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IMPACT OF ADVERTISING ON CUSTOMER PURCHASE BEHAVIOUR IN PHARMACEUTICALS THESIS SUBMITTED TO THE UNIVERSITY OF LUCKNOW FOR THE AWARD OF THE DEGREE OF DOCTOR OF PHILOSOPHY IN BUSINESS ADMINISTRATION SUBMITTED BY: RAM DHEERAJ Under the Supervision of DR S. K. KAUSHAL DEPARTMENT OF BUSINESS ADMINISTRATION UNIVERSITY OF LUCKNOW LUCKNOW 2014 DEPARTMENT OF BUSINESS ADMINISTRATION UNIVERSITY OF LUCKNOW Date: CERTIFICATE This is to certify that Mr. Ram Dheeraj has carried out the research work presented in this thesis entitled “Impact of Advertising on Customer Purchase Behaviour in Pharmaceuticals” for the award of Doctor of Philosophy from Lucknow University, Lucknow under my supervision. The thesis embodies results of original work, and studies are carried out by the student herself and the contents of the thesis do not form the basis for the award of other degree to the candidate or to anybody else from this or any other University/Institution. Supervisor Dr. S.K. Kaushal Assistant Professor Department of Business Administration DECLARATION I hereby affirm that my research work entitled “Impact of Advertising on Customer Purchase Behaviour in Pharmaceuticals” for the award of Doctor of Philosophy from Lucknow University, Lucknow is my own original work and has not been submitted for any assessment or degree/diploma or award at the University of Lucknow or any other University/Institutions. Ram Dheeraj Department of Business Administration COUNTERSIGNED This is to certify that the above declaration by the candidate is true to the best of my knowledge. Supervisor Dr. S.K. Kaushal Assistant Professor Department of Business Administration University of Lucknow. Lucknow. ACKNOWLEDGEMENT It is with immense gratitude and pleasure that I acknowledge the help and support of my supervisor Dr. S. K. Kaushal - 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 Prof. Arvind Kumar, Dean of Commerce Faculty, Mr. Sanjay Medhavi Head of Department, Department of Business Administration, Prof. J. K.Sharma, the former Head of Department, 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 thank Vijay Shankar Pandey and Robbin Verma 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 parents, wife Sunita, daughter Advika, brother Rahul and Sister Shilpi for 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. (Ram Dheeraj) ŝ 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 various ŝŝ promotional tools is different with respect to demographic variables. This research based on descriptive research or quantitative research. In this descriptive research CrossSectional 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. Doctor agreed that Medical Representative is a key element for providing information about medicines and they are important promotional channel used by companies that makes their long lasting effect on doctor. ŝŝŝ TABLE OF CONTENTS S.No 1 2 3 4 5 6 7 Description Page No. Acknowledgment Abstract Table of Contents List of Tables List of Figures List of Abbreviation List of Key words i ii iv viii xi xiii xv 1 1.1 1.2 1.2.1 1.2.2 1.3 1.3.1 1.3.2 1.3.3 1.3.4 1.3.5 1.3.6 1.3.7 Introduction Introduction Classification of Drugs OTC Drugs Ayurvedic Drugs Drug Promotion and Drug Advertising in India Advertising to the General Public Advertising The Products In Medical Journal Direct mailing of publicity material to doctors Medical conferences, especially for a new product Electronic or Broadcast Media Advertising Outdoor Media Other Media Pharmaceutical Advertisement for OTC medicine or Direct Consumer Advertising. Strategies for New And Switched OTC Pharmaceutical Products. Invest in generics Pharmaceutical Companies Business Strategies for Prescription Drugs Marketing approaches of Super Core Model. Marketing approaches of Core Model Pharmaceutical marketing process and challenges Growth Rate of OTC Medicines Branding in Pharmaceutical Marketing Understanding Consumer Behavior Consumer Behavior in Pharma Sector 1 1 4 4 6 7 11 11 13 13 13 14 14 1.4 1.5 1.5.1 1.5.2 1.5.2.1 1.5.2.2 1.6 1.7 1.8 1.9 1.10 ŝǀ 14 15 19 19 20 22 24 25 27 28 29 S.No Description Page No. 1.11 Consumer Pyramid 30 1.11.1 1.11.1.1 1.11.1.2 1.11.1.2.1 1.11.1.2.2 1.11.1.2.3 1.11.1.3 1.11.1.3.1 1.11.1.3.2 1.11.1.4 1.11.1.4.1 1.11.1.4.2 Factors Influencing Consumer Behavior Cultural Factors Social Factors Reference group Family Social status and role Personal Factors Age and stage in life cycle Personality and self concept Psychological Factors Motivation Perception 31 31 32 33 34 34 34 36 36 36 38 38 1.11.1.4.3 Learning 38 1.11.1.4.4 Belief and Attitude 39 1.11.1.5 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 2 3 3.1 3.2 3.3 3.4 3.5 3.6 Psychographic Factor Buying Preferences of Indian consumers Brand or Generic Promotional Spending for Prescription Drugs Marketing to Physicians and Consumers Different Marketing Strategies for Different Drugs Market Characteristics That Influence Promotional Strategies The purchasing process The Role of the Consumer (Patient) The Prescription Decision Compliance or Post – Purchase Behavior The Role of Price Chapterisation Scheme Review of Literature Research Methodology Need for this research Scope of the research Desk Research Pilot Study Research design Data collection method 39 40 41 41 42 44 44 45 47 47 48 49 50 52 72 72 73 73 74 75 75 ǀ S.No 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 4.1 4.1.1 4.1.2 4.1.3 4.1.4 4.1.5 4.1.6 4.2 4.2.1 4.2.2 4.2.3 4.2.4 4.2.5 4.2.6 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.10.1 4.10.2 Description Page No. Questionnaires Study Variables Sample Selection Survey Instrument Data collection Data analysis Brief Summary of tools used for Analysis Objective of the Study Research Hypothesis Research Assumptions Demographic Characteristics of Respondents (Consumers) Age wise classification of respondents Marital Status- wise classification of respondents Family type- wise classification of respondents Income- wise classification of respondents Qualification - wise classification of respondents Occupation - wise classification of respondents Sensitiveness of consumer towards advertisement Advertisement awareness Advertisement medium and attention Effect of advertising on consumer Advertising medium and OTC medicine (Over the counter drug) Suggestive measure for purchase of common use medicines Influencers for purchase of common use medicines Lasting effect of Advertisement Impact of Advertisement to create the need of pharmaceutical product Nature of Attention Attributes observed in advertisement Extent of influence of Pharmaceutical Advertisement Relying on Pharmaceutical Advertisement in purchase decision Advertising attributes that impacts in selection of medicines Demographic Characteristics of Respondents (Doctors) Qualification wise classification of doctors Classification on the basis of Position hold by Doctor 76 77 78 79 81 82 84 85 86 87 88 90 91 92 93 95 96 97 98 99 112 ǀŝ 113 125 138 153 154 156 158 159 160 162 166 170 171 S.No 4.10.3 4.10.4 4.10.5 4.10.6 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 5 6 Description Page No. Classification on the basis of No. of years of practice Classification on the basis of Regional Status of practice Classification on the basis of practice hours by doctors Classification on the basis of O.P.D frequency Impact of Pharmaceutical Advertisement on doctor's Prescription Behavior Importance of medium providing information about medicine available for patient in the market Reliability of information provided through different media about medicines Impact of Medical Representative on Doctor Prescription behavior Medical Representative as key element for providing information about medicines Importance of promotional items /other facilities distributed /provided by companies for doctors Effectiveness of information provided through different media in doctor prescription Importance of promotional channels used by companies and their long lasting effect on the mind of doctors Influence of prescription decision of doctor w.r.t Branded medicine, Generic medicine and patient demand Influence of prescription decision of doctor w.r.t specialized promotional channels, creativity in pharmaceutical advertisement and frequency of pharmaceutical advertisement Impact and extent of impact of Pharmaceutical advertisement Discussions and Conclusion Bibliography 172 173 175 176 178 190 196 201 203 205 209 214 220 221 224 244 253 APPENDICES Appendix A: - Questionnaire for Consumer. Appendix B: - Questionnaire for Doctor. ǀŝŝ i iv LIST OF TABLES S.No Table no.1.1 Table no. 4.1.1 Table no. 4.1.2 Table no. 4.1.3: Table no. 4.1.4 Table no. 4.1.5 Table no. 4.1.6 Table no. 4.2.1 Table no. 4.2.2 Table no. 4.2.2.1 Table no. 4.2.2.2 Description Showing top ten Indian OTC brands as per their sales and growth Age- wise classification of Respondent Marital Status - wise classification of Respondent Family type-wise classification of Respondent Income-wise classification of Respondent Qualification -wise classification of Respondent Occupation -wise classification of Respondent Advertisement awareness among respondents Advertisement medium and attention of respondents Association of medium of advertisement with type of family Association of medium of advertisement with educational qualification of consumer. 26 90 92 93 94 95 96 99 100 101 103 Table no. 4.2.2.3 Association of medium of advertisement with occupation of consumer. 105 Table no. 4.2.2.4 Association of medium of advertisement with marital status of respondent. 108 Association of medium of advertisement with age of respondent. Effect of advertising on respondent Effective medium of advertisement for common use medicines. 112 Table no. 4.2.4.1 Association of effective medium of advertisement with family type of respondent 116 Table no. 4.2.4.2 Association of effective medium of advertisement with educational qualification of respondent 118 Table no. 4.2.4.3 Association of effective medium of advertisement with occupation of respondent 121 Table no. 4.2.4.4 Association of effective medium of advertisement with marital status of respondent 124 Table no. 4.2.2.5 Table no. 4.2.3 Table no. 4.2.4 Table no. 4.2.5 Table no. 4.2.5.1 Suggestion by which consumer purchase common use medicines Association of suggestion by which common use medicine are purchased with family type ǀŝŝŝ Page No. 110 114 126 128 S.no Table no. 4.2.5.2 Table no.4.2.5.3 Table no. 4.2.5.4 Description Page No. Association of suggestion by which common use medicine are purchased with Educational qualification Association of suggestion by which common use medicine are purchased with occupation Association of suggestion by which consumer can purchase common use medicine with Marital Status. 133 136 Table no. 4.2.6 Influencer in selecting medicine for common diseases 139 Table no. 4.2.6.1 Association of factor influencing most in selecting medicine for common disease with family type 141 Table no.4.3 Association of factor influencing most in selecting medicine for common disease with Educational Qualification. Association between Occupation and factor influence most in selecting medicine for common diseases Association between Marital Status and factor influence most in selecting medicine for common diseases Association between Age and factor influence most in selecting medicine for common diseases. Lasting effect of Advertisement 153 Table no.4.4 Impact advertisement to create need among consumer. 155 Table no. 4.2.6.2 Table no. 4.2.6.3 Table no. 4.2.6.4 Table no. 4.2.6.5 143 145 149 151 Table no. 4.6 Nature of attention paid by consumer in pharmaceutical advertisement Attributes observed in advertisement 158 Table no. 4.7 Extent of influence of Pharmaceutical Advertisement 159 Table no.4.8 Relying on advertisement in purchase decision Advertising attributes that impacts in selection of medicines Doctor-directed promotion methods Qualification wise classification of Doctor Classification on the basis of Position hold by respondents 161 Table no. 4.5 Table no.4.9 Table no. 4.10 Table no.4.10.1 Table no.4.10.2 Table no.4.10.3 Classification on the basis of No. of years of practice Table no.4.10.5 Classification on the basis of Regional Status of Practice Place Classification on the basis of Practice Hours Table no. 4.10.6 Classification on the basis of O.P.D Frequency Table no.4.10.4 ŝdž 130 157 163 168 170 171 173 174 175 177 S. No Table no.4.11.1 Table no.4.11.2 Description Mean and standard deviation of all 27 items KMO and Bartlett's Test Page No. 178 181 Table no.4.11.3 Principal component analysis: Varimax rotation Matrix 182 Table no.4.11.4 Table.no.4.11.5 Total variance explained (Rotation) Naming of factors Importance of medium providing information about medicines 183 185 Table.no.4.12 Table.no.4.13 Table.no.4.14 Table.no.4.14.1 Table.no.4.15 Table.no.4.16 Table.no.4.17 Table no. 4.18 Table no. 4.19 Table no. 4.20 Table no. 4.21 Table no. 4.22 Reliability of information provided through different medium Visit of Medical Representative in practice hours. Frequency of MR Visited per day Medical Representative as key element Importance of promotional items Effectiveness of information provided through different media Importance of promotional channels used by companies and their long lasting effect on the mind of doctors Influence of prescription decision of doctor Influence of prescription decision of doctor w.r.t specialized promotional channels ANOVA by Doctor Educational Qualification ANOVA by Regional Status of Practice Place dž 191 197 202 203 204 205 210 215 221 223 224 233 LIST OF FIGURES S.No Fig.1.1 Fig 1.2 Fig. 1.3 Fig.1. 4 Fig1. 5 Fig. 1.6 Fig 1.7 Fig 1.8 Fig 4.1 Fig 4.2 Fig 4.3 Fig 4.4 Fig 4.5 Fig 4.6 Fig 4.7 Fig 4.8 Fig 4. 9 Fig 4.10 Fig 4.11 Fig 4.12 Fig 4.13 Fig 4.14 Fig. 4.15 Fig. 4.16 Fig. 4.17 Fig 4.18 Fig 4.19. Fig 4.20 Fig 4.21 Fig 4.22 Fig 4.23 Description Pull System Working In Chronic Therapy Segment Push System Working In Acute Therapy Segment Relationship between the key players of pharmaceutical industry Showing the growth of Indian OTC sales in US $ from 2006-07 to 2009-2010 Page No. 21 23 24 Showing the segment wise Indian OTC market percentage in 2013 26 Showing the percentage of OTC and prescription drugs used by Indians The Distribution Chain New Product Adoption Process Age - wise classification of Respondents Marital Status wise classification of Respondents Family type- wise classification of Respondents Income- wise classification of Respondents Qualification- wise classification of Respondents Occupation -wise classification of Respondent Advertisement awareness among respondents Advertisement medium and attention of respondents Effect of advertising on respondent Conceptual framework of consumer persuasion to purchase Effective medium of advertisement for common use medicines Suggestion by which consumer purchase common use medicines Influencing factor in selecting common use medicine Lasting effect of Advertisement Impact advertisement to create need among consumer Nature of attention paid by consumer in pharmaceutical advertisement Attributes observed in advertisement Extent of influence of Pharmaceutical Advertisement Relying on advertisement in purchase decision Advertising attributes that impacts in selection of medicines Qualification - wise classification of Doctor Classification on the basis of Position hold by respondents Classification on the basis of No. of years of practice džŝ 25 27 29 31 91 92 93 94 95 97 99 100 113 114 115 127 139 154 156 157 159 160 161 163 170 172 173 S.No Fig 4.24 Fig 4.25 Fig 4.26 Fig 4.27 Fig 4.28 Fig 4.29 Fig 4.30 Fig 4.31 Fig 4.32 Fig 4.33 Description Classification on the basis of Regional Status of Practice Place Classification on the basis of Practice Hours Classification on the basis of O.P.D Frequency Scree plot Importance of medium providing information about medicines Reliability of information provided through different medium Visit of Medical Representative in practice hours Frequency of MR Visited per day Importance of promotional items Effectiveness of information provided through different media Importance of promotional channels used by companies and their Fig 4.34 long lasting effect on the mind of doctors džŝŝ Page No. 174 176 177 182 191 197 202 203 206 210 216 LIST OF ABBREVIATION • DCA : Drugs and Cosmetics Act,1940 • DCR: Drugs and Cosmetics Rules,1945 • OTC: Over the Counter • DPCO: Drug Price Control Order 1995. • WHO: World Health Organization • OPPI: Organization of Pharmaceutical Producers of India. • IFMPA: International Federation of Pharmaceutical Manufacturers &Associations • INN: International Nonproprietary Name • POP: Point of Purchase • USP: Unique selling Point. • C&FA:Clearing and Forwarding agent • R&D: Research and Development. • NDA: New Drug Approval. • FDA: Food and Drug Administration. • DCGI: Drugs Controller General of India džŝŝŝ • CDSCO: Central Drugs Standard Control Organization. • MRP: Maximum Retail Price. • ISM: Indian System of medicines. • GATT: General Agreement on Tariffs & Trade • FMCG: Fast Moving Consumer Goods. • KOL: Key Opinion Leader. • CME: Continuing Medical Education. • DTCA: Direct to Consumer Advertising džŝǀ LIST OF KEY WORDS • Analgesic: are those drugs that mainly provide pain relief. • Antacids: are medicines that neutralize stomach acid or used to relieve acid indigestion, upset stomach, sour stomach, and heartburn. • Antiflatulents: is a drug used for the alleviation or prevention of excessive intestinal gas. • Antiseptic: is a substance which inhibits the growth and development of microorganisms. • Dermatological: medicine dealing with the skin, its structure, functions, and diseases. • Detailing: Interacting with doctors in their clinics and promoting the product. • Digestives: medicine that aids or promotes the digestion of food. • Drug Therapy: is the treatment of disease through the administration of drugs. • Generic drug: is a drug defined as "a drug product that is comparable to a brand/reference listed drug product in dosage form, strength, quality and performance characteristics, and intended use. • International Nonproprietary Name: is an official nonproprietary or generic name given to a pharmaceutical drug, as designated by the World Health Organization. • Medical Representative: Medical representative has to sell products of pharma companies or drug manufacturers by approaching doctors and detailing products to them. džǀ • Omeprazole: Medicine belongs to group of drugs called proton pump inhibitors. It decreases the amount of acid produced in the stomach. Omeprazole is used to treat symptoms of gastro esophageal reflux disease (GERD) and other conditions caused by excess stomach acid. • Prescription Drug: A prescription is a health-care program implemented by a physician or other medical practitioner in the form of instructions that govern the plan of care for an individual patient. • Schedule G drugs: Schedule G drug is a prescription drug that can be sold purely under medical prescription alone. • Schedule H drugs: These are drugs which cannot be purchased over the counter without the prescription of a qualified doctor. • Schedule K drugs: drug is not sold for medicinal use or for use in the manufacture of medicines and that each container is labeled conspicuously with the words “NOT FOR MEDICINAL USE”. • Schedule X drugs: A drug with a very high teratogenic risk to a fetus, based on controlled animal studies, which is contraindicated for use during pregnancy. • Steroid: A type of drug used to relieve swelling and inflammation. • Throat Lozenges : is a small, medicated tablet intended to be dissolved slowly in the mouth to temporarily stop coughs and lubricate and soothe irritated tissues of the throat (usually due to a sore throat), possibly from the common cold or influenza. • Topical drug: A topical medication is a medication that is applied to body surfaces such as the skin or mucous membranes to treat ailments. džǀŝ CHAPTER- 1 INTRODUCTION 1.1 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 consumer who purchase the OTC drug (Over the Counter Drug)1 which doesn’t requires the prescription of the doctors. The Pharmaceutical marketing differs from other ϭ OTC drug are medicines sold directly to a consumer without a prescription from a healthcare professional -1 types 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 in the price of prescription medicines2. 