Report on Asthma

EXECUTIVE  SUMMARY
Asthma is an inherited type of “twitchy” lung. The airways go into spasm and become narrow (constricted) when allergic or irritating substances enter them.Viral respiratory infections (colds) trigger most attacks, especially in younger children.
The disease that we know as asthma is caused by a combination of responses to triggers (events that set off an asthma attack). These are inflammatory responses, bronchial spasms, constrictions of the bronchial, and other actions in the body resulting in a hyper-responsive airway. Some of the triggers for asthma are allergens (such as dust mites or mold), infection (sinus or bronchial), emotional, stress, hormonal changes, irritants (such as cigarette smoke or dust), changes in humidity and temperature, exercise, and gastroesophageal reflux disease (GERD). People with a strong family history of asthma are more likely to develop asthma.
Symptoms:

• Wheezing (a high-pitched whistling or musical sound while breathing out).
• Recurrent attacks of wheezing, coughing, chest tightness, and difficulty in breathing.
• Sneezing and a runny nose (often but not always).
• Usually no fever.

Probable Market
The number of asthma patients has nearly doubled in the city during the last 10 years because of the degradation of environment, it is learnt. Congenital asthma is not curable said Dr AKM Mosharraf Hossain, an Associate Prof of the Bangabandhu Sheikh Mujib Medical University.He said about 7 million people suffer from Bronchial Asthma in Bangladesh. The condition usually begins at childhood,
Adulterated foods are also responsible for asthma, he said.

Asthma in Bangladesh appears to be a substantial public health problem: an estimated 7 million people including 4 million children suffer from asthma-related symptoms, he said. Asthma is a chronic condition that cannot be prevented or cured, however, individual attacks can often be prevented. The prevalence of asthma was 6.9 per cent. The prevalence of other asthma definitions were- ever wheeze (lifetime wheeze) 8 per cent, perceived asthma (perception of having asthma) 7.6 per cent, doctor diagnosed asthma 4.4 per cent.

The prevalence of asthma in children (5-14 years) was higher than in adults (15-44 years). Most of the resources of Asthmaest will be deployed around large use area i.e. in Trachea, lung, chest and diseases related to breathing problem .

Proposition: why ”Asthmaest”, – what is its superiority Differentiation
For Asthma patient There are several types of tablet, Inhaler, Nebuliezer, Injection available in the market. But all the existing product has some side effect or using problem(Inhaler has a problem of stop breathing for 10-15sc. When taking medicine). But Asthmaest has following distinct features and benefits which make it completely different and preferred choice of agent by Asthma specialist community than other available products:

a)                  Improvement over the way of using
b)                  No need to stop breathing
c)                  No side effect
d)                 Proportionate of medicine according to needs
e)                  Risk of Allergy and eczema is less.

Key Promotional Activities
Promotional activities will be concentrated around almost all targeted doctors and specific departments like Asthma, Bronchitis, Lung specialist, Dental Surgery, etc. with frequent visits to build awareness about a safe, easy and effective way of use.

2. PRODUCT  PROFILE
Product
Asthmaest
Side-Effects
Less probability of Vomiting  & Eczema.

Dose
Oral:   0.5mg 2-4 times daily
By Breath:      3-5 times daily
 
Presentations
Oral: powder mixed with water.    
By Breath: Taking smell.
 
Since internationally medicine of Asthma disease are available in tablet, injection & inhaler forms & as all the existing products have side effect or using problems and as there is a gap of powder based product which can be used very easily & frequently  so there is a convenient market waiting for Asthmaest is no doubt.
 
3. Market Characteristics,  Trends
 AND COMPETITIVE ENVIRONMENT
Quantitative market data
 
Overall market situation
A. Total pharma market is valued at Tk 14,931m in the year 2006 with a growth rate of 6%.
Total Institutional market: 41.36 m
Seviret             19.18 m with growth rate of 53%
Rexitrol           22,18 m with growth rate of -25%
 
Background of the market
–          There is a general fearness about the side effects as trembling whole body & bones are become thin & jelly less.
–          Lengthy using systems of inhaler & nebulaelizer.
–          Bellow consciousness about the cause of affecting asthma
–          Doctors are studying & researching about improving way of taking medicine.

Competitive environment
Market share of 5 different Products:

GSK’s “Ventolin” is the market leader and occupied 67%. Ventolin offers Tablet, syrup, Inhaler & nebulaezer. Next position is hold by Sulbutol of Fysons which market share is 20%. Sulbutol offers tablet & syrup. Bradil also offers tablet & syrup, market share is 8%.Aminphylin & Sultolin offers SR(sustain release) tablet & Inhaler  respectly. Ventolin Inhaler is the latest & has a large use, so this inhaler is the main competitor of our product.

