2009): A study report on “Internet as a Medium of Pharmaceutical

Companies Promotional Activities” concluded that Internet as liberal and hard to control

medium brings entirely new sets of solutions and/or problems to pharmaceuticals

marketers. The nature of the product, legal regulations and ethical principles create an

environment in which the marketers need above average creativity and care of the target

audience, message content and choice of appropriate communication channels for the

message to produce the desired effect.

15. Janet Hoek (2008):- Another study on " Ethical and practical implications of

pharmaceutical direct-to-consumer advertising". This paper examines healthcare

marketing and discusses the evolution, ethics and effects of advertising that promotes

prescription medicines directly to potential end-users. As a highly visible and

controversial element of healthcare marketing, DTC merits special attention since its use

is both restricted and under review, its regulation takes widely varying forms and its social

and medical consequences have generated ongoing disputes.

16. Paddison, A. and Olsen, K (2008):- A study report on "Painkiller purchasing in

the UK An exploratory study of information search and product evaluation", This paper

shows that interpersonal communication from family and friends is crucial in

purchase decision making due to its credibility and empathy. Interpersonal

communication can be instrumental as a substitute of pharmacists if it is deemed

trustworthy. It would be beneficial for companies to identify the structure and strength of

36

the influences of interpersonal/organizational exchange of information, which could gain

synergistic effect.

17. Davies, M. (2008): A study report on “Listening to Consumers in a Highly

Regulated Environment. Nielsen Online ".The study indicates the roles of consumers and

corporations have changed significantly since the rise of the Internet. YouTube give

consumers platform to voice opinions about products and brands. Consumers choose

social media sites including discussion boards, blogs and online groups. The anonymity of

the Internet affords a comfort level that encourages individuals to share details about their

symptoms, treatment history and experiences with their doctors, the efficacy and side

effects of medication, the impact of their condition on their own lives and more. At the

same time, the ubiquity of the internet can provide a connection between experienced

patients and someone newly diagnosed.

18. Vigilante,W.J., Jr. Mayhorn,C.B. and Wogalter,M.S. (2007): A study report on

"Direct-to consumer (DTC) drug advertising on television and online purchases of

medications”. The Result of this study indicated that participants frequently encounter

DTC ads and some report information seeking as a result. Participants reported

infrequently making online (Internet) purchases of prescription drugs possibly due to

safety and legal concerns. DTC ads influence interactions between doctors and their

patients. People appeared to be engaging in information seeking after they encountered

DTC advertisements. Another trend occurring with the proliferation of DTC ads is the

explosion in the use of the Internet. Internet provides opportunity to purchase drugs online

that might bypass physician’s restrictions.

19. Saurabh Kumar Saxena:- This article on "A review of marketing strategies work

by different pharmaceutical companies". His article presented the changing marketing

strategies when a pharma company shift acute base to chronic therapy base. This research

paper also gives an insight about shift in supply chain process and customer and end-

customer perception which is the base of formulation of different marketing strategies.

20. Manchanda, P. and Honka, E (2005): A study on “the effects and role of direct-to-

physician marketing”. These papers examine the physician attitudes toward detailing and

detailers and concluded that there is also strong evidence that detailing affects physician

(prescription) behavior in a positive and significant manner. While this relationship is

tolerated by physicians and promoted aggressively by detailers. The results also

demonstrate that while physicians claim to tolerate it as a necessary evil, it evidently has

an impact on prescription behavior via both a subjective and an objective path. They are

therefore heavily invested in this mode of promotion.

37

21. Donna U. Vogt (2005):- A study report on “Direct-to-Consumer Advertising of

Prescription Drugs”. This report examines legislative concerns and options on risk and

health information as they relate to advertising of drugs. It also discusses activities that

could be undertaken with current legislative authority to address concerns about DTC

advertising; and examines options for new statutory authority on DTC advertising.

22. AnantharamanRadhika, ParthanAnju and Mary Shepherd (2005):- A study report

on “A Brand’s Advertising and Promotion Allocation Strategy: The Role of the

Manufacturer’s Relationship with Distributors as Moderated by Relative Market Share ".

A comprehensive study found a weak relationship between DTCA and price for 20

heavily-advertised drugs, and concluded that DTCA costs ‘did not drive price increases. It

has also been argued that some new drugs are more expensive, as companies endeavor to

recover high R&D investments. However, newer drugs are more effective and help to

lower the costs of non-drug spending.

23. Kravitz, Richard L., Ronald M. Epstein, Mitchell D. Feldman, Carol E. Franz,

RahmanAzari, Michael S. Wilkes, L, Hinton. and P, Franks.(2005): A study on

"Influence of Patients' Requests for Direct-to-Consumer Advertised Antidepressants."

shows that DTC advertising leads to an increase in prescriptions for both patients with

conditions that are undertreated, and conditions for which drugs are at the margin of

therapeutic benefit. According to them, “the benefits of advertising will tend to dominate

when the target condition is serious and the treatment is very safe, effective, and

inexpensive. Harms are most likely to emerge when the target condition is trivial and the

treatment is relatively perilous, ineffective, or costly.”

24. Frank Windmeijer, Eric de Laat, Rudy Douven, and Esther Mot (2004):- A study

on" Pharmaceutical Promotion and GP Prescription Behavior". This study examined the

responses by general practitioners to promotional activities for pharmaceuticals by

pharmaceutical companies. Promotion can be beneficial for society as a means of

providing information, but it can also be harmful in the sense that it lowers price

sensitivity of doctors and it merely is a means of establishing market share, even when

cheaper, therapeutically equivalent drugs are available and concluded that conclude that,

on average, GP drug price sensitivity is small, but adversely affected by promotion.

25. Pioch, E.A. and Schmidt, R.A. (2004) :- A study report on " Community

pharmacies as good neighbours? A comparative study of Germany and the UK" .They

found that pharmacists have simultaneous roles; they have commercial interest in selling

and also providingimpartial advice. So, a conflict may exist between commercial roles and

38

professional duties. The majority of the consumers believed that pharmacists seldom have

the time to provide medication services.

26. Kaphingst, K.A., Dejong, W., Rudd, R.E., and Daltroy, L. H. (2004): A study

report on "A content analysis of direct-to consumer television prescription drug

advertisements" concluded that most DTCA gave consumers more time to absorb facts

about benefits than risks, which could have implications for the ‘‘fair balance’’

requirement. Some risk statements in the ads lacked important contextual information.

DTCA uses both medical and lay terms to convey medical ideas, suggesting that

consumer-friendly language is not used to communicate all information in the ads, as

urged by FDA (U.S. FDA, 1999). Complete references to additional product information

was given only in text, casting doubt on whether the advertisements were making

‘‘adequate provision’’ for dissemination of detailed product information. All

advertisements included at least one statement that directed consumers to seek more

information.