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 (Gonul FF et. al 2001). A study from Canada showed that the association with pharmaceuticals leads to less than appropriate prescribing behavior by the doctor (Lexchin J 1997).Many physicians, however, do not feel that their prescriptions are influenced by gifts and other incentives provided by pharmaceuticals (Liu SS 1995). 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 favourable attitude which leads to a favourable 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 Ϯ Prescription medicine is those medicines which are referred by doctors. -2 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 -3 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-today practice, and thus collects complete information on the product and its relative advantages over similar other products in the market. 1.2 Classification of Drugs: - In India, the import, manufacture, distribution and sale of drugs and cosmetics are regulated by the Drugs and Cosmetics Act, 1940 (DCA), the Drugs and Cosmetics Rules, 1945 (DCR) OTC Drugs. 1.2.1 OTC Drugs: - In India OTC drugs has no legal recognition, the phrase ‘OTC’ has no legal recognition in India, all the drugs not included in the list of ‘prescription’ only OTC drugs are considered to be non-prescription drugs. Hence ‘OTC Drugs’ means drugs legally allowed to be sold ‘Over the Counter’ by -4 pharmacists, i.e. without the prescription of a Registered Medical Practitioner. All those medicines which are listed in Schedules H and X of the Drug and Cosmetics Rules are prescription only drugs. Drugs listed in Schedule G (mostly antihistamines)3 do not need prescription to purchase but require the following mandatory text on the label: “Caution: It is dangerous to take this preparation except under medical supervision”. Currently, non-drug-licensed stores (e.g. nonpharmacists) can sell a few medicines classified as “Household Remedies” listed in Schedule K of the Drugs and Cosmetic Act4 in villages whose population is below 1000 subject to certain other conditions. There are different categories comes under OTC, out of which there are few categories which have spent maximum in brand building through on TV are as follows: 1. Rubs/ Balm - Moov, Iodex, Emami Mentho Plus, Himani Fast Relief, Amrujanjan Joint Ache Cream 2. Analgesic/ Cold Tablet - Dcold, Disprin, Stopache, Crocin. 3. Digestives - Eno, Hajmola, Dabur Hingoli, Pudin Hara. 4. Medicated Skin Treatment - Itch Guard, Krack, Ring guard. 5. Cough Lozenges - Strepsils, Halls 6. Vitamin/ Tonic/ Heath Supplements - Horlicks, Chawanprash– Dabur, Complan, Boost, Sona Chandi, Calcium Sandoz. 7. Antiseptic Cream/ Liquids - Borosoft, Boroplus, Dettol. ϯ Antihistamines are mainly used to help control symptoms caused by health conditions associated with allergic reactions. ϰ An Act to regulate the import, manufacture, distribution and sale of drugs. -5 1.2.2 Ayurvedic Medicines: - OTC drugs registered as ‘Ayurvedic Medicines’ (i.e. traditional Indian system of medicines containing natural/herbal ingredients) are also regulated by the DCA and DCR. Ayurvedic drugs are manufactured under a manufacturing license issued by the Ayurvedic State Licensing Authorities. However, they do not require a drug sale license and can be sold freely by non-chemists. Some of the largest OTC brands in India are registered as ‘Ayurvedic Medicines’ because of their plant-based natural active ingredients (e.g. Vicks Vapo Rub, Amrutanjan Pain Balm, Zandu Pain Balm, Iodex Pain Balm, Moov Pain Cream, Itch Guard Cream, Eno Fruit Salt antacid, Vicks Cough Drops, Halls Lozenges, Dabur Pudina Hara, Calcium Sandoz etc.). Considering the above framework, key categories with OTC potential in India would be: vitamins and minerals, health tonics, cough and cold, gastrointestinal, analgesics, dermatological, herbal/ayurvedic medicines, among others, which do not contain any substance listed in Schedules G, H or X. There is also a provision under schedule G and H which exempts Topical or external use (except ophthalmic and ear/nose preparations containing antibiotics and / or steroids) applications of the ingredients from these schedules. For Example: while Diclofenac5 is listed in Schedule H but Topical form of the same is excluded. Some of the vitamin supplements come under price control, which can be addressed by making dosage/formulation combination modification. Some of the non-scheduled drugs like Aspirin also come under price control, through Drug Price Control Order (DPCO). Additionally, there is also The Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954 and Rules, 1955. This Act controls the advertisements for certain category of drugs with a view to prevent people from self medication under the influence of misleading and exaggerated advertisements. ϱ drug used to treat pain and inflammation. -6 1.3 Drug Promotion and Drug Advertising in India: - Drug promotion in India or elsewhere has always attracted controversies as it is inherently unethical. (Thawani. V 2002). Unlike other commodities where consumers are choosers, prescription practices in the drugs category is driven by drug promotion. The very nature of prescription drugs market is ethically driven hence it is also called as the “ethical drug” market. In 1998, the World Health Organization (WHO), in an attempt to support and encourage the improvement of health care through the rational use of drugs and to curb unethical marketing practices, came out with a landmark “Ethical criteria for medicinal drug promotion”. It is an outline document which defines drug promotion as “as informative and persuasive activity by manufacturers and distributors in order to induce the prescription, supply, purchase and/or use of medicinal drugs”. However, as per the WHO this criterion does not constitute legal obligations; governments may adopt legislation or other measures based on them as they seem fit. It also advises that other groups may adopt self-regulatory measures based on them. Drug promotion also includes the activities of medical representatives, drug advertisements to physicians, provision of gifts and samples, drug package inserts, direct-to-consumer advertisements, periodicals, telemarketing, holding of conferences, symposiums and scientific meetings, sponsoring of medical education and conduct of promotional trials. It is well understood that the pharmaceutical companies do have trade interests in promoting their products for disseminating information about the drug it produces, but it should do so in a fair, accurate, and ethical manner. The blurring boundaries of what constitutes fair practices are of intense debate in issues involving drugs promotion. Many studies have noted that drug companies are involved extensively in promoting their brands by paying huge kickbacks and the relationship between actors in the distribution network is almost -7 always based on perverse set of incentives (Angell M. 2005). Studies have also identified the variety of ways and means in which the drug industry influences doctors and the doctor’s in turn due to their fiduciary position are susceptible to perverse incentives. In the year 2008, the pharmaceutical industry in India spent a total of Rs 4941.15 crore, in which advertising expenses were 823.57 crore and drug marketing 2470.44 crore.6 The Indian Medical Council Act 1956, and the Code of Medical Ethics 2002, governs the conduct of physicians in India. There are voluntary resolutions of various industry associations providing necessary guidance on drug promotion, but they have not been effective. In fact, there seems to be no logical reason that the voluntary codes which aim at restricting or regulating drug promotion is in direct conflict with the interests of drug industry. In totality, all measures currently available under law have largely remained ineffective to deal with the collusion crises in the prescription drug markets. An editorial in one of India’s reputed medical journal quotes that “The International Federation of Pharmaceutical Manufacturer's Association which had first suggested a self regulatory code of pharmaceutical marketing practices in 1981 adopted the revised version in 1994”. There seems to be obvious double standards in adoption of the code. While in the developed countries, these firms often publish reasonably ethical advertisements which are published in medical journals, the very same companies promote the same drug for different indications in developing countries. Advertising, as distinct from promotion is generally used as a direct measure to popularise a particular drug or a remedy. It is governed by the Drugs and Magic Remedies Act.7 6 Source www.cci.gov.in. An Act to control the advertisement of drugs in certain cases, to prohibit the advertisement for certain purposes of remedies alleged to possess magic qualities and to provide for matters connected therewith. 7 -8 The Drugs Enquiry Committee, 19308 under the chairmanship of Sir R. N. Chopra was the first authoritative attempt by the Government to look which scrutinized the pamphlets of drugs which made spurious claims. However, not much has been achieved since then except the introduction of the Drugs and Cosmetics Act, 1955 has “largely remained unenforced due to the apathy and general disinterest of the health care fraternity and the industry refuses to be cowed down by legislative enforcements” (Thawani.V. 2002). For example: Hamdard Dawa khana filed a writ to the Supreme Court of India asking it to declare the direction for recalling 40 drugs as bad in law as basically violating their right to free speech and right to carry on trade and business. It is well recognized that in case of prescription of a drug- where the doctor is decision maker for the ultimate user the patient, the industry has a powerful influence on prescribing habits (Lancet 1993). The industry is often blamed for its marketing practices, which has been considerable covered and discussed in western literature (Angell.M. 2005). It is noted that while doctors uniformly deny that their understanding of drug is influenced by the activities of industry, there is considerable evidence to support the efficacy of the personal encounter with a medical representative in shaping doctors' attitude towards drugs (Bhat.AD 1992). There is an essential difference between promotion and information. While delivering information to the doctors about new drugs, including its usefulness and efficacy may have precompetitive effects, marketing strategies adopted by firms may downplay the demand side and hence raise prices for consumers. How doctor decides which drug is to be prescribed to his patients is at the heart of controversy. Popular news reports and mapping of recent incidence of collusion between the profit-oriented pharmaceutical 8 A committee which scrutinized the pamphlets of drugs which made spurious claims. -9 companies, pharmacists and doctors, it is noted that these actors are routinely wooed with gifts ranging from mobile phones to sponsored weddings and sometimes postpaid mobile connections are also provided. Interviews conducted during the course of this study reveal that it extends from sponsored conferences in five-stars to high-value gifts like motorcycles and. There are even cases where pharma companies helped doctors to set up small nursing homes. However, there is no concrete evidence to point specific people, institutions or companies, since these interviews were held in confidence. A list of three collected news items published in the Times of India on drug promotion does portray various facets of drug promotion in India. Such incidences have long been noted in the medical fraternity, but have rarely been thoroughly investigated. In this study, based on earlier studies and reports, investigate such practices from a horizontal and vertical agreement point of view. This is despite the fact that inappropriate prescriptions could lead to dangerous side effects, medical complications and needless expenses for patients. It has also been noted that medical associations have allegedly warned pharmaceutical companies, that they you don’t sponsor our conference they will boycott your drugs. Some experts and commentators are also of the view that breakthrough drugs that enter the market early are promoted through scientific information.Some interviews also reveal that drug companies sponsor weddings and birthdays of doctor’s kith and kin. Medical representatives are under constant pressure to push for higher sales they reason why they resort to providing perverse set of incentives to the doctors. The sales driven motivations for MRs warrant that MRs resort to activities that can call ethics of promotion into question. Studies have indicated that promotional materials provided by pharmaceutical companies through their representative cannot be entirely relied upon. Source of primary literature on drug promotion are articles published in peer reviewed - 10 journals, secondary literature includes abstracts of various types of published literature, reference from text books and other standard literature. Commentators point that few physicians are equipped with skills to critically evaluate and appraise it. It is noted that lack of proper methodological understanding among physicians to evaluate these drugs is the prime reason for them being swayed away with arguments presented in promotional literature. It is suggested that physicians must see if a new drug is relevant to their practice in terms of population studied, the disease and the need for new treatment (Shetty VV et.al., 2008). These are the following method of pharmaceutical advertising1.3.1 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. 1.3.2 Advertising the Products in Medical Journal: - Journal advertisements attract attention because they are visually appealing also see them as a way of keeping medical practicenor 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. - 11 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. ¾ Name(s) of the active ingredient(s) using either International Nonproprietary Name (INN) ¾ (INN) or the approved generic name of the medicine ¾ Brand name ¾ Content of active ingredient(s) per dosage form or regimen ¾ Name of other ingredients known to cause problems ¾ Approved therapeutic uses ¾ Dosage form or regimen ¾ Side effects and major adverse medicine reactions ¾ Precautions, contraindications and warnings ¾ Major interactions ¾ Name and address of manufacturer or distributor ¾ Reference to scientific literature as appropriate - 12 1.3.3 Direct mailing of publicity material to doctors:- It is the sending of publicity 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 and it may be discussed in chapter 4. 1.3.4 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. 1.3.5 Electronic or Broadcast Media Advertising :- Electronic or broadcast media 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. The following OTC medicines advertising can be seen: • Digestives • Antacids - 13 • Antiflatulents • Cold rubs and analgesic balms/creams • Vitamins/tonics/health supplements (especially herbals and ayurvedic registered) • Medicated skin treatment • Analgesic/cold tablets • Antiseptic creams/liquids • Glucose powders • Cough syrups • Throat lozenges • Medicated dressings (Band-Aids) • Baby gripe water • Ayurvedic medicines and preparations 1.3.6 Outdoor Media: - This includes posters, neon signs, transit, point of purchase (POP), etc. Outdoor advertising can be a good supporting media to other forms of advertising. It is a good form of reminder advertising, especially, the POP advertising. 1.3.7 Other Media: - This includes direct mail, handbills, calendars, diaries, cinema advertising and internet and so on. These miscellaneous media can play an important supporting role to the major media such as television, and newspapers. 