Table-1: Available product in market & their price 

Table-2: Pricing position of currently available Inhaler, Injection & Asthmaest:

4. Marketing  Objective

General statement

To establish Asthmaest as an agent of choice to ensure the easiest way of use among all category of patients as normal, serious, Children, young & elderly.

Key issues

• Little understanding of our rural doctors & patients regarding coagulation cascade and related products
• Low potential of specialised products
• The market has to be cultivated first by generating interest and developing awareness since currently available brands did not popularise the concept
• High price of Injection, Nebulaelizer & Inhaler, even if compared against same medicine of other multinationals

Key assumptions

• Need of a favourable product(best usable for patient) is generally acknowledged by doctors
• New entrant is likely to emerge as soon as we build up the concept of taking medicine without using mask, spacer or cylinder.
• Currently available brands will reap up the benefit of our aggressive promotion
• Popularising the concept of using the product will largely depends on training and promotional and sponsorship support from Asthma association.

5.Marketing  STRATEGY

• To Asthma specialists : Asthmaest is the choice of agent in response to patient have no need to use spacer or inhaler which are lengthy process of use & poor using system.
• To Elderly people: During serious moment they can use very rapidly & no need to stop breathing.
• To Children: No more fear of using mask.
• Internists: Treatment of bronchial & Lung diseases.

Proposition:

Asthmaest has following distinct features and benefits which make it completely different and preferred choice of agent by community than other available products:

a)                  Improvement over the proportionate of drug

b)                  Rapidly using system

c)                  No more use of spacer, musk, nebulaelizer or injection.

d)                 Can use more frequency than inhaler

e)                   Risk Axiom or other Bronchial diseases is less

f)                    No side effect as trembling whole the body & thin of bone 

Unique Selling Points

Asthmaest has a more efficacy with easiest way of using & proportion of drug.

Clinical Trial Plan and Life Cycle Management Plan

Since Inhaler was launched in the market few years back and supported by lot of international clinical papers/international trials. No clinical trial on Asthmaest (powder based)  as such is in planned market.

However to gain confidence of local key opinion leaders a post marketing phase study  will be conducted during planned period.

Doses

Oral:   0.5mg 2-4 times daily

By Breath:      3-5 times daily

Presentations

Oral: powder mixed with water     

By Breath: Taking smell

We are planning to launch 250mg pack only at this moment, but it is essential to have all the forms available right from the beginning. Smaller pack of 10mg would be convenient for marketing 1-2 days therapy. It is also important to have different strengths of  taking smell in stead of capsule & tablet form which have serious side effect.

Pricing

Asthmaest is an imported product, therefore price is given by Directorate of Drug Administration and licensing Authority with definite mark up basis which is dependent on duty structure. Pricing calculation is done based on no duty, but 15% VAT. So, 180.88% mark up should be calculated on C&F price to derive MRP, that will give 12.5% commission to retail chemists on trade price.Discount policy

No provision for general discount. However a 3% discount may be offered in order to secure bulk orders initially, particularly in 2006. 

Institutional retail / Purchasing group

Price is the key issue for institutional purchase. Since price of Asthmaest is relatively lower than other available products there should be a great option for retail purchase.

So Asthmaest is planned to be included in the purchase list of the institutions by brand name after massive lobbing to the opinion leaders. 

Distribution

Through in-house distribution channel. No special precautions should be taken in order to store Asthmaest, since it could be stored in room temperature.

6. Target Customer

Doctors of following categories will be our customers for Asthmaest

• Medicine specialists
• Asthma Specialists
• Child specialists
• Bronchial Specialists
• Cardiac Surgeons

Table-3:Target customer & Sales force allocation:

7.   Promotional  Strategy  and  Platform

Promotional objectives and method

1. Develop awareness regarding the use of a Powder based medicine in serious moments:

a) to control & expand the space of Trachea

b) support of opinion leaders is a necessity

2.  Impose Asthmaest as an agent of choice in the segment where it has the most important

competitive advantage:

a) versus placebo

b) versus existing tablet

c) versus existing inhaler & nebulaezer.

3.  Develop relationships with prescribers /decision makers

4.  Reinforce the image of efficacy by launching all dosage forms/strengths

5. Focus and limit our promotion in hospital through a hospital team: commitment, willingness to succeed

• All prescribers and prospective prescribers of the target doctors . Asthmaest will be covered in 2006 with the objective of increasing awareness and usage of Asthmaest  by highlighting its superiority over other existing products and other similar preparations.