27. Weissman, J.S., Blumenthal, D., Silk, A.J., Newman, M., Zapert, K., Leitman, R.

and Feibelmann, S. (2004): A study report on “Physicians report on patient encounters

involving direct to-consumer advertising” in which surveys of physicians show a mixed

picture. Some physicians appreciate DTCA for increasing patients ‘awareness,

encouraging patients to seek medical advice for conditions that might otherwise go

untreated, and improving doctor-patient communication.

28. Bhattacharya J. and Vogt G. (2003):- A study on “A Simple Model of

Pharmaceutical Price Dynamics” present a model of price and promotion determination

over the drug life cycle. In this model the pharmaceutical company faces a multi-period

optimization decision and simultaneously manages price and promotion to influence

consumer and physician knowledge about their drugs. Bhattacharya and Vogt (2003) show

that the dynamic profit maximizing strategy for the firm is to initially employ a relatively

high level of promotion and to set a relatively low price. These levels will not only

increase current quantity demanded, but also raise future demand since high promotion

and low prices increase the physicians and the consumers stock of knowledge about the

drug. Since knowledge is costly to acquire, physicians’ prescribing patterns can be sticky,

and consumer use may also be sticky especially for chronic conditions, a high level of

current demand translates into high demand in future periods.

29. Murray, E., L, Bernard., Pollack, L., Donelan, K., Lee, K.,(2003):- A study on

“Direct-to-consumer advertising: physicians views on its effects on quality of care and the

doctor-patient relationship” found that found that 48% of patients believe DTCA promotes

unnecessary visits to doctors offices and 38% believe the ads cause patients to “take up

more of the doctors time.” It is difficult to determine whether this increase in time is

beneficial for the patient to convey new concerns to their physician, or whether physicians

39

are merely correcting the false expectations created by the emotional appeals in the

advertisements. Most likely, the increased time is beneficial for advertisements that

discuss widely under-diagnosed conditions, and harmful for conditions that are at the

margin of clinical benefit.

30. Mintzes, B., Barer, L., Morris, Richard L., Kravitz, K Bassett, Joel L., Arminee

K., Robert G. Evans, Richard P. and Stephen A. Marion., (2003) “How Does Direct-to-

Consumer Advertising (DTCA) Affect Prescribing?” Showed that physicians believed

patients who requested a drug were knowledgeable about the therapy. This perception of

knowledge may be translated to the perception of patient expectation for a prescription,

potentially leading to inappropriate prescribing: evidence shows that many patients who

request drugs based solely on DTC advertisements have not been informed about the true

efficacy of the drug, and may have misunderstood the side effects of the medication.

Therefore, physicians may be mistaken in their perception that the patient is well

informed, leading to questionable prescriptions as both the patient and physician believe

that the other is more informed.

31. Joel Lexchin and Barbara Mintzes (2002):- A study on “Direct-to-Consumer

Advertising of Prescription Drugs: The Evidence Says No”. This research examine that

there is little rationale for direct-to-consumer advertising of prescription drugs. Most new

drugs offer little if any therapeutic advantage over existing products. Direct-to-consumer

advertisements frequently downplay safety information. Physicians are highly ambivalent

about prescribing advertised drugs requested by patients. There is no evidence that direct

to consumer advertising results in any improvement in health outcomes.

32. Lyles, A. (2002):- A study on “direct marketing of pharmaceuticals to

consumers” shows that direct to consumer advertising of pharmaceuticals to consumers

follows changing social and economic trends which recognize patient autonomy in

healthcare management. DTCA is also a reaction of the pharmaceutical industry to more

restrictive prescription drug benefits and to the uncertain effectiveness of relying only on

traditional marketing activities such as medical journal advertisements and detailing

individual physicians

33.John E. Calfee (2002):- A study on “Public Policy Issues in Direct-to-consumer

Advertising of Prescription Drugs” .This study examines that DTC ads appear to provide

valuable information (including risk information), induce information seeking (mainly

from physicians), prompt patients to discuss conditions not previously discussed, and

generate significant positive externalities including the possibility of improved patient

compliance with drug therapy. The author suggests that a further relaxation of FDA rules

would accelerate the dissemination of valuable information, with favorable consequences

for drug development and consumer health.

40

33. Sengupta S. (2002):- The study report on "Prescription Drug Advertising: The

Effectiveness of Pitching Directly to Consumers" examined what demographic variables

were related to DTC ad exposure and recall rate. Female consumers showed significantly

higher exposure rates than males, and females were more likely to recall advertised drugs.

Another significant relationship was found between household income and ad exposure

and recall of the ads. Households with higher incomes were more likely to be exposed to

DTC ads and to recall brands of the advertised drugs. The relationship between age of the

respondent and ad exposure was not significant.

34. Merrill Matthews Jr (2001):- This policy report “who’s afraid of Pharmaceutical

advertising?” concluded that As the market for prescription drugs becomes more

competitive, consumers have more choices of high-quality drugs at reasonable prices. It is

competition and DTC advertising-not government regulation-that enables the choices and

will enhance the benefits. If legislators and health policy experts want to ensure that more

drugs are available at lower prices, they should consider policies that encourage

advertising and competition.

34. Merrill Matthews Jr (2001):- This policy report “who’s afraid of Pharmaceutical

advertising?” concluded that As the market for prescription drugs becomes more

competitive, consumers have more choices of high-quality drugs at reasonable prices. It is

competition and DTC advertising-not government regulation-that enables the choices and

will enhance the benefits. If legislators and health policy experts want to ensure that more

drugs are available at lower prices, they should consider policies that encourage

advertising and competition.

35. IrfanSharfoddinInamdar and Dr. MalharJayantKolhatkar (2001): This study on"

Doctor’s expectations from pharmaceutical products (medicine) which willinfluence their

prescription behavior". This study focuses on finding the need of customer and giving a

focused approach to the marketing team so that efforts will be directed at most important

factors and concluded that consumer looks for basic products like packaging, brand names

and other augmented product benefit however in case of medicinal product doctors have

given more importance to the core product benefit.

37. Eichner, R. and Maronick, T.J. (2001) A study report on "A review of direct-to-

consumer (DTC) advertising and sales of prescription drugs: does DTC advertising

increase sales and market share?” found that consumers are increasingly aware of DTCA,

and are often times requesting medications seen in advertisements. This kind of activity

has raised some concern amongst physicians who want to ensure that consumers are

provided with a fair-balance of benefit versus risk in formation.

41

38. Wilkes, M.S., Bell, R.A. and Kravitz, R.L. (2000):- A study on “Direct to-

consumer prescription drug advertising: trends, impact, and implications” report in a

recent survey that more than one-third of respondents reported asking their doctors for

information about a drug they had seen or heard advertised, and nearly one-quarter asked

for the drug itself. Of these, three-quarters reported that their doctors provided the

requested prescription.

Anselmi Kenneth (2000):- A study report on “A Brand’s Advertising and Promotion

Allocation Strategy: The Role of the Manufacturer’s Relationship with Distributors as

Moderated by Relative Market Share”. This study reveals that the relative market share

may be influenced by manufacturer’s advertising and promotion allocation decision. He

also added that advertising develops the manufacturer’s relationship with the distributors

and allocation to promotion can be increased in terms of discrete relationship among them.