1.4 Pharmaceutical Advertisement for OTC medicine or Direct Consumer advertising: - Prescription drugs are the drugs which are required to be dispensed - 14 under the supervision of a physician. On the other hand, over the counter drugs can be sold directly to the consumers/patients without any doctor's prescription. The traditional pharmaceutical media for exposing and raising the product message of prescription drugs are professional journals, magazines or newspapers, direct mail, convention or hospital displays and service items such as educational films, medical illustrations and photographs, office supplies, text books, and exhibitions etc. Pharmaceutical Advertisement for Direct Consumer normally done by Print Media Advertising. The print media consists of newspapers, magazines, journals, handbills, etc. No newspaper or journal today can survive without advertising revenue. Print media advertising, even today, is the most popular form; and revenue Derived by mass media from advertising has, therefore, been progressively increasing year after year. Print media appeals only to the sense of sight, i.e. eyes. Printed advertisements have the advantage of being directly in front of the consumer who elects to read them. By reading an advertisement the consumers becomes better informed and are more likely to follow-up on the product. In addition, print media has the advantage of being tangible to consumers who can carry the medium with them or follow-up with it on the web. 1.5 Strategies for New and Switched OTC Pharmaceutical Products:- OTC marketing 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 - 15 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. On the 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 expenses once the brand faces direct competition from revital and redirecting the savings - 16 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. - 17 iii) Innovation strategy sort 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 revital requires different skills to their traditional business and that it is difficult to be a strong player in both business models. - 18 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. 1.5.1 Invest in generics: - Pharmaceutical companies can try to fight at both ends of the market by introducing their own generic. This will reduce the profitability of generic9 makers and may discourage them from entering the category. On the other hand, pharmaceutical companies have realized that producing and marketing generics requires different skills to their traditional business and that it is difficult to be a strong player in both business models. Finally it is inevitable that the competition from generics will erode the profitability of the original brand and pharmaceutical companies should not put up a fight and the continuous investments in brand building, coupled with price cuts and at the end consumers, marketers both are happy. 1.5.2 Pharmaceutical Companies Business Strategies for Prescription Drugs: One of the constants of pharmaceutical company strategy over the past decade has been increasing scale. Only by growing larger are companies able to afford the considerable costs of drug development and distribution. Within this broad approach at least two business models are discernable: (i) Super Core Model involving the search for, and distribution of a small number of drugs from Chronic Therapy Area that achieve substantial global sales. The success of this model depends on achieving large returns from a ϵ Generic drugs are marketed under a non-proprietary or approved name rather than a proprietary or brand name. - 19 small number of drugs in order to pay for the high cost of the drug discovery and development process for a large number of patients. Total revenues are highly dependent on sales from a small number of drugs (ii) Core Model in which a larger number of drugs from Acute Therapy Area are marketed to big diversified markets. The advantage of this model is that its success is not Dependant on sales of a small number of drugs. 1.5.2.1 Marketing approaches of Super Core Model: - In pharmaceutical market there 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 Sun Pharma, Dr. Reddy Laboratories and Dabur Pharma 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 10 Source S.K.Saxsena “A review of marketing strategies work by different pharmaceutical companies” - 20 prescribe drugs and thus increase sales. In this model medical representatives are the key 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 1.1. 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 11 Oncology is a branch of medicine that deals with tumours. - 21 Pharmaceutical marketing is a specialized field where medical representatives form the backbone of entire marketing effort. Moreover field force should have good product knowledge of their products over other so as to convince doctors and PULL the demand for their products i.e. from Doctor to Retailer to Stockiest to C&FA to company. 1.5.2.2 Marketing approaches of Core Model:-Pharmaceutical companies appoint one company depot or C&FA usually in each state and authorized stockiest(s) in each district across the country. Company depot/C&FA send stocks to authorized stockiest as per the requirement and then retail chemists buy medicines on daily or weekly basis from authorized stockiest as per demand. Patients visit chemists for buying medicines either prescribed by a doctor, advertised in the media or through any other channel. Here patient is end customer and doctor is direct customer for any pharmaceutical company but from the doctor’s point of view who acts as a direct customer, he wants an effective supply chain management for prescribed company. In present scenario companies are focusing more and more on the availability of products so as to enjoy good image at the customer’s (doctors) workplace. Many companies such as Glaxo, Pfizer, Dabur, FDC, Aventis and Cipla etc. are known for their availability of products. For marketing of these types of products companies require more and more field force to remind their products on daily basis to their direct customer (doctor). Moreover field force should have good knowledge of product schemes and offers. Also field force is required to have a good rapport with retailers. Field force also required to ensure good availability of their products to convince doctors and PUSH their products i.e. from to stockiest to doctor via retailer and it is shown in fig 1.2. It has also been observed that sometimes there are more than fifteen or sixteen representatives in a day are meeting with their customer and - 22 requesting for same type of products. Although field force visits are important for an update on drugs and their usage to the customers. The doctors are, in general, sneaking away, trying to hide from sales representatives, since there are too many and they are too pushy and there is very little time, and the representatives probably have noticed that the reluctant doctors have always less time for short meetings and less interest and tend to reduce the time of the visit. CORE CUSTOMER (Doctor) END- CUSTOMER (Patients) CORE CUSTOMER (Retailers) CORE CUSTOMER (Stockiest) CUSTOMER (C & FA) Fig 1.2 Push System Working In Acute 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 - 23 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 Medical Representative Stockiest Chemist Patient Doctor Source: SK Saxsena (Supply chain of Indian Pharmaceutical Industry) Fig. 1.3 Relationship between the key players of pharmaceutical industry 1.6 Pharmaceutical marketing process and challenges: - Sometimes called medico marketing or pharma marketing in some countries, is the business of advertising or otherwise promoting the sale of pharmaceuticals or drugs. In the - 24 pharmaceutical and healthcare industries, a complex web of decision-makers determines the nature of the transaction (prescription) for which direct customer of pharma industry (doctor) is responsible. Essentially, the end-user (patient) consumes a product and pays the cost. Use of medical representatives for marketing products to physicians and to exert some influence over others in the hierarchy of decision makers has been a time-tested tradition. 1.7 Growth Rate of OTC Medicines: - India currently ranks 11th in the global OTC market size. It is estimated that it will reach 9th position within five years. Currently the Indian OTC market (including frank OTC medicines which are advertised and deemed OTC brands, and ones that are non - advertised or Rx marketed but with large OTC sales component) is estimated to represent approximately USD 1,813 million (euro 1362 million) with an annual growth rate of 10.7 percent at the end of calendar year 2009.12 Source: IMS Health market prognosis, March 2010 Fig.1. 4 Showing the growth of Indian OTC sales in US $ from 2006-07 to 20092010 12 Source Pharma Times 2011 - 25 Source: PWC report on Indian pharma 2013 Fig1. 5 showing the segment wise Indian OTC market percentage in 2013 Table 1.1 Showing top ten Indian OTC brands as per their sales and growth13 Top 10 Indian OTC brands 2008 S.no Leading brands (Sales $Million) India 10.7 75.8 84.5 11.5 2 Vicks 72.4 81.9 13.1 29 32.9 13.4 4 Revital 25.4 30.7 20.7 5 Zandu Balm 28.4 30.5 7.6 6 Dettol 23.7 26.4 11.2 7 Liv.52 25 25.8 3.4 8 Becosules 22.7 24.9 10.1 9 Hajmola 20.2 21.2 4.9 17.6 20.7 18.2 10 Iodex Source : Nicholas Halls DB6 2010 - 26 1638.9 1813.4 Growth'09/08 1 Dabur Chyawanprash 3 Boroplus 13 2009 Source: Pharma Outlook 2012 Fig. 1.6 showing the percentage of OTC and prescription drugs used by Indians 1.8 Branding in Pharmaceutical Marketing:- Branding is a key issue in the pharmaceutical 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 - 27 success formula was simple: discover a drug that was needed, introduce it to the doctor via a medical representative, and watch the prescriptions get filled. What is more, the products themselves, secured under a decade of patented protection, were almost guaranteed to generate large profits. Integrated brand strategies were unheard of and unimportant. Pharmaceutical branding is an important way of creating awareness among the public to the potential benefits of drugs and medicines. The marketing process and branding give the public ready knowledge of what the product is about and thereby induces them to buy that particular product from among many other similar products in the market. Marketing teams are spending more and more resources on getting the name of the pharmaceutical product right. However naming a drug or medicine is not the same as naming an electronic consumer product or FMCG product careful thought and consideration to all important factors is required for a pharmaceutical product. If the product is going to be sold internationally then the name should not be wrong when translated into the local languages. 1.9 Understanding Consumer Behavior:- The term consumer behaviour is defined as the behaviour 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 behaviour 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. - 28 Thus a marketer has to take into account various factors while deciding on marketing a product as consumers have different preferences and some times totally diverse preferences. So the task of manufacture and marketer becomes onerous and therefore it is very important to understand the consumer behaviour. Understanding consumer behaviour 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. 1.10 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 marketer and this consumption and purchase mechanism/behavior is shown in fig 1.7 and the cause of purchase behavior and impact of advertisement will be discussed in chapter 4. Medical Practioner Influence Feed back Feed back Salesman Buys from Consumer Sells to Distributor Sells to Whole seller The Distribution Chain Fig 1.7 The Distribution Chain - 29 - Influence Buys from Retailer 1.11 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 are and who are willing to try new offerings. 2. Gold tier: - They are also heavy users but are more prices sensitive. They ask for more discounts, free samples etc. and are likely to prescribe several brands. 3. Iron tier: - It consists of customers who are spending volumes; profitability and prescribing pattern do not merit special treatment from the company. 4. Lead tier: - It consists of customers who actually cost the company money because they claim more attention then 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 as described in fig 1.8 along with the percentage. The first tier, platinum tier can be compaired 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. - 30 (Source: Consumer Behaviour in Pharmaceutical Marketing) Fig 1.8 New Product Adoption Process 1.11.1 Factors Influencing Consumer Behavior The various factors influencing consumer behaviour are: 1. Cultural factors 2. Social factors 3. Personal factors 4. Psychological factors 5. Psychographic factors 1.11.1.1 Cultural Factors: - Culture is the fundamental determinant of a persons want and behaviour. Companies often design specialized marketing programs to serve each subculture. This programme is called diversity marketing. The effect of culture upon a consumer’s behaviour is considerable, and culture is a factor which has the greatest influence (Kotler 2003). Culture creates the foundation of the individual’s values, opinions and behaviour, 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 - 31 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. (Kotler 2003). Consumers are more prone to accept products that are in line with the values, preferences, customs and norms of their culture. Nonethe-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 behaviour and these social classes display the hierarchy of society, and are characterized by a set of factors (Solomon et.al. 2006). 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. Indians are much more oriented towards ayurvedic or herbal medicines. It is in the Indian culture to use Neem, Tulsi and Haldi etc. So, it's much easier to position non allopathic drugs in India because of its cultural set up. 1.11.1.2 Social Factors: - A consumers buying behaviour is also affected by the people around. Family is a strong entity that has an influence on buying behaviour. This includes both the parents, as well as the spouse/husband and kids with - 32 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 behaviour 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. (Kotler et.al., 2005). The social factors which influence consumer behaviour are: i. Reference group ii. Family iii. Social status and role 1.11.1.2.1 Reference group: - A reference group consists of all the groups that have a direct (face to face) or indirect influence on the person's attitudes or behaviour. 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 (should be discussed in chapter 4). A marketer should know how to reach and influence these opinion leaders in order to influence consumer purchase - 33 behaviour. 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. 1.11.1.2.2 Family: - Family is an important determinant of social factor. If there is 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. 1.11.1.2.3 Social status and role: - The person’s position is defined in terms of role 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. 1.11.1.3 Personal Factors: - Consumers can furthermore be segmented according to their personal characteristics and personality type that shape their consumer behaviour. 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 behaviour due to these characteristic. Not only are personality and personal traits affecting the consumer’s behaviour but also the consumer’s self-concept. The selfconcept stands for the way the consumer does see himself and the way he evaluates - 34 his own attributes. The self concept is related to the buying behaviour 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 behaviour. 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 behaviour 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 (Solomon et.al 2006) and the level of influence will be discussed in coming chapters. The various personal factors which influence consumer behavior are: i. Age and stage in the life cycle ii. Occupation and economic circumstances iii. Life Style iv. Personality and self concept - 35 1.11.1.3.1 Age and stage in life cycle: - The choice of product and brand differs with age. With the increase in age and experience of physicians, their prescribing behaviour 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. 1.11.1.3.2 Personality and self concept: - Personality is the individual characteristic 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 companies 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. 1.11.1.4 Psychological Factors: - Motivation can be used to describe one’s behaviour 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 (Solomon 2006). In accordance to a - 36 theory outlined by Sigmund Freud14, 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 symbolised in an acceptable product (Solomon et.al.,1999). Abraham Maslow15 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 (Kotler et.al., 2005). With the help of the five senses; taste, smell, sight, touch and hearing, consumers interpret 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 behaviour does as well. Consumers are drawn to prod-ucts 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 (Solomon 2006). The major physiological factors are: i. Motivation ii. Perception iii. Learning iv. Beliefs v. Attitudes 14 Sigmund Freud was an Austrian neurologist, now known as the father of psychoanalysis. Abraham Harold Maslow was an American psychologist who was best known for creating Maslow's hierarchy of needs. 15 - 37 1.11.1.4.1 Motivation: - A motive is an internal emerging force that orients a person'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 Bristol Meyers Squibb16 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. 1.11.1.4.2 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. 1.11.1.4.3 Learning: - Learning involves changes in an individual's behaviour arising 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 16 Bristol - Meyers Squibb is an American pharmaceutical company - 38 their product. Some of the physicians who are techno-savy are also attracted by the medical representatives as they use e-Detailing17 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. 1.11.1.4.4 Belief and Attitude: - A belief is a descriptive thought that a person holds 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. 