• Opinion leaders will be visited four  times a moth to establish the concept of using Asthmaest routinely in each risky situation. High prescribers will be visited at least  four times also in a month and the followers will be visited twice in a month. They will be reminded about the better using, efficacy, tolerability, and compliance of Asthmaest over competitive products.

• Attractive posology cards, detail aids, booklets, product monograph, video cassettes on taking medicine and product reminders with creative ideas to highlight benefits of Asthmaest will be used. For these materials, good retention value and focus on product name and logo will be specifically considered.

Media strategy

Detailing, with more than 40% weightage of promotion for Asthmaest is planned for 2006. Weightage on doctors meetings will be 20%, and on journal service, product monographs, etc. are 40%.

Budget

Promotional Budget for Asthmaest for 2006 is Tk 1031 K of which Tk 500 K is for doctors’ meeting and symposia, and Tk. 40 K is for advertising. Rests are for detail aids and product reminders.

8. Sales Force

Number of sales force needed/ available

A dedicated team of 10 persons is required to promote Asthmaest in 2006 to selected doctors. If we employ a dedicated team they will be able to make 4 calls per day since a huge portion of their time will be spent in travelling and waiting for opinion leaders and high prescribers. Alternatively we may also promote this product sharing sales force time of our existing bigger team, but sales force time will remain almost same since making sales calls to opinion leaders and high prescribers is always time consuming (4 calls per day).

Product position in detailing

In detail Asthmaest will be discussed with 1^st Priority – in all cycles round the year, since it will be promoted by a dedicated team.

Sales Training

A 5 day special training programme will be organized on Asthmaest. In order to make the programme an effective one, we need a trainer from World Asthma association, America. One of the resource person should receive train the trainers course from World Asthma association, America.

 Other resource personnel would be: Training Manager, Medical Affair Associates, National Sales Manager, guest speakers from Asthma Association of Bangladesh etc.

We should also request for following materials from World Asthma association, America. for sales force and the trainer:

1      a)   Training Manuals for sales force: with any guide, OHPs

slides, etc. for the trainer

b)      Souvenirs, brochures, etc. for sales force members attending

training

2     Launching literature                                                                      4000 pieces

3     Introduction to World Asthma association (booklets)                 500 copies

4     Product Monograph for opinion leaders                                      100 copies

5     Video Cassettes and display materials for doctors meeting

6     Reprints and folders, to be distributed among participants of

clinical meetings, seminars etc.                                                     500 to 2000 copies

7     A second set of literature and give-away for the second

promotional cycle                                                                          4000 pieces

Contents of these programs would include product profile, competitive advantage, use of journal reprints, hospital selling, and selling skills in relation to Asthmaest.

A refreshers course, follow-up training would be conducted after one month of the induction training to measure the knowledge level and reinforce their activity.

Sampling policy

• Sampling of Asthmaest will be restricted only to opinion leaders to allow them to try it on selective patients so that their confidence on Asthmaest is reinforced.

• In addition, real prospects of Asthmaest will receive samples in full course so that they can gain confidence by using it.

Medical advertising

Asthmaest will be advertised in four (4) five medical journals only published by Asthma association, Child hospital, Chest hospital & Doctors association of Bangladesh.

Product Publicity

For 2006 two ‘Product Reminders’ are planned. One is pen and another is desk organizer. These are the gifts which will have good retention value for the doctors. Product name and logo will be clearly mentioned on these gifts to ensure continuous reminder to the doctors.

Doctors meeting on Asthmaest will be arranged in relevant departments of all Medical College Hospitals & in Asthma association . We are planning to organize at least 12 meeting in 2006. If possible foreign speakers will read the key note paper.  Number of participating doctors in each meeting is about 200. Budget per meeting is about Tk.300000 (excluding travelling and honorarium of foreign speaker

 9. Market   Research   Plan

A small scale market survey will be done to prepare the market map and to calculate future market potential segment wise.

10. Profit  and  Loss  Account

Sales turn over is gradually increasing over the planned period. Gross Profit although very low but is increasing by value. Two different situations have been analysed based on  different C&F and Trade Prices. Direct expenditure as % of net sales is also decreasing. Net product contribution although negative seems to be improving over the time.

11.  RISK  AND  OPPRTUNITYS

High risk of totally different types of using. If we can understand people about its easiest method of using then it should be our great opportunity.

No Possibility of bulk sales is less, as the concept of using such product is very new and helpful for patients. The gap of using & side effects of all existing products are great opportunity for us.

High

The acceptability of inhaler is the main threat.

Medium

Conclusion