Brand with low relative market share may experience greater opportunity for advertising

in relational exchange and pressure for promotion in discrete exchange.

40. Hoffman J.R and Wilkes M.S (1999) - A study report on “Direct to consumer

advertising of prescription drugs: an idea whose time should not come”. They express

their views on basis of their experience in US that DTCA, unreasonably increases

consumer expectations, forces doctors to spend time disabusing patients of

misinformation, diminish the doctor-patient relationship because a doctor refuses to

prescribe an advertised drug, or results in poor practice if the doctor capitulates and

prescribes an inappropriate agent.

41. Rizzo.J (1999):- A study report on “Advertising and Competition in the Ethical

Pharmaceutical Industry: The case of Hypertensive Drugs”. Rizzo, studies the effect of

detailing expenditures on the price elasticity of anti-hypertensive prescription drugs. He

finds that increased detailing efforts reduce the price elasticity. This reduction may

consequently result in higher prices, though Rizzo does not examine the direct link

between detailing and price. The study is based on pooled annual data from 1988 to 1993,

which predates the DTCA policy shift, and only considers direct promotion to physicians.

42. Thompson, CA.(1998): A study report on “Consumer Ads Build Awareness But

Not Understand of Advertised Medications, Survey Reveal” in which Advertisements are

recalled at the highest rate by patients suffering from allergies, osteoporosis, hypertension,

or arthritis, which have therapies that are highly advertised through DTCA. Despite the

fact that consumers ages 53 to 89 are most likely to take a medication for one of these

conditions, this age groups is the least likely to recall a prescription drug advertisement.

42

43. Peyrot, M., Alperstein, N. M., Doren, D. V. and Poli, L. G. (1998):- A study on

"Direct-to-Consumer Ads Can Influence Behavior" created and tested a model to explain

consumer prescription drug knowledge and drug brand requesting behavior. They included

four factors that influence consumer knowledge and drug request behavior: demographic

factors such as age, gender, race, and socio-economic status, media exposure, attitudes

toward DTC prescription drug advertising, and awareness of prescription drug advertising.

The model indicates that demographic factors such as gender, income, education, and

race/ethnicity significantly affect knowledge and drug requests. Attitudes toward

advertising and advertising exposure moderate the influence. Media exposure increases

exposure to advertising and in turn, increases knowledge and leads to drug requests.

Attitudes toward drug advertising affect behavioral outcomes, but the research results

showed a somewhat confusing pattern. People believing that advertising educates

consumers tended to have greater drug knowledge. They also found that negative attitudes

toward drug advertising were associated with greater drug knowledge.

44. Hopper, J.A., Speece, M.W. and Musial, J.L. (1997):- A study report on “Effects

of an Educational Intervention on Residents Knowledge and Attitudes Toward

Interactions with Pharmaceutical Representatives “collected information on the effects of

an educational intervention aimed at training physicians in interactions with sales

representatives. They surveyed residents and faculty before and after the intervention.

Before the intervention, physicians slightly agreed that contact with detailers was not

beneficial, but strongly disagreed that it might influence their prescribing in negative

ways. However, physicians were rather neutral about whether interactions were likely to

influence the prescribing behavior of other physicians in negatives ways.

45. Lynda M. Maddox (1997):- A study report on “The use of pharmaceutical Web

sites for prescription drug information and product requests" found that while patients are

quite comfortable discussing a prescription drug that is advertised, those exposed to

DTCA may be less likely to initiate discussion and are unsure whether or not they will

seek additional information.

46. Caudill, T.S., Johnson, M.S., Rich, E.C. and McKinney, W.P. (1996):- A study

report on “Physicians, Pharmaceutical Sales Representatives, and the Cost of Prescribing"

surveyed physicians about their attitudes toward the educational value and behavioral

influence of pharmaceutical sales representatives. Physicians agreed that sales

representatives provided useful and accurate information about newly and already

established drugs, but only slightly agreed that they performed an important teaching

function. Physicians strongly agreed that sales representatives should be banned from

making presentations where the physicians practice.

43

47. Berndt, E., Bui, L., Reiley, D., Urban, G., (1995):- A study report on

“Information, Marketing and Pricing in the US Antiulcer Drug Market”. This study

considers the role of detailing, medical journal advertisements and DTCA in the market

for anti-ulcer drugs prior to the shift in FDA guidelines. Thus, the DTCA examined in this

study was very limited and confined only to print media. They find that the promotion

stock increases demand for anti-ulcer drugs, with the strongest effect found for detailing

and the smallest effect found for DTCA. This pattern of results, suggesting that detailing

may be more effective in raising sales than DTCA.

Williams, J.R. and Hensel, P.J. (1995):- A study report on "Direct-to-Consumer

Advertising of Prescription Drugs,” conducted a path analysis to determine the path from

DTC ad exposure to purchase. They found that educational level and health status were

negatively related to attitudes towards DTC advertising and in turn, attitudes toward DTC

advertising were significantly related to the intention to seek more information from a

friend and a pharmacist. They did not find a significant path from exposure to visiting

with a doctor, who is considered the most important information source.

49. Basara, L.R (1994):- A study report on " Practical considerations when evaluating

direct-to-consumer advertising as a marketing strategy for prescription medications"

proposed several reasons for the increase including, increasing ability of consumers to

influence physicians, the use of advertising to manage safety concerns and educate

consumers, the use of advertising to influence physicians through the repetition of key

marketing messages. and the use of advertising as a differentiation strategy.

50. Walker G. (1993):- A study report on" Code of practice for the pharmaceutical

Industry "This report examines that in India now the daily visit of the doctors should be

twelve and four visit to each doctor in a month. Drug samples can only be provided to a

doctor in response to a signed request and should not exceed four days' treatment for a

single patient. In Sweden, the representatives must meet a group of doctors after obtaining

an appointment from the head of the department. On an average only two such meetings

per year are permitted. The promotional material is screened by the head of the department

and the presentation by representative allowed, only it the product information is new and

scientific.

51. Lagace, Rosemary R., Dahlstrom, Robert and Gassenheimer, Jule (1991):- A

study on “The Relevance of Ethical Salesperson Behavior on Relationship Quality:

The Pharmaceutical Industry” showed that the salesperson's ethical behavior and expertise

positively affected physician attitudes (especially trust and satisfaction). It also found that

the frequency of visits did not significantly affect satisfaction.

44

52. McKinney, W.P., Schiedermayer, D.l., Lurie, N., Simpson, D.E., Goodman, J.L.,

Rich, E.C. (1990):- A study report on “Attitudes of Internal Medicine Faculty and

Residents Toward Professional Interaction with Pharmaceutical Sales Representatives

“examined physicians' attitudes toward detailing and its potential for ethical compromise.

They found that physicians had somewhat negative attitudes toward the educational and

informational value of detailing activities, but also acknowledged sales representatives'

support for conferences and speakers.