1.11.1.5 Psychographic Factor:- It is much more important to know what sort of patient has a disease. This is the kind of thinking a marketer needs to have while dealing with psychographic behavior of the consumer (Psychography is the science of using psychology and demographics to better understand consumer behaviour). Here marketers believe that positioning occurs not in the market place, but in the 17 e-Detailing use of electronic, interactive media to facilitate sales presentations to physicians - 39 customer's mind. Psychographic studies are mainly based on VALS (Value, Attitudes and Life Style survey). This VALS consists of eight segments: Primary Motivation Ideals Achievements Self expression Innovation High Thinkers Achievers Expressions Innovators Low Believers Strivers Makers Survivors This is done basically to break the market into meaningful places. Internally homogenous but externally heterogeneous. For Example: Johnson and Johnson has used psychographics to position its OTC analgesics, Mortin (for aggressive dedicators) and Tylenol18 (for cautious ones). 1.12 Buying Preferences of Indian consumer:- A promo survey conducted by Brand Equity has revealed the consumer buying behaviour of the Indian consumer. It is observed in the survey that majority of Indian consumers does shopping not because of the product but the purchase of a specific product offers them a chance to win great gifts. This survey was particularly carried out to find out the demand of particular brands, analyzing buying behavior, reasons that drive brand loyalty, preferences for promotion tools, participation mode and prizes. Although this kind of survey may be hard to find in Indian context for the doctors while prescribing a product, it can be fairly assumed that while prescribing a particular brand doctors are likely to prefer those brands that offers them tangible and intangible benefits attached 18 Tylenol is a pain reliever and a fever reducer used to treat many conditions such as headache, muscle aches etc. - 40 to the brand. Tangible benefits are gifts, samples, participation in CME (Continuing Medical Education) or conferences etc. where as intangible benefits include patient compliance, duration of therapy (generally duration of therapy should be short) effectiveness of the product, company image etc. A specific survey of this kind would throw the light on the prescription of doctor in India. 1.13 Brand or Generic: - This is the biggest doubt a physician has in his mind when he has to prescribe a medicine. The choice between a brand and a generic is always a difficult one. Generally marketers believe that there are two factors which motivate the doctor to prescribe brand or generic drug: 1. Physicians evaluate the relative efficacy of brand name drugs and their generic substitutes and prescribe the brand name drugs when they are associated with therapeutic gains and outweigh their relatively higher cost to patient. 2. Physicians tend to prescribe branded drugs, even without evidence of their therapeutic superiority, because neither they nor their insured patients bear these drugs increased cost with respect to generic substitutes. If this hypothesis is true (should be discussed in chapter 3), moral hazard is evident in physicians prescribing behavior because they are little or no incentive to internalize the drug costs. 1.14 Promotional Spending for Prescription Drug: - Pharmaceutical company’s efforts to promote prescription drugs have attracted the attention of policymakers because such activities may affect the rate at which different drugs are prescribed and consumed, the total amount spent on health care and what ultimately are the health outcomes. Those promotional activities usually undertaken on behalf of brand-name, rather than generic, drugs may influence consumers and health care professionals - 41 through a variety of channels. For example, advertisements for prescription drugs that are aimed at consumers may prompt individuals to seek medical treatment they might otherwise have delayed. Such advertisements may also influence individuals to request a specific drug that is higher or lower in price or that is more or less effective than one they had previously used. Promotional efforts aimed at physicians may help them keep abreast of the latest drug therapies and improve their ability to treat patients. Those efforts may also lead doctors to prescribe brand-name medications that are more expensive than alternatives. The way that pharmaceutical manufacturers promote prescription drugs has changed significantly in the past decade. Until the late 1990s, pharmaceutical manufacturers confined their marketing efforts largely to physicians and other health care providers. In the late 1990s, however, drugmakers began marketing directly to consumers a practice known as direct-to-consumer (DTC) advertising. The Food and Drug Administration (FDA) issued draft regulatory guidance in 1997 (which was finalized two years later) that clarified the agency’s expectations about the way information in DTC advertisements should be presented in the broadcast media. Since then, the manufacturers of many prescription drugs have increased their purchases of air time on television and of advertising space in newspapers and magazines in an effort to make consumers aware of their products and to encourage them to visit their doctors to request a prescription. In 2008, spending on DTC advertising totaled $4.7 billion, nearly one-fourth of pharmaceutical manufacturers’ expenditures for all promotional activities. Those developments may be having an impact on the functioning, cost, and effectiveness of the nation’s health care system. 1.15 Marketing to Physicians and Consumers :- Drug companies use advertising and promotions in much the same way that producers of other goods do to inform - 42 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 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-toconsumer 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 - 43 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 person and online, including some that offer physicians credit for continuing medical education. 1.16 Different Marketing Strategies for Different Drugs:- Pharmaceutical manufacturers 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. 1.17 Market Characteristics That Influence Promotional Strategies :- A pharmaceutical 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 - 44 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. (Sleath et.al., 2001) centered around the doctors as an important source of communication for consumers. (Ganther et.al., 2001) found that older segments have greater faith in doctors and are less skeptical towards 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 (Liu 1995). 1.18 The purchasing process: - The consumer evaluates different alternatives that are available 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 - 45 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 behaviour 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 behaviour 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 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 behaviour 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 - 46 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). 1.19 The Role of the Consumer (Patient):- Physicians have traditionally treated patients 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. 1.20 The Prescription Decision: - Given that many diseases are chronic in nature, the assumption 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 (Fraenkel et.al., 2004). An open area of research therefore is the development and testing of models that incorporate the utilities of both - 47 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 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). 1.21 Compliance or Post – Purchase Behaviour: - Consumer post-purchase behaviour is an important determinant of product usage, satisfaction and repeat purchase behavior. For patients, non-compliance leads to medical complications (Loden and Schooler, 2000) and increased health-care costs (Johnson and Bootman, 1995). For pharmaceutical firms, lost sales, driven by brand switching and negative word of mouth that result from perceived product failure, are estimated at $ 15–20 billion annually (Beavers, 1999). Poor compliance also leads to lower customer retention, resulting in lowered prescription revenue for pharmacy retailers (Huffman and Jackson, 1995 & Jackson et.al., 1996). Given this, it is not surprising that the compliance problem has been called the holy grail of pharmaceutical marketing (Van Der Pool, 2003). The medical literature has identified hundreds of social, economic, medical and behavioral factors associated with poor compliance. The important ones are the severity of the condition, salience of the condition, price and misconceptions and misguided expectations from the therapy (Fincham and Wertheimer, 1985). A surprising conclusion from a multitude of studies is that demographic variables are - 48 very poor predictors of compliance when condition specific effects are controlled for (Sabate, 2003). In terms of the role of marketing on compliance (Bowman et.al., 2003) study the determinants of compliance behavior using a unique set of patient diaries. Using a comprehensive set of covariates and a linear latent class model, they find a number of compliance drivers that are consistent with the medical literature and marketing constructs. Their finding that an upcoming physician visit increases compliance is particularly robust. With respect to advertising, they find that different market segments of patients have varied responses (sometimes negative) which they attribute to inflated expectations set by ads. (Wosinska 2005) uses a large patient panel to test whether the number of missed therapy-days decreases with the level of DTC advertising expenditure. She finds a positive effect of DTC advertising on compliance for patients taking the competitor brand and a negative effect on compliance for the advertised brand. While this is surprising, the economic significance of both these effects is very small. She hypothesizes that the negative effect is due to the advertising providing information not only about the benefits, but also about the drug’s associated risks. 1.22 The Role of Price: - The increased expenditure for drug promotion will affect the price 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 omeprazole19, a proton pump inhibitor20, 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 19 Omeprazole is used to treat gastro esophageal reflux disease (GERD) and other conditions caused by excess stomach acid 20 Proton-pump inhibitors (PPIs) are a group of drugs whose main action is a pronounced and longlasting reduction of gastric acid production - 49 on prescription behavior? There are no recently published studies that have addressed the factors that influence the prescription behavior of physicians in India. This study also aims to identify the factors that influence the prescription behavior of physicians. 1.23 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 - 50 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 advertisement and further recommendations. - 51 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. Ravindra Goyal and Pranav Pareek (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 Azmi Hassali, Mohamed Izham and Mohamed Ibrahim (2013):- A study on “Physicians’ perceptions of medical - 52 representative visits in Yemen: a qualitative study”. This paper concluded 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. 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 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 - 53 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 has undergone 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 - 54 a presence on Face book. These pharmaceutical companies have been cautious in the use of 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 medicinerelated questions. The results confirmed that Australian consumers were exposed to DTCA of prescription medicines on the Internet. Although Australia is a DTCArestricted country, consumers are not exempt from exposure to advertising of pharmaceutical products, including prescription medicines, on the Internet. 10. Montoya Ricardo, Oded Netzer, and Kamel Jedidi (2010) - Another study on “Dynamic Allocation of Pharmaceutical Detailing and Sampling for Long-Term - 55 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 nonadvertised 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 fastgrowing part of this picture. The credibility that users have been attributing to Internet 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 - 56 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 - 57 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 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. - 58 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”. This paper 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. 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. Anantharaman Radhika, Parthan Anju 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 - 59 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, Rahman Azari, 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" - 60 .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 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 - 61 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 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 - 62 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 - 63 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. 34. 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. 35. 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 regulationthat 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. 36. Irfan Sharfoddin Inamdar and Dr. Malhar Jayant Kolhatkar (2001): This study on" Doctor’s expectations from pharmaceutical products (medicine) which will influence their prescription behavior". This study focuses on finding the need of - 64 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. 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. 39. 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 - 65 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. - 66 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. - 67 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. 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. 48. 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 - 68 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 - 69 expertise positively affected physician attitudes (especially trust and satisfaction). It also found that the frequency of visits did not significantly affect satisfaction. 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. 54. 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 - 70 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. 56. 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 with OTC drugs, due to extensive advertising by companies. The trend towards self medication is likely to grow towards these products. - 71 CHAPTER- 3 RESEARCH METHODOLOGY 3.1- Need for this research: The broad areas in which research is needed were identified 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? - 72 13. What is the importance of ethical issues while prescribing the drugs? 14. What is the importance of brand in prescription of drugs? 15. What is the importance of frequency of pharmaceutical advertisement? 3.2- Scope of the research:-Advertising plays an important role to aware the general public 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. As far as Uttar Pradesh State is concern it is the largest state in terms of population and growing very fast. If make it a country then it may be sixth largest country in the world in terms of population, so we have a great demographic diversification in Uttar Pradesh. Advertisements reach each place whether it is hill area or plane area in any form whether it may be print, electronic or word of mouth etc. People In Uttar Pradesh speaks different languages, have different cultures and various other practices that’s why every type of advertisement is very effective because of reach ability of the news paper, magazines, television sets and internet facilities. As far as the advertiser concern, it is the duty of the advertiser to make effective advertisement. In Uttar Pradesh, every kind of people is living i.e. Low income, Middle income and higher income people. Here every brand is available whether the product is prescribed or non- prescribed. 3.3-Desk Research:- This was the first step of the research process. The three thrust area of the desk research was. 1- To know about the pharmaceutical advertisement to doctor. 2- The Indian pharmaceutical advertising medium. 3- The market for OTC Drugs like painkillers, ointments, coughs syrups etc. - 73 The details of review of literature on advertising and its impact on consumer behavior have already been given in the previous chapter. The next chapter will contain details about the other thrust areas. 3.4- Pilot Study: - It was decided to conduct a pilot study for the following reasons. 1- To finalize the method of measuring advertising effectiveness (including testing and its validity) this will be used in the main empirical research. 2- To finalize the questionnaires to be used in the main empirical research. 3- To gain familiarity with the field work and the problems that can occur at different stages of the research. At the beginning of the pilot study, a list of tentative hypothesis and information needs was made to ad in the preparation of the questionnaires. After several preparations of the questionnaires given in appendix was finalized. The questionnaires were made only in English. Sampling for the pilot study: - Lucknow District was given as the geographic scope of the pilot study. Lucknow District is our sample area Data Collection for the Pilot Study:- 50 response sheets (of doctor and consumer each) were filled from the Lucknow District. The distribution of urban responses was more or less in proportion to the size of street. The unit for which data was collected the household and Hospitals. Data analysis for the pilot study:- An analysis was to be done on the computer with the help of SPSS software. The data captured in the response sheet was given numeric codes and entered on to coding sheets, to facilities data entry on C.O data was checked and corrected before analysis could begin. The main emphasis was on the - 74 analysis needed for testing the validity of the measurement. Other than that, one way frequencies of the important variables were obtained and only the major hypothesis were tested. After analyzing the data we found some problems undertaking the questionnaires, then we changes according to the research. Main Empirical Research: - Work done for the main empirical research is being discussed below under various sub headings. 3.5-Research design: - 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. 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 3.6-Data collection method: In this research data collected from primary source and as well as secondary source. The secondary data collected from Governing Bodies, magazines, news papers, journals and other published material. Internet also used for collecting secondary information. The primary data collected through questionnaires. - 75 In the questionnaires three kinds of scaling used namely Nominal and Ordinal scale & Interval to know the respondents demographic profile and attitudes towards the advertisement. 3.7-Questionnaires: - Set the work done up to this time provide valuable inputs to designing 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). 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). - 76 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). B-The questionnaire of the Doctor (customer) have following distinct points:1. An introductory paragraph. 2. The identification information. 3. The Demographic variables asked (Q1a to Q1c). 4. The general information asked about the position and consultation (Q1d to Q1h). 5. To know the importance of medium providing information about medicine (Q2a to 2g ). 6. To know the reliability of information provided through different media (Q3a to Q3g). 7. To know the Medical Representatives (MRs) visiting hours (Q4a to Q4b). 8. The importance of promotional items (Q5a to Q5f). 9. To know about prohibiting bodies that influence promotional activities (Q6). 10. To ask about effectiveness of information (Q7a to 7g) 11. To know the information about brand medicine, generic medicine, importance of DCA etc. (Q8 to Q13) 12. To ask about importance of promotional channels (Q14a to Q14 g) 13. To know the importance of celebrities specialized channels, regulatory acts, creativity frequency of advertisement etc. (Q15 to Q21). 3.8 Study Variables:- Variables measured in this study are the cumulative scores for consumer and doctor’s perceptions of both OTC drug advertising & prescription drug - 77 advertising concerning their attitudes, beliefs about the effects of drug advertising and the impact of drug advertising on consumer and doctor, on the selection of drug products by the patients and . The scores were obtained using a series of survey questions to address each of the given objectives. Other variables included the demographic factors such as gender, practice hour, Qualification, number of years of practicing as a doctor; and other miscellaneous factors such as where and how often are OTC drug advertisements seen by the subject, frequency of patient interaction regarding OTC drugs and prescription volume. 3.9 Sample Selection: - The study population consists of doctors & consumers licensed in the hospitals and other place also. SAMPLING DESIGN: - Target populations for the collection of data are residential doctors and some patient in the hospitals during the period of collection of data. The period for the collection data is different for various hospitals. The research has spent on average three days at the single hospital in the process of collecting data from doctors as well as patients. Non probability systematic convenient sampling technique has been used by us for the collection of data on the basis of Age, Gender, Education, Occupation, Marital status, Family monthly income for consumers and qualification, position hold by respondent, no. of practice hours, years of practice place of practice, Out Patient Department (OPD) frequency etc. for doctors. 1. Universe: - The first step in developing any sample design is clearly defining the set of objects to be studied. In this research universe is finite. Geographical region divided on the basis of different location Divisional head quarter of Uttar Pradesh such as, Lucknow, Allahabad and Kanpur districts. Again each divisional - 78 headquarter stratifies on the basis of different location to collect the information. The objective was that each group represents the universe. 2. Sampling unit:-A decision has to be taken concerning a sampling unit before selecting sample. In this research, sample unit stratified on the basis different age group, male and female, different education level, occupation, family monthly income, and marital status of the respondents for consumers and qualification, position hold by respondent, no.of practice hours, years of practice place of practice, o.p.d frequency etc. for doctors. The sample had drawn from the districts of 3 Divisional head quarter namely Lucknow, Allahabad and Kanpur.The reason behind selection of these district as sample unit due to:a) High No. of Hospitals. b) These district having medical college and due to this high number of patients came for cure of the disease. 3. Size of sample: - This refers to the number of items to be selected from the universe to constitute a sample. The total no. of sample size was 200 for doctor and 400 for consumer. 4. Sampling Technique: This study is broadly on sales promotion activities adopted by 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. 3.10 Survey Instrument: - The instrument used for the study is a questionnaire, constructed by the researcher. The questionnaires were constructed to obtain - 79 responses from the target sample group of consumer & doctors about the impact of pharmaceutical advertisement. The questionnaires was made in English The survey consists of two parts. Part-I is comprised of consumers consist of 14 questions. Q.1a to 1g was used to know the demographic variables of the respondents such Age, Gender, Education, Occupation, Marital Status, and Monthly family incomes. Q.2 to 4 was asked to know about advertisement, medium of advertisement and how the advertisement affects the consumer.Q.5 was used to know the medium of advertisement more affective for common use medicines (OTC).Q.6 was used to know by which suggestion consumer will purchase common use medicines Q.7 was used to know the long lasting effect of advertisement. Q.8 was used to know the extent of advertising of various pharmaceutical products create the need for the Product in consumer mind. Q.9 was used to know about new advertisement of pharmaceutical how much consumer pay attention. Q.10 was used to know about product attribute observe in advertisement. Q.11 was used to know influencing factor in selecting medicine for common diseases Q.12 was used to know the extent of advertising influenced in purchasing a particular type of Pharmaceutical product/ medicines. Q.13. was used to know the rely on while making a purchase decision Q.14. was used to know the impact of attributes like Theme of Advertisement, Visual presentation, Strength of Medicines, Dosage form& Role of celebrities. Part II is comprised of doctors consist of 21 questions. Q.1a to 1h was used to know the demographic variables of the respondents such Age, Gender, Education, Occupation, Marital Status, and Monthly family incomes. Q.2a to 2g was used to know the importance of medium providing information about medicine such as Medical representative, medical journals, clinical papers, - 80 Television, internet etc. Q.3a to 3g was used to know the reliability of information provided through different media about medicines such as Medical representative, medical journals, clinical papers, Television, internet etc Q.4 to 4b was used to know the Medical Representatives (MRs) visiting hours and importance of information provided by MRs Q.5a to 5f was used to know the importance of promotional items such as Frees samples, Trips to seminar, lunch and dinner for staff and family. Q.6 is about prohibiting bodies that influence promotional activities. Q.7a to 7g was used to know the effectiveness of information provided through different media such as MRs, Medical Journals, clinical papers, electronic media etc. Q.8 to 13 was used to know the importance of brand, generic medicine in prescription & importance of ethical issues and advertising agency.Q.14a to 14g was used to know the importance of promotional channels used by companies and their long lasting effect on the mind such as Medical representative, medical journals, clinical papers, Television, internet etc.Q.15 to 21 was used to know the importance of celebrities, specialized channels, creativity, frequency etc for drug advertisement. Firstly used Nominal scale especially Dichotomous and Multiple choice questions to categorize the Age, Gender, Education, Occupation, Family monthly income, marital status of the respondents. Second kind of scaling was very important to know the attitude of the respondent i.e. Interval scale especially Likert scales. 3.11 Data collection:- In this section primary data collected through personal interview. The fieldwork carried out in divisional Head Quarter namely Lucknow, Allahabad and Kanpur. The whole Lucknow, Allahabad and Kanpur district stratified on the basis of area sampling. In this regards the territory divided into different location such as Colony, Mohalla, hospitals, clinics and some public place selected to collect the data. Two different booklets of questionnaires were prepared one for - 81 consumer and one for doctor which were given to the respondents and told to him tick the answer of each question. For the purpose of study, questionnaires were got filled in each districts of selected divisions, giving total of 200 questionnaires for doctors, out of these 150 questionnaires were finally retained for analysis while 50 questionnaires were rejected as they were incomplete. Similarly giving total of 400 questionnaires for consumers, out of these 329 questionnaires were finally retained for analysis while 71 questionnaires were rejected as they were incomplete 3.12 Data analysis:- After fieldwork done the raw data converted into coding. The coded data fill in the SPSS sheet. In this research seven demographical variables for consumer and three demographical variables for doctors were taken to find out frequency distribution of each variable. Tabulated data described the number of respondents in a particular categories such the total no. of respondents fall in different slabs. Seven demographical variable of consumers and three demographic variables were converted into tabulation. Both the demographical variables compare with the other question relating to attitude of the respondents to find out the cross-tabulation. The cross-tabulation showed the relationship of one variable to another. Before data could be analyzed it was checked thoroughly not only was the print out of the data file checked manually, range cheeks and logical checks were also applied on the data. Data was analyzed with the help of SPSS package. The test of hypothesis that was used throughout the Chi -square test. Through the Chi-square test Null-Hypothesis checked whether the Null- Hypothesis accept or reject. The formula for Chi- Square is Chi-Square = (Oi-Ei) x (Oi-Ei) / Ei Where Oi = The observed frequency. Of cases in the ith category. - 82 Ei =The expected no. of cases in the ith. K = The no. of categories. For a 2 x2 contingency of table the modified formula of Chi -Square was used. [N (AD-BC)-N\2] x [N (AD-BC)-N\2] Chi- square = -------------------------------------------------(A+B) (C+D) (A+C) (B+D) Where N= Total Sample size. A= Number of in the upper row left cell. B= Number in the Upper row right cell. C= Number in the lower row left cell. D= Number in the lower row right cell. D.F. = Degree of freedom, calculated as (r-1) (c-1). Whenever the result was significant and the contingency table was bigger then 2x2 the difference between the groups, on the measured variable, was located by partitioning the contingency table into 2x2 sub tables and analyzing each of them. The table may be partitioned into as many 2x2 sub tables as there are degree of freedom in the original table. The method of constructing the tables in such that each table is collapsed to form the next table. The two rows of the preceding table are combined to form the first row of the succeeding table and if need be, the two columns of the preceding table are combined to from the first columns of succeeding table. It is the discretion to the research to arrange/rearrange the original table so that the collapsing - 83 combining of categories makes sense. The row and column totals of these sub tables are the row and columns totals of the entire sample, not just of the particular sub table. This reflects the fact that these are sub tables obtained from a larger sample. The formula for x2 of these sub tables also reflects this fact. The Null- Hypothesis checked with 5% significant level. Before calculating the Null- Hypothesis degree of freedom found from the table. With the help of SPSS package it automatically calculated. The chi-square value compare with Critical value. In this case when calculated value less than the critical value then Null –hypothesis accept otherwise reject. 3.13 BRIEF SUMMARY OF TOOLS USED FOR ANALYSIS 1. Descriptive Statistics: - Researcher has used the descriptive techniques for the profiling of data. Profiling of the data is essential for the scientific study and for ensuring that we have all relevant data for making completed comparison and analysis. 2. Factor Analysis: - However, although factor analysis is probably most famous for being adopted by psychologists, its use is by no means restricted to measuring dimensions of personality. Many of the other researchers use this technique for the purpose of knowing which are the primarily factors which affect the particular activity. So the factor analysis technique is used by us to find the prominent factors which are affecting the behavior of the doctors for the recommendation of particular brand of medicine and also try to find the factors which influence patient to buy the particular medicine which are coming under the category of OTC drugs. 3. ANOVA Test:- ANOVA is applied on the data to check whether difference exists in impact of advertisement perceived by various educations and regional status of practice of doctors among all the dimensions. 4. Data analysis Software: SPSS software 20 is used for the analysis of the data - 84 3.14 Objective of the Study: Because the research indicates that billions of dollars are wasted on crafting drug advertisements. The research objective is to measure the effect of pharmaceutical company’s promotional activities on the physicians prescribing behavior in one side and also wanted to measure the effect of advertisement on consumer buying behavior and identify the most effective promotional mix. Promotional tools used by pharmaceutical companies will be tested and by the end of the thesis, we should be able to identify which promotional tools are more effective & influencing physicians prescribing behavior and consumers buying behavior. The objective of the research can be framed in points given below: 1. To study the effective promotional tools to be used by pharmaceutical companies in obtaining prescriptions from the physicians. 2. To study which are the most effective promotional tools to be used by pharmaceutical companies in influencing the doctor prescription behavior. 3. To assess the consumer attention about different medium of pharmaceutical advertisement. 4. To study the impact of detailing (advertisement through medical representative) on the physicians prescribing behavior. 5. To study the impact of Scientific/Educational promotional tools on the physicians prescribing behavior. 6. To study the impact of advertisement through electronic media and print media on consumers buying behavior. 7. To examine the more effective medium of advertisement for common use medicines (OTC). 8. To assess the retaining ability of the consumers with reference to the pharmaceutical advertisement. - 85 - 9. To study the extent of advertising influenced the consumer for purchasing of medicines. 10. To assess the consumer attention towards different medium of advertisement. 11. To study the impact of advertisement by celebrities on consumers buying behavior. 3.15 Research Hypothesis: - Hypothesis is defined as a set of proposition set forth as an explanation for the occurrence of some specified group of phenomena either asserted merely as a provisional conjecture to guide some investigation or accepted as highly probable in the light of established facts. So for the study of factors influencing doctors prescribing behavior and consumers buying behavior certain hypothesis are formulated which are given below:Ho1: There is no significant association of demographic variables like family type, education, occupation, marital status and age on consumer purchase behavior. Ho2: Doctor’s advice do not creates significant impact on consumer persuasion to buy a particular drug. Ho3: Effective medium of advertisement do not creates significant impact on consumer persuasion to buy OTC drug. Ho4: There is no significant association of demographic variables like family type, education, occupation, marital status and age on medium of advertisement and attention paid by consumer. Ho5: There is no significant association of advertisement through electronic media on consumers buying behavior Ho6: There is no significant association of advertising through print media on consumers buying behavior - 86 Ho7: Various pharmaceutical medium of advertisement do not creates significant impact on doctor prescription behavior. Ho8: There is no significant association of detailing (advertisement through medical representative) on the physicians prescribing behavior. Ho9: There is no significant association of qualification of doctors and impact of pharmaceutical advertisement. Ho10: There is no significant association of regional status of practice place and impact of pharmaceutical advertisement. Ho11: There is no significant association of promotional items such as free samples, trips to seminar etc. on the physicians prescribing behavior Ho12: There is no significant association of Medical journals, clinical papers or seminars conducted by companies on the physicians prescribing behavior. 