53. Perri, M.W. and Dickson, M. (1988) :- In the study "Consumer Reaction to a

Direct-to-Consumer Prescription Drug Advertising Campaign" examined a relationship

between DTC ad exposure and patient behavior measured in the form of drug inquiry.

Applying the consumer information-processing framework, they tested factors that might

influence the relationship, such as involvement and medical conditions. They conducted

research through observation and a survey with patients who visited doctors after

exposure to a direct mail campaign. Even though they found no significant relationship

between involvement and the behavioral outcome, consumers’ medical condition was

significantly related to drug inquiry behavior.

Proctor, R. and M.A. Stone. (1982):-A study report on marketing research, noted that the

principal aim of consumer behavior analysis is to explain why consumers act in particular

ways under certain circumstances. It tries to determine the factors that influence consumer

behavior, especially the economic, social and psychological aspects that can indicate the

most favored marketing mix that management should select. Consumer behavior analysis

helps to determine the direction that consumer behavior is likely to make and to give

preferred trends in product development, and attributes of alternatives communication

method etc. Consumer behaviors analysis views the consumer as another variable in the

marketing sequence, a variable that cannot be-controlled and that will interpret the product

or service not only in terms of the physical characteristics, but in the context of this image

according to the social and psychological makeup of that individual consumer (or group

of Consumers).

55. Lumpkin, J.R. and Greenberg, B.A. (1982):- A study report on “Apparel-shopping

patterns of the elderly consumer " found that the elderly rated every information source,

i.e., newspaper, magazines, radio, TV, etc. lower in importance than their younger

counterparts. More adept consumers can also deviate from pharmacists’ advice and make

purchases on their own personal experiences.

54. Nies, E.A. (1982):- A study report on " Drug Information Sources: For Academic

and public Libraries “explain that Generally, OTC drugs are available without prescription

and in most cases are advertised directly to the public. Consumers are becoming familiar

45

with OTC drugs, due to extensive advertising by companies. The trend towards self

medication is likely to grow towards these products

46

CHAPTER- 3

RESEARCH METHODOLOGY 3.1- Need for this research:The broad areas in which research is needed wereidentified

before specific objectives or hypothesis of the research were formulated. It was felt that

research is needed to find out the following.

1. How print pharmaceutical advertisements attract the attention of the consumer?

2. Up to what extent pharmaceutical advertisement aware to the customer and finally

consumers buy the product?

3. To know the impact level of pharmaceutical advertisement on consumer behavior.

4. How the theme of pharmaceutical Advertisement influence the buying behaviors.

5. How the visual presentation, illustration attract the attention of buyer?

6. How to make the right pharmaceutical advertisement for different age group, male,

female, lower income, middle income and higher middle income people?

7. What is the impact of pharmaceutical advertisement with respect to different

Occupation, marital status and educated people?

8. What should be the suitable medium for advertisement to get the consumer and

Doctor’s attention?

9. Up to what extent celebrities play a major role in placing the OTC drugs among the Consumer and doctor.

10. How electronic media effects on consumer purchase behavior among the youth.

11. How promotional activities, other facilities and gift items alters the prescription

behavior of doctors.

12. How various sources like medical representative, clinical papers impact on

Doctors?

47

Scope of the research:-Advertising plays an important role to aware the generalpublic about the product or services. The drug market is highly competitive, and consumer

advertising is a prominent influence in drug purchase and consumption. To aware about the public, advertisement is very effective to tell about the product or services. Here every

brand is available whether the product is prescribed or non- prescribed.

Research design: - This research based on descriptive research or quantitative

researchIn this descriptive research Cross-sectional study used to

comparedemographical variables with attitude of the respondent. There were seven

demographic variables such as Family Size, Age, Gender, Educational Qualification,

Occupation, Family Income and Marital status of the of the consumers and demographic

variables for doctors such as Gender, Qualification, Regional Status of practice place. This

study identifies and evaluates the Sales promotions activities adopted by pharmaceutical

companies to influence the behavior of doctors and customers. Factors affecting

prescription behavior of doctors and consumers’ preferences towards the particular

companies drugs affect the sales of the companies. The promotional activities and change

in the perception of consumers after confronting with the promotion activities adopted by

the companies have also been examined. Basically this research is describing the

population surveyed and its characteristic, so it is descriptive research

-Questionnaires: - Set the work done up to this time provide valuable inputs todesigning

both the questionnaires. They were prepared in English. The coding plane of the responses

was decided before hand. The structures of the data file in which the data was to be

entered, was also decided before hand. Hence, it was possible to incorporate into the

questionnaires the no. of the field in which the data was to be entered. This made the

subsequent steps of data collection and data entry earlier. In this research SPPS software

used for analysis and interpretation of the hypothesis. There are two types of questionnaire

were prepared which are as:-

A-The questionnaire of the direct consumer have following distinct points.

1. An introductory paragraph.

2. The identification information.

3. The Demographic variables asked (Q1a to Q1g).

4. General information regarding advertisement (print, radio, television, word of mouth) (Q3

to Q4).

48

5. Some information asked to know about the advertisement media used for common

OTC medicines (television, news paper, friends and relative) (Q5 to Q6).

6. In this section some questions were asked to know the impact of the OTC

Advertisement and the need creation (Q7 to Q8).

7. In this portion questions were asked about the attention paid by the consumer and the

aspect of the product (Q9 to Q10).

8. Asking buyer buying behavior and influencing factor in selecting the medicines for

Common diseases (Q11 to Q13).

9. Asking needed information in terms of Likert Scale to rate the medicine

advertisement (Q14).

49

Selected Variables

Our study has one dependent and five independent variables which are given below:-

Dependent Variable: Consumer’s buying Behavior

Independent Variable: Necessity, Pleasure, Dominance, Brand Recall and Stimulation.

We have shown our variables in conceptual Model shown in Figure 1

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Definitions of variables

Necessity:The fundamental needs method is one of the essential approaches to the

dimension of absolute poverty in developing countries. It tries to outline absolutely the

minimum assets necessary for lengthy-time period bodily properly-being, commonly in

terms of intake items. The poverty line is then defined as the quantity of profits required to

meet the ones wishes. The 'simple needs' approach turned into added by way of the

International Labor Organization's World Employment Conference in 1976.Perhaps the

excessive point of the WEP was the World Employment Conference of 1976, which

proposed the satisfaction of basic human wishes because the overriding goal of

countrywide and international improvement policy. The simple needs technique to

improvement turned into advocated via governments and employees and employers

corporations from everywhere in the global. It prompted the programmers and regulations

of predominant multilateral and bilateral development companies, and turned into the

precursor to the human improvement approach so necessity define as

“Requirements of time for the unique situation, that may be quench or satisfy the

purchaser’s demand when earnings boom, requirements also increase”.