3.16 Research Assumptions:- The physicians prescribing behavior is affected by the pharmaceutical companies promotional activities and customers buying behavior is influenced by advertising activities adopted by pharmaceutical companies. The sample represents resident’s physicians and visiting patient in the respective hospitals. Respondents are answering the questionnaire truthfully and honestly. This study covering about one hundred physicians executed to find out the impact of various information sources in influencing the physicians prescribing behaviour, concluded that pharmaceutical company’s promotional information (commercial sources) plays a major role in the decision process of the physician to prescribe drugs than even scientific sources. - 87 CHAPTER- 4 DATA ANALYSIS OF SURVEY RESULTS 4.1 Demographic Characteristics of Respondents (Consumers):For marketers and consumers the advertisements play a very vital role. The study of cognitive effect of advertisements can help both the marketers and the regulating authorities. The marketers may understand in a better way as to how the advertisements may change the perceptions of the consumers. On the other hand, the regulating authorities may prevent deception against consumers with this kind of understanding. It must be understood by the marketers that supply of right quality and quantity of goods and services to consumers at reasonable prices constitute the responsibility of an enterprise toward its customers. The enterprise must take proper precaution against adulteration, poor quality, lack of desired service and courtesy to customers thus misleading and dishonest advertising, and so on. They must also have the right of information about the product, the company and other matters having a bearing on their purchasing decision. Advertisers often rely on strong subjective and evaluative claims in order to differentiate their brands and pharmaceuticals chemical constituents from competitors. Consumers are being provided with increasing amounts of decision-relevant information in their purchasing environments. As stated above, the understanding, how consumers select and organize information, can be used to create marketing communications that have a better chance of being attended to and processed. Cognition is an important subject to an advertiser and marketer dealing in non-durable products because the process is highly complex. Advertiser, therefore, needs to know in advance how consumers are likely to process and interpret a message. - 88 The differences in attitude and level of involvement for a particular product may raise so many problems with the individual characteristics that influence consumer’s decision making as to non-durable goods. The word demography means related to the human population. Market demographics refer to all the data that is collected for the purpose of providing information to organizations such as government offices and marketing departments. Details of the population in relation to their age, sex, employment status are usually included in marketing demographics. This data is usually used to make policy decisions and for research of the market conditions. Characteristics such as gender, age, education, profession, occupation, income level, and marital status, are all typical examples of demographics that are used in surveys. When designing a survey, the research needs to assess who to survey and how to breakdown overall survey response data into meaningful groups of respondents. Both assessments are based on demographic considerations. A demographic profile can be used to determine when and where advertising should be placed so as to achieve maximum results. A tool for determining a demographic profile is the use of demographic partitions. Demographic partitions refer to the multitude of advanced segmentations of user groups. The segmentation structure is determined through the analysis of large data collections where the conclusions drawn are specific to an underlying set of initiatives͘ The main objective of market demographics is to understand the different segments of the population and also to get a clear idea of the needs and wants of the different segments in the society. On the basis of this information organizations can build a marketing strategy. The major types of demography that is included in marketing is the age of the targeted group, the gender ratio, the level of the income that exists and the race and the ethnic groups that exist in the targeted group. - 89 The targeted audiences for a product or service need to be potential clicks-to-sale initiators, directly influencing business turn-around. Consumer preference and their decisions are influenced by their demographic characteristics such as age, sex, marital status, family size, education, and their professional status. Since, these characteristics are easily quantifiable, they enable marketer to describe accurately and specifically and to understand certain consumer characteristics. Keeping this consideration, an attempt was made to isolate the demographic characteristics of the respondents. 4.1.1 Age wise classification of respondents:Consumer needs and wants change with age. Age and life-cycle have potential impact on the consumer buying behavior. It is obvious that the consumers change the purchase of goods and services with the passage of time. Researchers have found age to be important demographic variable to distinguish consumer segment. Keeping this into consideration, an attempt was made to classify the respondents on the basis of age. Respondents included in the sample were classified into five age groups which include age group 18-28 years, 29-39 years, 40-50 years, 51-61 years and > 61 years. The information about age-wise classification of respondents is presented in table no. 4.1.1 Table No. 4.1.1:- Age- wise classification of Respondent S. No Age Group No. of Respondents Percentage 1 18-28 year 96 29.2 2 29-39 year 129 39.2 3 40-50 year 46 14.0 4 51-61 year 45 13.7 5 > 61 year 13 4.0 329 100.0 Total - 90 Fig 4.1:- Age - wise classification of Respondents The analysis of data indicates that 29.2% of the respondents are in the age group of 18-28 years, 39.2% of the respondents are in the age group of 29-39 years, 14% of the respondents are in the age group of 40-50 years, 13.7% of the respondents are in the age group of 51-61 years and remaining 4% are in the age group of more than 61 years.The analysis clearly projects that the sample is dominated by those respondents who are in the age group of 29-39 years. 4.1.2 Marital Status- wise classification of respondents:The family has been the focus of most marketing efforts and for many products and services, the household continues to be the relevant consuming unit. Family life-cycle consists of different stages such young singles, married couples, unmarried couples etc which help marketers to develop appropriate products for each stage For developing appropriate marketing Strategies, the researchers are interested in determining the demographic and media profile of household decision makers. Keeping this into consideration, an attempt was made to classify the respondent on the - 91 basis of their marital status. The marital status-wise classified categories include married, unmarried, widow & separated. The results are presented in table no. 4.1.2 Table No. 4.1.2:- Marital Status - wise classification of Respondent S. No Marital Status No. of Respondents Percentage 1 Married 208 63.2 2 Unmarried 118 35.9 3 Widow 2 0.6 4 Separated 1 0.3 329 100.0 Total Fig 4.2:- Marital Status wise classification of Respondents The analysis elaborates that the sample includes 63.2% married respondents, 35.9% unmarried respondents, 0.6% widow respondent and 0.3% seperated respondents. This signifies that the sample is dominated by the respondents of married category. 4.1.3 Family type- wise classification of respondents:A family is defined as a group consisting of two parents and their children living together as a unit. A household is defined as a person or group of person occupying a housing unit, whether related or unrelated. In recent years, there have been two important changes in the family and the marital status. The first one is the sharp - 92 increase of single person household and second is the decline in average household. Keeping this into consideration, an attempt was made to classify the respondents on the basis of family type. The family type classified categories included in respondents are joint family and nuclear family .The results are shown in table no. 4.1.3 Table No. 4.1.3:- Family type-wise classification of Respondent S. No Type of family No. of Respondents Percentage 1 Nuclear 254 77.2 2 Joint 75 22.8 329 100.0 Total Fig 4.3:- Family type- wise classification of Respondents The analysis suggest that 77.2% respondents belong to joint families and 22.8% respondents belong to nuclear family .This analysis clearly highlights that sample is dominated by the respondents belonging to joint families. 4.1.4 Income- wise classification of respondents:Income of the consumers has long been an important variable for distinguishing market segments. Income simply indicates the ability or inability of the consumer to pay for a product, while the actual choice may be based on personal life style, taste - 93 and values. Keeping this into consideration, an attempt was made to classify respondents on the basis of their income. For this purpose, the respondents were classified into five categories: one who has annually income less than Rs.1.5 lacs. Others categories of respondents include those with annual income Rs.1.5 lacs- 3.0 lacs, 3.0 lacs - 5.0 lacs, 5.0 lacs-7.0 lacs and more than 7.0 lacs.The results are shown in Table no.4.1.4 Table No. 4.1.4:- Income-wise classification of Respondent ^͘EŽ Annual Income No. of Respondents Percentage ϭ Less than 1.5 lacs 8 2.43 Ϯ 1.5 lacs- 3.0 lacs 59 17.93 ϯ 3.0 lacs- 5.0 lacs 120 36.47 ϰ 5.0 lacs-7 .0 lacs 105 31.91 ϱ more than 7.0 lacs 37 11.25 329 100.00 Total Fig 4.4:- Income- wise classification of Respondents The analysis projects that the sample includes 2.43%, 17.93%, 36.47%, 31.91% and 11.25% respondent respectively representing the group of respodents with annual income upto Rs.1.5 lacs,1.5 lacs-3.0 lacs, 3.0 lacs-5.0 lacs,5.0 lacs-7.0 lacs and more - 94 than 7.0 lacs and above.This signifies that the sample is dominated by those respondents who are having the annual income between 3.0 lacs-5.0 lacs. 4.1.5 Qualification - wise classification of respondents:An attempt was made to identify academic profile of the respondents. It is appropriately believed that understanding and impacts of advertising on consumers are closely associated with their level of education. For identifying this, the respondents included in the sample were classified on the basis of their education level. The education level-wise classified categories include the respondents who are undergraduates, graduates and post graduates and above. The information in this regard is presented in table no.4.1.5 Table No. 4.1.5:- YƵĂůŝĨŝĐĂƚŝŽŶ -wise classification of Respondent S. No Qualification No. of Respondents Percentage 1 Undergraduate 76 23.10 2 Graduate 98 29.79 3 Post Graduate & Above 155 47.11 329 100.00 Total Fig 4.5:- Qualification- wise classification of Respondents - 95 The analysis of data suggests that 23.10% respondent fall in the undergraduate categories. Another 29.79% respondents have their education up to graduation level and 47.11% of the respondents are qualified up to post graduation and above. The analysis clearly highlights that the sample is dominated by those respondents who have educational qualification post graduate and above. 4.1.6 Occupation - wise classification of respondents:The occupation of an individual plays a significant role in influencing his/her buying decision. An individual’s nature of job has a direct influence on the products and brands he picks for himself/herself. Occupation is one of the important demographic variables which influence the consumption pattern of consumer. For making the appropriate marketing strategy and positioning the product in a better and effective way it is necessary to identify the occupational group that has average interest in their product and services. Keeping this into consideration, an attempt was made to classify the respondent on the basis of their occupation. For this purpose, the occupation-wise classified categories of the respondents included Students, Business, Government Services, Professionals and Housewife. The information in this respected is depicted in table no.4.1.6 Table No. 4.1.6:- Occupation -wise classification of Respondent ^͘EŽ Occupation No. of Respondents Percentage ϭ Student 49 14.89 Ϯ Business 60 18.24 ϯ Government Service 83 25.23 ϰ Professional 97 29.48 ϱ Housewife 35 10.64 ϲ Any Other 5 1.52 329 100.00 Total - 96 Fig 4.6:- Occupation -wise classification of Respondent The analysis indicates that the sample is dominated by the respondents of professional categories as it was indicated by 29.48% of the repondents. Another 25.23% respondent fall in Government service category, 18.24% respondents belongs to Business category, 14.89% respondents belongs to Student category, 10.64% respondents belongs to Houswifes category and 1.52% respondents belongs to others category. 4.2 Sensitiveness of consumer towards advertisement:The advertisement is an effort by the sellers/manufacturers to communicate message about their product/services to the consumer or ultimate users. Thus, it becomes more important to assess whether the advertisement is able to attract the first attention followed by the retention of the potential buyers of the proposed product/services. In other words,the assessment of the sensitiveness of consumers toward advertisement becomes very crucial in order to study the impact of advertising on the brand prefrence of the consumers. Advertisement enable practitioners to be more consumersensitive to ensure that the advertising campaigns are properly conceived to avoid - 97 adverse effects on a firm’s performance. It also checked in order to meet the following objectives: a. For examining the awareness,ability to perceive and ability to learn the consequences of action of the consumers subsequent to the impact of an advetisement. b. The theoretical insight communicates several dimensions about the sensitiveness of consumers towards advertisement. The personal values and goals of consumers are linked with their buying intention and actions. Thus, it becomes crucial to highlight whether consumer is sensitive towards barrios advertisement displayed on different media. Without assessing this, the ultimate impact of an advertisement cannot be properly highlighted. This view point became one of the objectives for proposed assessment of sensitiveness of consumers. Before attempting to know the ultimate impact of advertisement on the target consumers, it is necessary that we know how far they have access to various media of advertisements, their likeness for advertisement, effect of advertisement, attributes of advertisement, more affective medium of advertisement etc. An attempt has been made in the present study to assess the respondents on the above mentioned factors. 4.2.1 Advertisement awareness:Advertisement awareness is the extent to which the intended audience or targeted customers are aware of an advertising message. Advertising is used for communicating 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. To know awareness about advertisement respondents were requested to indicate their awareness about advertisement. The relevant data and analysis are given below in table no.4.2.1 - 98 Table No. 4.2.1:- Advertisement awareness among respondents Awareness about Advertisement S. No Description No. of Respondents Percentage 1 YES 297 90.27 2 NO 32 9.73 Total 329 100.00 Fig 4.7:- Advertisement awareness among respondents The study indicates that 90.27% respondent are aware about advertisement and 9.73% of respondent are unaware about advertisement. 4.2.2 Advertisement medium and attention:Attention is a necessary ingredient for effective advertising. Attention is the cognitive process of selectively concentrating on one aspect of the environment while ignoring other things. Direct-to-Consumer or DTC advertising is a form of advertising that pharmaceutical companies are using to promote brand name medications through newspaper, magazine, television, radio and Internet marketing.There are various medium by which consumer get the attention. To know about attention among consumer with reference to various advertisement media an attempt has been made. The relevant data and its analysis are given below in table no. 4.2.2 - 99 Table No. 4.2.2:- Advertisement medium and attention of respondents Medium of Advertisement & Attention paid by consumer S. No Medium of Advertisement No. of Respondents Percentage 1 Print 47 14.29 2 Radio 43 13.07 3 Television 185 56.23 4 Word to Mouth 54 16.41 Total 329 100.00 Fig 4.8:- Advertisement medium and attention of respondents The study indicates that more than half (56.23%) respondent paid attention on television advertisement.Similarly 14.29% respondent paid attention to print media advertisement, 13.07% respondent paid attention to radio media advertisement and 16.41% respondent paid attention to word to mouth medium of advertisement.Thus the study highlights that respondent paidmore attention on television medium of advertisement followed by word to mouth,print & radio medium of advertisement. An attempt was also made to assess the degree of relationship of Demographic variables like family size, Educational qualification, Occupation, Marital Status and age of respondents with advertisement and consumer attention.For this purpose the data was - 100 processed to establish the relationship of factors which are responsible for determining medium of advertisement that get attention with demographic profile of respondent.The information in this respect is presented in table no 4.2.2.1 to 4.2.2.5 4.2.2.1 Association between family type and medium of advertisement get the Consumer attention:- An attempt was made to assess the degree of relationship of customer attention toward the different medium of advertisement with family type of respondents. The information in this respect is presented in table no 4.2.2.1 Table No. 4.2.2.1:- Association of medium of advertisement with type of family Family type * Which medium of Advertisement get your Attention Cross tabulation Which medium of Advertisement get your Attention Word to Print Family Nuclear type Count Expected Radio Television Mouth Total 35 32 150 37 254 36.3 33.2 142.8 41.7 254.0 13.8% 12.6% 59.1% 14.6% 100.0% 12 11 35 17 75 10.7 9.8 42.2 12.3 75.0 16.0% 14.7% 46.7% 22.7% 100.0% 47 43 185 54 329 47.0 43.0 185.0 54.0 329.0 14.3% 13.1% 56.2% 16.4% 100.0% Count % within Family size Joint Count Expected Count % within Family size Total Count Expected Count % within Family size Pearson Chi-Square 4.284 a Degree of freedom Asymp. Sig. (2-sided) 3 .232 - 101 The analysis of data in the above table indicates that among the nuclear family 150 respondents are in the opinion that television medium of advertisement get more attention. Similarly 35 respondents of print medium advertisement, 32 respondents of Radio advertisement and 37 respondent of word to mouth advertisement give their opinion regarding attention of advertisement. Further in 75 respondent of joint family 35 respondent are in the opinion of television medium of advertisement create more impact to consumer of Joint family. Similarly 12, 11 & 17 respondents give their opinion regarding print, Radio & Word to mouth Advertisement respectively which create attention of consumer. In context to the data analysis of whole family (both nuclear and joint) the 185 respondent give their opinion that Television advertisement get their attention, 47, 43 and 54 respondent give their opinion regarding advertisement of print, radio & word to mouth respectively .To know the association of family type and medium of advertisement get the Consumer attention Ȥ2 test statistic can be tested for the Hypothesis. Ho-There is no association of family type and medium of advertisement get the Consumer attention. H1- There is association of family type and medium of advertisement get the Consumer attention Here Chi-Square test statistic (Ȥ2) = 4.284 Critical value at 5% level of significance with degree of freedom = 7.815 Since Ȥ2 (3) =4.284, p > 0.05 at 5% level of significance then there is no significant association of medium of different advertisement to get the consumer attention with type of family. 