Pleasure:Pleasure describes the vast class of mental states that human beings and

different animals experience as high-quality, fun, or really worth in search of. It includes

extra precise mental states consisting of happiness, leisure, enjoyment, ecstasy, and

euphoria. The early psychological account of satisfaction, the delight principle, describes

it as a positive feedback mechanism, motivating the organism to recreate inside the

destiny the scenario which it has just observed fulfilling and to keep away from conditions

that have induced pain in the past

The revel in of pleasure is subjective and one-of-a-kind individuals will enjoy one-of-a-

kind kinds and amounts of satisfaction inside the equal state of affairs. Many fulfilling

reports are associated with pleasing primary organic drives, along with eating, workout,

hygiene, and intercourse the appreciation of cultural artifacts and activities inclusive of art,

track, dancing, and literature is frequently pleasant.

Based upon the inducement salience model of reward the appealing and motivational

belongings of a stimulus that induces approach conduct and consummator conduct an

intrinsic reward has additives: a "looking" or desire issue that's contemplated in technique

behavior and a "liking" or satisfaction thing that is pondered in consummator conduct.

While all gratifying stimuli are rewards, some rewards do no longer evoke satisfaction. So

satisfaction defends as the situation in which individual feel suitable, thrilled, or

comfortable in a selected state of affairs.

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Dominance: In the world, there a lot of manufacturers, as an example, Prada, Helmes, and

so forth. It is probably actual that a few brands unfold everywhere in the nations.

However, it isn't apparent that worldwide brands make our identity be lost,

The maximum critical reason is that we've quite a few brands. For example, if you buy

groceries to the grocery store, you may see a variety of products. Even if you’d like to buy

handiest beer, you may see some manufacturers, Asahi, Sentry and Sapporo. It doesn’t

occur that you see simplest one brand. And the further reason is that maximum of humans

can selected one which they prefer among manufacturers. It is possible for us to choose

one logo with our options. If you go to department shop together with your pals, might

you want to buy same brands? Sometimes you may do, but, commonly you may choose

different one. The very last reason is that manufacturers have opportunity to show man or

woman identity. As you could see, brands are probably to be chosen by means of our

alternatives. For this, selecting manufacturers can show our personality or what we adore.

It is plenty clearer for others to recognize what we think or remember. Brands items

dominating globally have a whole lot of arguable problems, which include identity.

However, it is not positive that this has opportunity to danger man or woman identity.

There are three reasons why I strongly disagree with this statement. Brands have a lot of

types, and also choice, then they can show what we like or assume

It’s any person feeling that can be underneath manipulate or it can be loose on a selected

situation.

Brand Recall:Brand don't forget plays a critical position in getting more clients to stay

with your emblem in addition to buy your logo repeatedly. When you as a client purchase

a certain product, as soon as the product is finished or deteriorated, instinctively you

would really like to purchase from the identical logo, because the experience it has

presented you turned into first-class. Also whilst a brand is out of the market after which

it reappears, if you previously had a nice enjoy you are most probably going to buy it once

more.

Brand Recall is the extent to which an emblem name is recalled as a member of a brand,

products or services magnificence, as distinct from emblem recognition. Common market

studies usage is that pure logo don't forget requires “unaided bear in mind”. For example a

respondent may be asked to recollect the names of any motors he may recognize, or any

cigarette manufacturers he might also recognize.

How is emblem keep in mind categorized?

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Generally speaking, brand bear in mind can be divided into two major categories, namely

unaided and aided recollect. In phrases of aided emblem keep in mind, researcher’s

measure the volume to which a logo name is remembered while the real logo call is added

into discussion. For example, one kind of query may be “Do you recollect BMW brand?

Thus, in this example, the name of the logo is noted, enhancing the memory within the

client’s thoughts. However, in an effort to stay aggressive in nowadays incredibly

challenging business environment, managers are focusing greater on unaided logo do not

forget, as it'd mean a competitive benefit towards their rivals. By this we mean that if the

patron can take into account the brand while not having it formerly referred to, then the

brand has a high impact at the purchaser and he recalls the logo very well.A emblem’s

value is at once related to its presence within the memory of clients. Quite certainly, if a

consumer remembers a brand, he is likely to shop for that emblem. If he doesn’t take into

account it, he'll buy the only he remembers. Thus, for a brand, it is vital to set itself in

purchaser’s memory. Brand recall examples

1. When i talk of shoes, you will probably think of Adidas, Reebok or Nike, wherever you

are. This is one of the best examples of brand recall.

2. When i talk of premium automobiles, you might think of Audi, Mercedes or BMW.

3. When i talk premium clothing, then i am sure all of you must have a different brand in

your mind because each person is different.

4. If i ask you your favorite carbonated beverage, more than 50% will say Pepsi or Coca

cola.

The above are brand recall examples of the real world which help us take decisions on a

daily basis. Thus, for a company to have high brand recall is the best blessing in terms of

the turnover it can obtain due to this one single factor. Brand recall defiant as“It’s a level

of consumer that recognized as the potential user of specific brand & it’s related with a

specific product”.

Stimulation:

The condition of feeling that is changeable from person to person in different places or

situations i.e. feeling of enthusiasm, active, excitement, sleepy and bored.

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Hypothesis

We have formulated the following hypothesis for our study

Hypothesis 1

H1A: Necessity of advertisement is effective for FMCG’s in consumer’s mind

H1B: Necessity of advertisement enhance the demand of the Fast Moving Consumer

Goods (FMCGs)

Hypothesis 2

H1A: Pleasure of advertisement is effective for FMCG’s in consumer’s mind

H1B: Pleasure of advertisement enhance the demand of the Fast Moving Consumer Goods

(FMCGs)

Hypothesis 3

H1A: Dominance of advertisement is effective for FMCG’s in consumer’s mind

H1B: Dominance of advertisement enhance the demand of the Fast Moving Consumer

Goods (FMCGs)

Hypothesis 4

H1A: Brand recall advertisement is effective for FMCG’s in consumer’s mind

H1B: Brand recall advertisement enhance the demand of the Fast Moving Consumer

Goods (FMCGs)

Hypothesis 5

H1A: Stimulation advertisement is effective for FMCG’s in consumer’s mind

H1B: Stimulation advertisement is enhance the demand of the Fast Moving Consumer

Goods (FMCGs)

Hypothesis

H0: Advertisement does not effect on the consumer’s buying behavior H1: Advertisement

really effects the consumer’s buying behavior.

54

Size of sample: - This refers to the number of items to be selected from theuniverse to

constitute a sample. The total no. of sample size was 200 for doctor and 250 for consumer.

Sampling Technique:This study is broadly on sales promotion activities adoptedby

pharmaceutical companies. The populations which are included in the study are basically

residing in those regions. So, researchers have used the ‘convenience random sampling’

which was performed purposefully. Researchers have collected the data only from those

people, who are either doctor in the hospital or the patient in the hospital during that

period or other place also.

Survey Instrument: - The instrument used for the study is a questionnaire,constructed by

the researcher. The questionnaires were constructed to obtain responses from the target

sample group of consumer & doctors about the impact of pharmaceutical advertisement.

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CHAPTER- 4

Data Analysis

Data analysis

From total 231 respondents, there were 167 male and 64 female. Their percentage was

72.3% & 27.7% respectively. Their age level: less than 18 were 50, 19-24 were 101, 25-30

were 56, 31-40 were 17, 41-50 were 6 and above 51 was only 1. Their education level: 23

were Matriculation, 72 were Intermediate, 57 were Graduate, 59 possess Master, and 20

were M.Phil. / Ph.D.

Table

1:

Monthly Income Level of

Respondents

Frequency Percent Valid Percent Cumulative Percent

Less 10,000 112 48.5 48.5 48.5

11,000 to

30,000 78 33.8 33.8 82.3

Valid

31,000 to

50,000 33 14.3 14.3 96.5

>51,000 8 3.5 3.5 100.0

Total 231 100.0 100.0

On the basis of their monthly income the respondents were divided into four categories.

Among total 231 respondents 112 were earning less than 10,000 PKR, 78 were earning

between 11,000-30,000 PKR, 33 income was between Pak Rs.31,000-50,000 and 08

income was more than Rs.50,000

Table 2: Citi-wise classification of the respondents.

Frequency Percent Valid Percent Cumulative Percent sahiwal 48 20.8 20.8 20.8

Lahore 50 21.6 21.6 42.4

Valid

okara 42 18.2 18.2 60.6

harappa 46 19.9 19.9 80.5

Multan 45 19.5 19.5 100.0

Total 231 100.0 100.0

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The respondents of our research belong to different cities. There were 48 from Sahiwal

,50 from Lahore, 42 from Okara, 46 from Harappa and 45 from Multan.

4.1 Analysis Descriptive Statistics

Our research was based on cross sectional data of 18 questions. With 5 independent

variables, (Necessity have 6 questions), (Pleasure have 3 questions), (Dominance have 2

questions), (Brand Recall have 4 questions) and (Stimulation have 3 questions). We have

given simple descriptive statistics of Independent variables in Table 3. Table 3 Effects of

necessity advertisement on consumer’s buying behavior (it contains 6 questions)

Strongly Disagree Neutra l Agree Strongly Disagree Agree

1 Does advertisement necessary to attract the consumers? 4 11 29 143 44

2

Does print advertisement (Newspaper etc)

to be necessary? 7 17 45 135 27

3 Does the outdoor/street advertising relevance to Your daily life? 9 42 36 126 18

4

Does outdoor/street advertisement poorly

displayed, that's why not attractive? 4 37 41 141 8

5 In this competition market, any product can’t survive without advertisement? 8 17 12 142 52

6 Do You buy the goods when you feel its 3 13

27

necessary/needed? 18 170

From the above table, we’ve observed that the 61.90% consumers are agreed& 19.04%

are strongly agreed that advertisement is necessary to catch the consumer’s attraction. In

second question 58.87% consumers are agree and 19.48% are neutral that print media ads

to be necessary. In next 54.54% are agree and 16% are neutral that street ads are relevant

to daily life. In fourth question 61% are agree that street ads are poorly displayed. In fifth

61.47% consumers are agree that in this competition market any product can’t survive

without advertisement. In last question 73.59% consumers are agree that they buy goods

when they feel it is necessary

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Table 4 Effects of pleasure advertisement on consumer’s buying behavior (it contain 3

questions)

Strongly Disagree Neutral Agree Strongly Dis agree Agree

7

Does restrictive advertisement also attract

7 your mind and convince you. 7 35 39 143

8

Does advertisement a source of pleasure &

3 12 8 52

156 entertainment?

9

Do You think that television commercials

2 8 12 42

167 have vast coverage than anything else?

Above table shows the 61.90% consumes are agree that even restrictive advertisement

are also attract them. In eighth question 67.53% are strongly agree that ads are the source

of an entertainment. In last 72.29% consumers are strongly agree that television

commercials have vast coverage, than anything else.

Table 5 Effects of dominance advertisement on consumer’s buying behavior (it contains 2

questions)

Strongly Disagree Neutra l Agre e Strongly

Dis agree Agree

10 Does advertisement always an influence 7 6

20 177 21

& dominate You?

11 Do You like to buy the goods for 21 141

dominance & increase the standard of 3 6 60

living in society?

In tenth question 66.62% consumers are agree that advertisement always having an

influence and dominate us. In last eleventh question 61% consumers are agree that mostly

they buy the goods to show the standard of living in society

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Table 6 Effects of brand recall advertisement on consumer’s buying behavior (it contains

4 questions)

Strongly Disagree Neutral Agree Strongly

Dis agree Agree

12 Does advertisement create the awareness, 7 25 8 80 33 so that You prefer to buy the low priced

goods?

13 Does advertisement convince You to buy 11 31 28 139 22 the same brands?

14 Does the FMCG Co. should give ads, for 3 9 22 136 61 brand recall in Your mind?

15 Does your participation in purchasing 13 58 34 112 14 influenced by friends & family?

From the above table, in twelfth question shows that 80 consumers are agree and 33

consumers are strongly agree that advertisement is a major source of awareness regarding

FMCG’s. in next 60 % are agree that yes advertisement convince us to buy the same

brands etc. in fourteenth 58.87% are agree that yes FMCG companies should give ads

regularly for introducing the other brands of the same company. In last fifteenth question

48.48% consumes are agree that their participation in buying influenced by friends and

family who were inspired by the advertisement.

Table 7 Effects of stimulation advertisement on consumer’s buying behavior (it contains 3

questions)

Strongly Disagree Neutral Agree Strongly

Dis agree Agree

16 Does adve rt i se m e nt stimulate or 6 12 65 134 14

encourage You to purchase the products?

17 Does advertisement always influence 4 13 47 152 15

Your buying habits?

18 Does advertisement motivate you, to shift 7 6 17 162 39

from one brand to another brand?

In this above table the results of sixteenth question 58% consumers are agree that

advertisement stimulate and encourage them to buy the goods. In seventieth there are

65.80% consumers are agree that yes mostly it influenced their buying behavior. In last

question 70.12% consumers are agree that advertisement motivate them to shift from one

brand to another brand, due to additional benefits and characteristics.

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Reliability Test of Data

There were five Independent Variables that include, Necessity (6 items), Pleasure (3

items), Dominance (2 items), Brand Recall (4 items), and Stimulation (3 items).These

subscales having the total eighteen questions. The data relating of these variables was

tested through Cronbach’s Alpha. The results are shown in table 8

Independent Variables Cronbach’s alpha Coefficient

Necessity 0.848 Pleasure 0.865 Dominance 0.743 Brand Recall 0.716 Stimulation 0.875 Cronbach alpha 0.8

These five subscales are fully met the standard criteria for checking and measuring

reliability of scale. Our analysis show in the results of 0.8 (ἀ) and it is minimum value

should not be decrease 0.7.So From the above table we observed that the values of

Cronbach’s alpha are not less than 0.7 that is considered as excellent and indicated

reliability of the data.

4.3 Correlation Analysis

Here we have tried to find out the basic correlation between independent and dependent

variables that are:-“(1) Necessity, (2) Pleasure, (3) Dominance, (4) Brand Recall and (5)

Stimulation” (Independent Variables) with the “Consumer’s Buying Behavior”

(Dependent Variable). Above mentioned different variables were analyzed and observed

individually one by one.