4.2.2.2 Relation between Educational Qualification and medium of advertisement get the Consumer attention:- The analysis of data indicates amongst - 102 the 76 respondent of undergraduate educational qualification 48 respondent give the opinion that Television medium of advertisement get more attention where as 6, 8 & 14 respondent give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention. Table No. 4.2.2.2:- Association of medium of advertisement with educational qualification of consumer. Educational Qualification * Which medium of Advertisement get your Attention Cross tabulation Which medium of Advertisement get Total your Attention Print Radio Televisio Word n to Mouth Educational Under Count 6 8 48 14 76 Qualification graduate Expected 10.9 9.9 42.7 12.5 76.0 Count % within 7.9% 10.5 63.2% 18.4% 100.0% Educational % Qualification Graduate Count 9 25 46 18 98 Expected 14.0 12.8 55.1 16.1 98.0 Count % within 9.2% 25.5 46.9% 18.4% 100.0% Educational % Qualification Post Count 32 10 91 22 155 Graduate Expected 22.1 20.3 87.2 25.4 155.0 Count % within 20.6% 6.5% 58.7% 14.2% 100.0% Educational Qualification Total Count 47 43 185 54 329 Expected 47.0 43.0 185.0 54.0 329.0 Count % within 14.3% 13.1 56.2% 16.4% 100.0% Educational % Qualification Pearson Chi-Square Degree of freedom Asymp. Sig. (2-sided) a 28.724 6 .000 - 103 Similarly amongst 98 respondent of graduate educational qualification 46 respondent give the opinion that Television medium of advertisement get more attention where as 9, 25 & 18 respondent give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention. Further 155 respondent of post graduate educational qualification 91 respondent give the opinion that Television medium of advertisement get more attention where as 32, 10 & 22 respondent give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention. In context to the data analysis of whole respondent of different qualification the 185 respondent give their opinion that Television advertisement get their attention 47, 43 and 54 respondent give their opinion regarding advertisement of print, radio & word to mouth respectively. To know the association of Educational Qualification and medium of advertisement get the Consumer attention Ȥ2 test statics can be tested for the Hypothesis Ho-There is no association of Educational Qualification and medium of advertisement get the Consumer attention. H1- There is association of Educational Qualification and medium of advertisement get the Consumer attention Here Chi-Square test statistic (Ȥ2) = 28.724 Since Ȥ2 (6) =28.724, p < 0.05 at 5% level of significance then there is significant association of medium of different advertisement to get the consumer attention with educational Qualification. 4.2.2.3 Relation between Occupation and medium of advertisement get the Consumer attention:- The analysis of data indicates amongst the 49 respondent who are student 22 respondent give the opinion that Television medium of advertisement - 104 get more attention where as 4, 18 & 5 respondent give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention. Table No. 4.2.2.3:- Association of medium of advertisement with occupation of consumer. Occupation * Which medium of Advertisement get your Attention Cross tabulation Which medium of Advertisement get your Attention Count 4 18 22 Word to Mouth 5 Expected 7 6.4 27.6 8 49 8.20% 36.70% 44.90% 10.20% 100.00% 5 7 42 6 60 8.6 7.8 33.7 9.8 60 8.30% 11.70% 70.00% 10.00% 100.00% 15 10 46 12 83 11.9 10.8 46.7 13.6 83 18.10% 12.00% 55.40% 14.50% 100.00% 23 7 44 23 97 13.9 12.7 54.5 15.9 97 23.70% 7.20% 45.40% 23.70% 100.00% Count 0 1 26 8 35 Expected 5 4.6 19.7 5.7 35 0.00% 2.90% 74.30% 22.90% 100.00% Print Student Radio Television Total 49 Count % within Occupation Business Count Expected Count % within Occupation Occupation Government Count Service Expected Count % within Occupation Professional Count Expected Count % within Occupation Housewife Count % within Occupation Contd….. - 105 Occupation * Which medium of Advertisement get your Attention Cross tabulation Which medium of Advertisement get your Attention 0 0 5 Word to Mouth 0 0.7 0.7 2.8 0.8 5 0.00% 0.00% 100.00% 0.00% 100.00% Count 47 43 185 54 329 Expected 47 43 185 54 329 14.30% 13.10% 56.20% 16.40% 100.00% Print Any Count Radio Television Total 5 Other (Please Expected Specify) Count % within Occupation Total Count % within Occupation Pearson Chi-Square Degree of freedom 59.119a 15 Asymp. Sig. (2-sided) 0 Similarly amongst 60 respondent who are business man by occupation 42 respondent give the opinion that Television medium of advertisement get more attention where as 5, 7 & 6 respondent give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention. Further 83 respondent who are in government service by occupation 46 respondent give the opinion that Television medium of advertisement get more attention where as 15, 10 & 12 respondent give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention. Similarly 97 respondent who are professional by occupation 44 respondent give the opinion that Television medium of advertisement get more attention where as 23, 7 & 23 respondent give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention. Furthermore 35 respondent who are housewife 26 respondent give the opinion that Television medium of advertisement get more attention where as 0, 1 & 8 respondent - 106 give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention and 5 respondent having some other occupation all 5 respondent give the opinion about Television advertisement medium get more attention To know the association of Educational Qualification and medium of advertisement get the Consumer attention Ȥ2 test statistic can be tested for the Hypothesis Ho-There is no association of Occupation and medium of advertisement get the Consumer attention. H1- There is association of Occupation and medium of advertisement get the Consumer attention Here Chi-Square test statistic (Ȥ2) = 59.119 Since Ȥ2 (15) =59.119, p < 0.05 at 5% level of significance then there is significant association of medium of different advertisement to get the consumer attention with Occupation. 4.2.2.4 Relation between Martial Status and medium of advertisement get the Consumer attention:- The analysis of data indicates amongst the 208 married respondent 116 respondent give the opinion that Television medium of advertisement get more attention where as 33, 23 & 36 respondent give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention. Similarly amongst 118 unmarried respondent 67 respondent give the opinion that Television medium of advertisement get more attention where as 13,20 &18 respondent give their opinion that print, radio & word to mouth medium of advertisement respectively get more attention. - 107 Table No. 4.2.2.4:- Association of medium of advertisement with marital status of respondent. Marital Status * Which medium of Advertisement get your Attention Cross tabulation Which medium of Advertisement get your Attention Word to Radio Television Mouth 33 23 116 36 208 29.7 27.2 117.0 34.1 208.0 15.9% 11.1% 55.8% 17.3% 100.0% 13 20 67 18 118 16.9 15.4 66.4 19.4 118.0 11.0% 16.9% 56.8% 15.3% 100.0% Count 1 0 1 0 2 Expected Count .3 .3 1.1 .3 2.0 50.0% 0.0% 50.0% 0.0% 100.0% Count 0 0 1 0 1 Expected Count .1 .1 .6 .2 1.0 0.0% 0.0% 100.0% 0.0% 100.0% 47 43 185 54 329 47.0 43.0 185.0 54.0 329.0 14.3% 13.1% 56.2% 16.4% 100.0% Print Marital Married Status Count Expected Count % within Total Marital Status Unmarried Count Expected Count % within Marital Status Widow % within Marital Status Separated % within Marital Status Total Count Expected Count % within Marital Status Pearson Chi-Square Degree of freedom 6.629a 9 - 108 Asymp. Sig. (2-sided) .676 Further among 2 widow respondent 1 respondent give their opinion that print advertisement & 1 respondent give their opinion that television advertisement get more attention. Similarly one separated respondent give their opinion that television advertisement get more attention. In context to the data analysis of whole respondent of different marital status the 185 respondent give their opinion that Television advertisement get their attention 47, 43 and 54 respondent give their opinion regarding advertisement of print, radio & word to mouth To know the association of marital status and medium of advertisement get the Consumer attention Ȥ2 test statistic can be tested for the Hypothesis Ho-There is no association of marital status and medium of advertisement get the Consumer attention. H1- There is association of marital status and medium of advertisement get the Consumer attention Here Chi-Square test statistic (Ȥ2 ) = 6.629 Since Ȥ2 (9) =6.629, p > 0.05 at 5% level of significance then there is no significant association of medium of different advertisement to get the consumer attention with marital Status. 4.2.2.5 Relation between Age and medium of Advertisement to get Attention:The analysis of data in the table above indicates that among the 96 respondents of age group 18-28 years 54 respondent are in the opinion that television medium of advertisement create more attention, 8 respondent give their opinion that of print medium of advertisement create more attention, 16 respondent give their opinion that of radio medium of advertisement create more attention and 18 respondent give their opinion that word to mouth medium of advertisement create more attention. - 109 Table No. 4.2.2.5:- Association of medium of advertisement with age of respondent. Age * Which medium of Advertisement get your Attention Cross tabulation Which medium of Advertisement get your Total Attention Print Radio Television Word to Mouth Count 8 16 54 18 96 13.7 12.5 54 15.8 96 8.30% 16.70% 56.20% 18.80% 100.00% 23 10 74 22 129 18.4 16.9 72.5 21.2 129 17.80% 7.80% 57.40% 17.10% 100.00% 9 4 27 6 46 6.6 6 25.9 7.6 46 19.60% 8.70% 58.70% 13.00% 100.00% 4 13 20 8 45 6.4 5.9 25.3 7.4 45 8.90% 28.90% 44.40% 17.80% 100.00% 3 0 10 0 13 1.9 1.7 7.3 2.1 13 23.10% 0.00% 76.90% 0.00% 100.00% Count 47 43 185 54 329 Expected Count 47 43 185 54 329 14.30% 13.10% 56.20% 16.40% 100.00% Expected Count 18-28 % within Age Count Expected Count 29-39 % within Age Count Age Expected Count 40-50 % within Age Count Expected Count 51-61 % within Age Count Expected Count > 61 Total % within Age % within Age Pearson Chi-Square 25.799 Degree of freedom Asymp. Sig. (2-sided) 12 0.011 a Similarly age group of 29-39 years among 129 respondents, 74 respondent are in the opinion that television medium of advertisement create more attention, 23 respondent give their opinion that of print medium of advertisement create more attention, 10 respondent give their opinion that of radio medium of advertisement create more attention and 22 respondent give their opinion that word to mouth medium of - 110 advertisement create more attention. Out of 46 respondent of age group 40-50 years 27 respondent are in the opinion that television medium of advertisement create more attention, 9 respondent give their opinion that of print medium of advertisement create more attention, 4 respondent give their opinion that of radio medium of advertisement create more attention and 6 respondent give their opinion that word to mouth medium of advertisement create more attention. Further among 45 respondent of age group 51-61, 20 respondent are in the opinion that television medium of advertisement create more attention, 4 respondent give their opinion that of print medium of advertisement create more attention, 13 respondent give their opinion that of radio medium of advertisement create more attention and 8 respondent give their opinion that word to mouth medium of advertisement create more attention. Similarly age greater than 61 years among 13 respondents, 10 respondents are in the opinion that television medium of advertisement create more attention and 3 respondents give their opinion that of print medium of advertisement create more attention. To know the association of age and advertisement media that creates attention Ȥ2 test statistic can be tested for the Hypothesis Ho-There is no association of age and advertisement media that create attention. H1- There is association of age and advertisement media that create attention. Here Chi-Square test statistic (Ȥ2 ) = 25.799 Since Ȥ2 (12) =25.799, p < 0.05 at 5% level of significance then there is significant association of age and advertisement media that create attention. - 111 4.2.3 Effect of advertising on consumerAdvertising affects everyone. Advertising can create a shift in thinking by consumers, which may take different forms. For example, after viewing an ad, a consumer may decide that his or her usual product either seems better or worse that the one being advertised, without knowing exactly why. Other effects of advertising that create a more conscious shift in consumers thought processes may be due to a strong informational aspect. Advertising is an effective tool to attract people and to divert their attitude positively toward product. There is a moderate relationship between consumer purchase attention environmental factors and emotional factors. If consumer is emotionally attached with the product he/she will prefer to purchase that product. Advertising can create a shift in thinking by consumers, which may take different forms. Other effects of advertising that create a more conscious shift in consumers' thought processes may be due to a strong informational aspect. Advertisement affect consumer in many ways whether by recall,positive impression, cretae intrest and making decision etc. To know how advertisement affects on consumer an attempt has been made. The relevant data and its analysis are given below in table no.4.2.3 Table No. 4.2.3:- Effect of advertising on respondent Effect of advertisement on consumer S. No Description No. of Respondents Percentage 1 Recall 60 18.24 2 Positive impression 84 25.53 3 Interest 102 31.00 4 Decision Process 83 25.23 329 100.00 Total - 112 Fig 4. 9:- Effect of advertising on respondent The study indicates that advertisement effect 31% respondent by generating intrest. Similarly advertisement effect 25.53% respondent by making positive impression about the product & advertisement effect 18.24% respondent by recall i.e the process of remembering. Recall is one of the several major measures used in advertising effectiveness testing today, in addition to others such as persuasion and advertising liking. Similarly Advertisement effect 25.23% respondent in such a way by which consumer decision process are influenced. 4.2.4 Advertising medium and OTC medicine (Over the counter drug):Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a prescription from a healthcare professional, as compared to prescription drugs, which may be sold only to consumers possessing a valid prescription. Essential medicines are one of the vital tools needed to improve and maintain health. However, for too many people throughout the world medicines are still unaffordable, unavailable, unsafe and improperly used. Drug promotion to consumers is becoming an increasingly important component of drug companies’ marketing strategies (Mintzes, 1998). In the past, most consumer advertisements promoted over-the- 113 counter medicines. 