Table 9 Results of Correlation analysis between Consumers Buying Behavior (D.V) and

Independent variables is below.

Correlation between advertisement and consumer’s buying behavior that r

value

p value

effects due to these factors

Necessity of advertisement

0.72 0.00

Pleasure of advertisement 0.67 0.00 Dominance of advertisement 0.76 0.00 Brand Recall advertisement 0.88 0.00 Stimulation advertisement 0.81 0.00

The above table shows the Pearson r value is much greater than p value, that is 0.00, and

parallel side the sigma (2 tailed) “p” value is less than 0.05. So it’s clearly indicating that

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the positive correlation is existing between the advertisement and consumer’s buying

behavior.

4.5 Regression Analysis

The results obtained through regression methods are shown in Table 10.

Table 10 Result of the Regression Analysis showing the Impact of advertisements on

Consumers buying behavior.

Model R R Square Adjusted R Square Std. Error of the Estimate 1 .518 .097 .22 .45401 1 .660 .426 .413 .66651 1 .695 .397 .284 .50442 1 .799 .539 .522 .64431 1 .726 .551 .539 .64401

As per the results from the above table we analyzed that bi variety correlation r (R) is

0.518 that indicated a strong positive linear relation flanked by different advertisements

and the consumer’s buying behavior with their purchasing. The coefficient of

determination r2(R square) of 0.097 that is indicating the advertising influence that make

to change the buyer’s buying behavior. It is due to those ads which consumer watch by

different sources. However this could be overestimated so we used adjusted R square as

the better estimate for the whole sample. The standard error of estimates was 0.454.

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CHAPTER- 5

DISCUSSIONS AND CONCLUSION

The conducted research has been executed to answer the research questions. The purpose

of research was to know the impact of pharmaceutical advertising on doctor (customer)

prescription behavior and consumer purchase behavior. The research focus on various

aspects of pharmaceutical advertising like advertising through medical representative,

attributes of pharmaceutical advertising, pharmaceutical advertisement of FMCG Product

for consumers and pharmaceutical promotion and prescription behavior of doctors.

From the data analysis of respondent our findings show that the awareness of

advertisement among respondent is higher than 90%. It shows that our topic to study the

impact of advertisement has much relevance in current scenario. Our finding about

medium of advertisement shows that advertisement through television get more attention

as the respondent percentage is more than 56%.The second attractive medium is word to

mouth in which the respondent percentage is more than 16% while this is quite less from

the television advertisement medium. The data analysis also shows that, association of

medium of advertisement that get the attention of respondent with type of family shows

that there is no significant association between medium of advertisement that get the

attention of respondent and type of family.

Advertising affect consumer in many ways whether by recall, positive impression, create

interest and also in decision process. From the data analysis of the effectiveness of

advertisements long lasting impact we found that it develop the interests among

respondents towards particular medicines. We also see that it is also effective in affecting

the decision process and positive impression of the consumer towards particular

medicines.

OTC medicines (Over the counter drug) are medicines sold directly to a consumer without

a prescription from a health care professional. The data analysis of advertising

effectiveness of OTC drugs (common use medicines), shows that television medium of

advertisement are more effective medium of advertisement for consumer persuasion to

purchase the medicines. The second effective medium of advertisement is news paper in

which the respondent percentage is 31%. This study indicates that there is significance

association between types of family, marital status of consumers with effective medium of

advertisement for OTC drug as the Chi-Square value is insignificant. Similarly this study

also indicates that there is a significant association between educational qualifications,

occupation with effective medium of advertisement for OTC drugs as the Chi-Square

value is significant.

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The trends towards self medication are likely to grow as consumers are becoming familiar

with OTC drugs, due to extensive advertising by companies. Doctor, retailer, Television, Friends and relatives, News papers also act as suggestive measures for consumer to purchase the OTC drugs (common use medicines). This study indicates that about 31%

respondent purchase common use medicines by suggestive measure of television followed by doctor.

OTC drug purchase by consumer generally influenced by advertising, friends& relatives, retailer doctor etc. The analysis of data shows that 31% of respondent influenced by advertisement of pharmaceutical for purchase of medicines and little bit less 30.70% of

respondent influenced by friends and relatives for purchase of medicines. Doctor also influences respondents for purchasing of common use medicines but extent of influence is

less advertisement and friends& relatives. Also found that consumers are becoming familiar with OTC drug due to extensive advertising by companies. This study also reveals that family type, qualification, occupation, marital status and age of respondent

have no significant association with influencer (advertising, friends& relatives, retailer doctor etc) in selecting medicines for common disease as the Chi-Square value is

insignificant. Advertisement creates need among consumers but pharmaceutical advertising have a

direct impact on health of consumers. The analysis of data indicates that about 32% of respondent agree to some extent that advertisement create need among consumer. The

next finding focused on the nature of attention paid by respondent in pharmaceutical advertising and it was found that about 48% of respondent paid some attention about pharmaceutical advertisement. This research is also made to assess the lasting effect of

advertisement on consumer and it is found that about 28% of respondent having lasting effect of advertisement is about one week whereas about 24% of respondent having

lasting effect of more than one month.

In pharmaceutical advertisement some pharmaceutical product attribute like strength of

medicines, dosage form, route of administration and dosing schedule etc. are observed by

consumer in pharmaceutical advertisement .This research indicates that more than 50% of

respondent observed strength of medicines in pharmaceutical advertisement. Similarly this

study also reveals that about 32% respondent influence to some extent by pharmaceutical

advertisement and about 45% of respondent are agree to some extent that they relied on

these pharmaceutical advertisement while making purchase decision.

Medical Representative is important source to support the pharmaceutical sales activity. In

research 78% of doctor agreed that medical representative visiting in their practice hours,

63% doctor says that about 5-10 MRs visited per day in their clinic and as a key element

for providing information about medicines and about 69% doctor agreed that MRs is a key

element for providing information about medicines also found that Physicians agreed that

sales representatives provided useful and accurate information about newly and already

established drugs, but only slightly agreed that they performed an important teaching

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function whereas RavindraGoyal and PranavPareek (2013) examines that Medical

representatives provide incomplete medical information to influence prescribing practices;

they also offer incentives including conference, Seminars, national and aboard

sponsorship.

There are various promotional items like free samples There are various promotional

items like free samples, Trip to Seminars, lunch/ Dinner for physician’s family and there

staff ,tickets to special entertainment events are provided by pharmaceutical companies to

doctors to boost their sales and for doctors trips to seminars having mean value 2.71 and

free samples having mean value 2.77 are important promotional items.

Mahmoud Abdullah Al-Areefi et. al (2013) concluded that that physicians are aware that

the medical representatives could influence their prescribing decision; they welcome

representatives to visit them and consider receiving free samples, gifts and various kinds

of support as a normal practice. He also found that the majority of the physicians had

positive interactions with medical representatives. The physician’s main reasons stated for

allowing medical representatives visits are the social contacts and mutual benefits they

will gain from these representatives.

Managerial Implications for doctors:In terms of managerial implication, thefindings do

provide some insights and feedback for administrators of media industry in drafting

various advertising strategies on how to increase the favorable attitude towards advertising

for doctors. As part of the efforts to create favorable attitude, some suggested strategies

include: ensuring the sources of advertisement are credible, trustworthy, believable,

informative message.

Conclusion: - Quite a number of important conclusions can be drawn from thefindings of

this study. Consumer paid more attention when Television medium of advertisement and

television medium of advertisement is more affective for purchase of common use

medicines. The advertisement of OTC drug was found to be persuasive, but not high

enough so that consumers can directly go and ask for the advertised drug. Advertisement

also acts as a influencer in selecting medicines for common diseases and create need up to

some extent and theme of advertisement influence the consumer to buy the products.

Visual presentation of advertisement creates more attention and makes their impacts in

selection of medicine. From the results, we can also consider that doctor prescription for

medicine is responsive to advertising. This research has proposed five important factors of

pharmaceutical advertising such as Detailing, Advertising effectiveness, Brand

positioning, Influence, and Informative.

As far as Detailing is concerned in pharmaceutical advertising; it is accused of promoting

medicines that leads to change in prescription behavior because of marketing and

promoting strategies. Advertising effectiveness can add value to a company and provide

64

feedback about necessary changes made for doctors for prescription of medicines. Brand

positioning place a consumer brand in doctor mind that motivate him for prescription of

medicine. Advertising through Medical representative influence the doctor prescribing

practices by important scientific information .The informative advertising allows doctors

to have access to product and service information without any hassle. Informative

advertising benefits doctors by carrying specific, definite and tangible facts about product.

Drug promotion strongly influences prescribing behavior. Company funding of doctors, of

educational events and of research are important elements in this influence. In this it is

found that MRs are important promotional channel used by companies that makes their

long lasting effect on doctor mind followed by specific seminars held by companies . The

reliability and effectiveness of information provided through medical journal and clinical

paper are important for doctors. The findings provided insight into possible target areas

for educational interventions about pharmaceutical marketing. Such a finding will provide

the basis for policymakers in the public and private health sector in Pakistan and those

countries which have a similar health system to develop a suitable policy and regulations

in terms of drug promotion. A national formulary will help physicians to prescribe

approved medicine.

From the above discussion we have drawn the conclusion that advertisement can change

the behavior of the consumer’s. Factors likewise necessity of advertisement, pleasure of

advertisement, dominance of advertisement, brand recall advertisement, and stimulation

of advertisement. These are very helpful in creating and shifting the consumer’s buying

behavior that is a very positive sign for the advertising and marketing companies. Our

results also proved the model of the study which reveal that advertisements have

significant impact on the consumers ‘buying behavior and widen their choices. This study

will definitely be proved helpful for the marketing and advertising companies to promote

their products in the light of our empirical results. It will enable to focus huge consumer

markets of Punjab.

65

7. Recommendations

In the light of our empirical results we want to make the following recommendations:-

1. Consumer’s buying behavior should be continuously observed while preparing the

advertisement messages/Ads.

2. The advertisement messages must be clear so that the common consumers can also

understand them.

3. Advertisement policy should be designed accordingly geographically, to keep in mind the

socio economic status of the consumers.

4. Latest advertisement concepts of marketing should be introduced to achieve the maximum

goal of the FMCG Companies

5. A creative way of advertisement must be adopted to catch the attention of the consumers.

6. THE repetition of the ads on one type of media may reduce the interest of the viewers and,

therefore, advertisements should be given on electronic and print media.

7. Awareness and comparison ads will very helpful to catch the attention of the consumers,

towards the desired FMCG.

8. Online advertising can capture the attention of the internet users, they can directly order

from the online web portal.

9. Shelf designing is very useful tool to attract their attention and liking view point, when

they visit the shop, automatically shelf advertisement catch their interest and they will

pick ad buy FMCG.

10. Teasing or surprising ads like (latest addition is coming soon) are also very constructive to

stimulate the consumers.

11. Product recommendation is very common practice, through this way multiple purposes

can be achieved. Message convey to the recommended person and to the other general

audience.

12. In the shopping mall or display the relevant item near to each other, it will make a need of

the consumers to take another FMCG’s with their desired products.

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13. Getting your customers to have an emotional attachment with your brand is one of the

keys to keep them loyal with their brands.

14. Add the multiple functions in the FMCG advertisements to catch the maximum interest of

the consumers.

15. Social media have a great influence now day advertisement through social media will be

very fruitful to expand the sale of FMCG.

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Effects of Advertisement on Consumer’s Buying Behavior

Reasons of brand switch

Name _____________________

Gender: Male / Female

Description:

I am a student in BBA. I am going to conduct a Research on the Topic of Effects of

Advertisement on Consumer’s Buying Behavior as per requirement of my degree. My

Topic is to identify the Reason of brand switch so, for this I need your assistance and I

want to know your view. Kingly provide me information regarding to my topic and

answer the questions. Carefully,

Thanks

Age: a. 25—35 b. 35—45 c. 45—55

71

Effects of necessity advertisement on consumer’s buying behavior (it contains 6 questions) Strongly Disagree Neutra l Agree Strongly

Disagree Agree

1 Does advertisement necessary to attract

the consumers?

2 Does print advertisement (Newspaper etc)

to be necessary?

3 Does the outdoor/street advertising

Relevance to Your daily life?

4 Does outdoor/street advertisement poorly

Displayed, that's why not attractive?

5 In this competition market, any product

Can’t survive without advertisement?

6 Do You buy the goods when you feel its

Necessary/needed?

Effects of pleasure advertisement on consumer’s buying behavior (it contain 3 questions) Strongly Disagree Neutral Agree Strongly

Dis agree Agree

7 Does restrictive advertisement also attract

your mind and convince you.

8 Does advertisement a source of pleasure &

entertainment?

9 Do You think that television commercials

have vast coverage than anything else?

Effects of dominance advertisement on consumer’s buying behavior (it contains 2 questions) Strongly Disagree Neutra l Agre e Strongly

Dis agree Agree

10 Does advertisement always an influence

& dominate You?

11 Do You like to buy the goods for

dominance & increase the standard of

living in society?

Effects of brand recall advertisement on consumer’s buying behavior (it contains 4 questions) Strongly Disagree Neutral Agree Strongly

Dis agree Agree

12 Does advertisement create the awareness, so that You prefer to buy the low priced

goods?

13 Does advertisement convince You to buy the same brands?

14 Does the FMCG Co. should give ads, for brand recall in Your mind?

15 Does your participation in purchasing

influenced by friends & family?

Effects of stimulation advertisement on consumer’s buying behavior (it contains 3 questions) Strongly Disagree Neutral Agree Strongly

Dis agree Agree

16 Does adve rt i se m e nt stimulate or

encourage You to purchase the products?

17 Does advertisement always influence

Your buying habits?

18 Does advertisement motivate you, to shift

from one brand to another brand?

72