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 amongst consumers.The conceptual frame work of medium of advertisememnt for OTC drug are given below in fig no.4.10 dĞůĞǀŝƐŝŽŶ EĞǁƐƉĂƉĞƌ ZĂĚŝŽ ŽŶƐƵŵĞƌ WĞƌƐƵĂƐŝŽŶ ƚŽWƵƌĐŚĂƐĞ /ŶƚĞƌŶĞƚ KƚŚĞƌ DĞĚŝƵŵ ŽŶĐĞƉƚƵĂů&ƌĂŵĞǁŽƌŬ Fig 4.10:- Conceptual framework of consumer persuasion to purchase To know which advertising medium is more effective among consumer for common use medicine an attempt has been made. The relevant data and its analysis are given below in table no.4.2.4 Table No. 4.2.4:- Effective medium of advertisement for common use medicines. Effective medium of advertisement for common use medicines. S. No Description No. of Respondents Percentage 1 Television 144 43.77 2 News Paper 102 31.00 3 Radio 38 11.55 4 Internet 33 10.03 5 Others 12 3.65 329 100.00 Total - 114 Fig 4.11:- Effective medium of advertisement for common use medicines While product placement is riskier than conventional advertising, it is becoming a common practice to place products and brands into mainstream media. The analysis indicates that for common use medicine television medium of advertisement effect 43.77% respondent. Similarly News paper medium of advertisement effect 31.00% respondent for common use medicine & radio medium of advertisement effect 11.55 % respondent for common use medicine. Similarly Internet information about medicine or Advertisement on Internet effect 10.03% respondent for common use medicine and other medium of advertisement (Magazines,brouchers,kiosks etc.) effect 3.65% respondent for common use medicine An attempt was also made to assess the degree of relationship of Demographic variables like family size,Educational qualification,Occupation and Marital Status of respondents with effective medium of advertisememnt .For this purpose the data was processed to establish the relationship of factors which are responsible for determining effective medium of advertisement with demographic profile of respondent. The information in this respect is presented in table no 4.2.4.1 to 4.2.4.4 - 115 4.2.4.1 Relation between family size and more effective medium of advertisement for OTC drug:- The analysis of data in the table above indicates that among the 254 nuclear family 116 respondent are in the opinion that television medium of advertisement is more effective for selecting the common use medicines (OTC). Table No. 4.2.4.1:- Association of effective medium of advertisement with family type of respondent Family type * For common use medicines (OTC) which medium of advertisement is more affective Cross tabulation For common use medicines (OTC) which medium of advertisement is more affective News Television Family Nuclear type Count Expected Paper Radio Internet Other Total 116 74 29 27 8 254 111.2 78.7 29.3 25.5 9.3 254.0 45.7% 29.1% 11.4% 10.6% 3.1% 100.0% 28 28 9 6 4 75 32.8 23.3 8.7 7.5 2.7 75.0 37.3% 37.3% 12.0% 8.0% 5.3% 100.0% 144 102 38 33 12 329 144.0 102.0 38.0 33.0 12.0 329.0 43.8% 31.0% 11.6% 10.0% 3.6% 100.0% Count % within Family size Count Expected Count Joint % within Family size Count Expected Count Total % within Family size Pearson Chi-Square 3.348 a Degree of freedom Asymp. Sig. (2-sided) 4 .501 - 116 Similarly 74 respondent of News Paper advertisement, 29 respondent of Radio advertisement, 27 respondent of Internet & 8 respondent of other medium of advertisement give their opinion regarding attention of advertisement more effective for selecting the common use medicines (OTC). Further in 75 respondent of joint family 28 respondent are in the opinion of television medium of advertisement is more effective for selecting the common use medicines (OTC). Similarly 28 respondent of News Paper advertisement, 9 respondent of Radio advertisement, 6 respondent of Internet & 4 respondent of other medium of advertisement give their opinion regarding attention of advertisement more effective for selecting the common use medicines (OTC). In context to the data analysis of whole family (both nuclear and joint) the 144 respondent give their opinion that television medium of advertisement is more effective for selecting the common use medicines (OTC), 102 respondent of news paper, 38 respondent of Radio advertisement, 33 respondent of Internet & 12 respondent of other medium of advertisement give their opinion regarding advertisement more effective for selecting the common use medicines (OTC). To know the association of family type and medium of advertisement more effective for selecting common use medicines.Ȥ2test statistic can be tested for the hypothesis. Ho-There is no association of family type and medium of advertisement more effective for selecting common use medicines. H1- There is association of family type & medium of advertisement more effective for selecting common use medicines Here Chi-Square test statistic (Ȥ2 ) = 3.348 - 117 Since Ȥ2(4) =3.348, p > 0.05 at 5% level of significance then there is no significant association of family type & medium of advertisement more effective for selecting common use medicines͘ 4.2.4.2 Relation between Educational Qualification and more affective medium of advertisement for OTC drug:The analysis of data indicates amongst the 76 respondent of undergraduate educational qualification 45 respondent give the opinion that Television medium of advertisement are more effective for OTC medicine where as 21, 3, 0 & 7 respondent give their opinion that Newspaper, radio, Internet & other medium of advertisement respectively are more effective for OTC medicine . Table No. 4.2.4.2:- Association of effective medium of advertisement with educational qualification of respondent Educational Qualification * For common use medicines (OTC) which medium of advertisement is more affective Cross tabulation For common use medicines (OTC) which medium of advertisement is more affective Educational Under Count Qualification graduate Expected Telev News ision Paper Radio Internet Other 45 21 3 0 7 76 33.3 23.6 8.8 7.6 2.8 76.0 59.2 27.6% 3.9% 0.0% 9.2% 100.0% 42 36 12 8 0 98 42.9 30.4 11.3 9.8 3.6 98.0 42.9 36.7% 12.2% 8.2% 0.0% 100.0% Total Count % within Educational % Qualification Graduate Count Expected Count % within Educational % Qualification Contd….. - 118 Educational Qualification * For common use medicines (OTC) which medium of advertisement is more affective Cross tabulation For common use medicines (OTC) which medium of advertisement is more affective News Television Post Count Graduate Expected Paper Radio Internet Other Total 57 45 23 25 5 155 67.8 48.1 17.9 15.5 5.7 155.0 36.8% 29.0% 14.8% 16.1% 3.2% 100.0% 144 102 38 33 12 329 144.0 102.0 38.0 33.0 12.0 329.0 43.8% 31.0% 11.6% 10.0% 3.6% 100.0% Count % within Educational Qualification Total Count Expected Count % within Educational Qualification Pearson Chi-Square Degree of freedom Asymp. Sig. (2-sided) 36.508 8 .000 Similarly amongst 98 respondent of graduate educational qualification 42 respondent give the opinion that Television medium of advertisement are more effective for OTC medicine where as 36, 12, 8 & 0 respondent give their opinion that that Newspaper, radio, Internet & other medium of advertisement are more effective for OTC medicine. Further 155 respondent of post graduate educational qualification 57 respondent give the opinion that Television medium of advertisement are more effective for OTC medicine where as 45, 23, 25 & 5 respondent give their opinion that Newspaper, radio, Internet & other medium of advertisement are more effective for OTC medicine. In context to the data analysis of whole respondent of different qualification the 144 respondent give their opinion that Television advertisement are more effective for OTC medicine and 102, 38, 33, 12 respondent give their opinion - 119 regarding advertisement of Newspaper, radio, Internet & other medium of advertisement are more effective for OTC medicine. To know the association of Educational Qualification and medium of advertisement more effective for common use medicine Ȥ2test statistic can be tested for the Hypothesis Ho-There is no association of Educational Qualification and effective medium of advertisement for common use medicines (OTC) H1- There is an association of Educational Qualification and effective medium of advertisement for common use medicines (OTC) Here Chi-Square test statistic (Ȥ2) = 36.508 Since Ȥ2 (8) =36.508, p < 0.05 at 5% level of significance then there is significant association between Educational Qualification and effective medium of advertisement for common use medicines (OTC). 4.2.4.3 Relation between Occupation and more affective medium of advertisement for OTC drug:- The analysis of data indicates amongst the 49 student respondent 19 respondent give the opinion that Television medium of advertisement are more effective for OTC medicine where as 18, 9, 0 & 0 respondent give their opinion that Newspaper, radio, Internet & other medium of advertisement are more effective for OTC medicine. Similarly amongst 60 respondent of business occupation 33 respondent give the opinion that News paper medium of advertisement are more effective for OTC medicine where as 36, 12, 8 & 0 respondent give their opinion that that Television, radio, Internet & other medium of advertisement are more effective for OTC medicine. - 120 Table No. 4.2.4.3:- Association of effective medium of advertisement with occupation of respondent Occupation * For common use medicines (OTC) which medium of advertisement is more affective Cross tabulation For common use medicines (OTC) which medium of advertisement is more affective News Television Paper Student Count Expected Radio Internet other Total 19 16 8 2 4 49 21.4 15.2 5.7 4.9 1.8 49.0 38.8% 32.7% 16.3% 4.1% 8.2% 100.0% 18 33 9 0 0 60 26.3 18.6 6.9 6.0 2.2 60.0 30.0% 55.0% 15.0% 0.0% 0.0% 100.0% 43 31 4 3 2 83 36.3 25.7 9.6 8.3 3.0 83.0 51.8% 37.3% 4.8% 3.6% 2.4% 100.0% 41 12 15 26 3 97 42.5 30.1 11.2 9.7 3.5 97.0 42.3% 12.4% 15.5% 26.8% 3.1% 100.0% 23 7 0 2 3 35 15.3 10.9 4.0 3.5 1.3 35.0 65.7% 20.0% 0.0% 5.7% 8.6% 100.0% 0 3 2 0 0 5 2.2 1.6 .6 .5 .2 5.0 0.0% 60.0% 40.0% 0.0% 0.0% 100.0% Count % within Occupation Business Count Expected Count % within Occupation Government Occupation Service Count Expected Count % within Occupation Professional Count Expected Count % within Occupation Housewife Count Expected Count % within Occupation Any Other Count (Please Expected Specify) Count % within Occupation Contd……. - 121 Occupation * For common use medicines (OTC) which medium of advertisement is more affective Cross tabulation For common use medicines (OTC) which medium of advertisement is more affective News Television Total Count Expected Count % within Paper Radio Internet other Total 144 102 38 33 12 329 144.0 102.0 38.0 33.0 12.0 329.0 43.8% 31.0% 11.6% 10.0% 3.6% 100.0% Occupation Pearson Chi-Square Degree of freedom Asymp. Sig. (2-sided) 97.098 20 .000 Further 83 respondent of Government service 43 respondent give the opinion that Television medium of advertisement are more effective for OTC medicine where as 31, 4, 3 & 2 respondent give their opinion that Newspaper, radio, Internet & other medium of advertisement are more effective for OTC medicine. 97 respondent who are professional by occupation 43 respondent give the opinion that Television medium of advertisement are more effective for OTC medicine where as 12, 15, 26 & 3 respondent give their opinion that Newspaper, radio, Internet & other medium of advertisement are more effective for OTC medicine. Out of total 329 respondent 35 respondent are housewife in which 23 respondent give the opinion that Television medium of advertisement are more effective for OTC medicine where as 7, 0, 2 & 3 respondent give their opinion that Newspaper, radio, Internet & other medium of advertisement are more effective for OTC medicine. 5 Respondent of different other occupation in which 3 & 2 respondent give their - 122 opinion that Newspaper, radio medium of advertisement are more effective for OTC medicine. To know the association of Occupation and medium of advertisement more effective for common use medicine Ȥ2 test statics can be tested for the Hypothesis Ho-There is no association of Occupation and effective medium of advertisement for common use medicines (OTC) H1- There is an association of Occupation and effective medium of advertisement for common use medicines (OTC) Here Chi-Square test statistic (Ȥ2 ) = 97.098 Since Ȥ2 (20) =97.098, p < 0.05 at 5% level of significance then there is significant association Occupation and effective medium of advertisement for common use medicines (OTC). 4.2.4.4 Relation between marital status and more affective medium of advertisement for OTC drug:The analysis of data indicates amongst the 208 married respondent 69 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, whereas 56 respondents give their opinion that by doctor suggestion they will purchase common use medicine and 16 respondents give their opinion that newspaper medium of advertisement act as suggestive measure for purchase of common use medicines, 15 respondents give their opinion that by retailer suggestion and 52 unmarried respondents by friends and relatives suggestion they purchase common use medicines. - 123 Table No. 4.2.4.4:- Association of effective medium of advertisement with marital status of respondent Marital Status * For common use medicines (OTC) which medium of advertisement is more affective Cross tabulation For common use medicines (OTC) which medium of advertisement is more affective News Television Paper Total Radio Internet other Marital Married Count 95 71 25 11 6 208 Status Expected 91.0 64.5 24.0 20.9 7.6 208.0 45.7% 34.1% 12.0% 5.3% 2.9% 100.0% 47 30 13 22 6 118 51.6 36.6 13.6 11.8 4.3 118.0 39.8% 25.4% 11.0% 18.6% 5.1% 100.0% Count 1 1 0 0 0 2 Expected .9 .6 .2 .2 .1 2.0 50.0% 50.0% 0.0% 0.0% 0.0% 100.0% Count 1 0 0 0 0 1 Expected .4 .3 .1 .1 .0 1.0 100.0% 0.0% 0.0% 0.0% 0.0% 100.0% 144 102 38 33 12 329 144.0 102.0 38.0 33.0 12.0 329.0 43.8% 31.0% 11.6% 10.0% 3.6% 100.0% Count % within Marital Status Unmarried Count Expected Count % within Marital Status Widow Count % within Marital Status Separated Count % within Marital Status Total Count Expected Count % within Marital Status Pearson Chi-Square Degree of freedom 18.933 a 12 - 124 Asymp. Sig. (2-sided) .090 Furthermore amongst 118 unmarried respondent of 31 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, whereas 36 respondents give their opinion that by doctor suggestion they will purchase common use medicine and 17 respondents give their opinion that newspaper medium of advertisement act as suggestive measure for purchase of common use medicines, 14 respondents give their opinion that by retailer suggestion and 20 respondents by friends and relatives suggestion they purchase common use medicines. Further 2 widow respondent of 1 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine & 1 respondent give their opinion that newspaper medium of advertisement act as suggestive measure for purchase of common use medicines. Similarly 1 respondent give their opinion that by Newspaper medium of advertisement act as suggestive measure for purchase of common use medicines. To know the association of marital status and suggestion by which consumer can purchase common use medicine Ȥ2 test statics can be tested for the Hypothesis. Ho-There is no association of marital status and suggestion by which consumer can purchase common use medicine H1- There is an association of Occupation and suggestion by which consumer can purchase common use medicine Here Chi-Square test statistic (Ȥ2 ) = 15.584 Since Ȥ2 (12) =15.584, p > 0.05 at 5% level of significance then there is no significant association marital and suggestion by which consumer can purchase common use medicine. 4.2.5 Suggestive measure for purchase of common use medicines: - Rational use of medicines refers to the correct, proper and appropriate use of medicines. - 125 Rational use requires that patients receive the appropriate medicine, in the proper dose, for an adequate period of time, and at the lowest cost to them and their community. The trend towards self-medication is likely to grow as consumers are becoming familiar with OTC drugs, due to extensive advertising by companies. A consumer’s information originates from their existing knowledge or experience (internal sources) and from a variety of external sources i.e. pharmacists, interpersonal communication, advertising and the media. Pharmaceutical products include both prescription and non-prescription over the counter drugs. OTC products are somewhat similar to consumer goods, while the prescription drugs share some characteristics of industrial goods and other characteristics of consumer goods (Mortanges et al., 1997). Liu (1995) is also of the view that in pharmaceutical industry, prescription products are considered to be organizational buying, whereas over the counter preparations are categorized as consumer buying. Due to changes in the category of many drugs from prescription to over the counter drugs, more self care information is available (Westerlund et al., 2001). To know which suggestive medium is more effective among consumer for purchase of common use medicine an attempt has been made. The relevant data and its analysis are given below table no 4.2.5 Table no. 4.2.5:- Suggestion by which consumer purchase common use medicines Suggestion by which consumer purchase common use medicines S. No Description No. of Respondents Percentage 1 Doctor 92 27.96 2 Retailer 29 8.81 3 Television 102 31.00 4 News paper 34 10.33 5 Friends & Relatives 72 21.88 329 100.00 Total - 126 Fig 4.12: Suggestion by which consumer purchase common use medicines The study indicates that about 31.00 % respondent purchase common use medicine by suggestive measure of television medium of advertisement..Similarly 27.96 % respondent purchase common use medicine by suggestion of doctor 21.88 % respondent purchase common use medicine by suggestion of friend and relatives. Furthermore 10.33 % respondent purchase common use medicine by suggestion of doctor 8.81 % respondent purchase common use medicine by suggestion of Retailer. Thus the study highlights that television medium of advertisement act as a suggestive measure for consumer for purchase of commom use medicines. An attempt was also made to assess the degree of relationship of Demographic variables like family size, Educational qualification,Occupation and Marital Status of respondents with suggestion by which consumer will purchase common use medicines.For this purpose the data was processed to establish the relationship of factors which are responsible for determining suggestion by which consumer will purchase common use medicines with demographic profile of respondent.The information in this respect is presented in table no 4.2.5.1 to 4.2.5.4 - 127 4.2.5.1 Relation between Family Size and suggestion by which consumer can purchase common use medicine:The analysis of data in the table above indicates that among the 254 nuclear family 77 respondent are in the opinion that television medium of advertisement act as suggestive measure for purchasing of common use medicines. Table no. 4.2.5.1:- Association of suggestion by which common use medicine are purchased with family type. Family type * By which suggestion you will purchase common use medicines Cross tabulation By which suggestion you will purchase common use medicines Family Nuclear type Count Expected News Friends & paper Relatives Doctor Retailer Television Total 64 20 77 26 67 254 71.0 22.4 78.7 26.2 55.6 254.0 25.2% 7.9% 30.3% 10.2% 26.4% 100.0% 28 9 25 8 5 75 21.0 6.6 23.3 7.8 16.4 75.0 37.3% 12.0% 33.3% 10.7% 6.7% 100.0% 92 29 102 34 72 329 92.0 29.0 102.0 34.0 72.0 329.0 28.0% 8.8% 31.0% 10.3% 21.9% 100.0% Count % within Family size Count Expected Joint Count % within Family size Count Expected Total Count % within Family size Pearson Chi-Square 14.629 Degree of freedom a 4 - 128 Asymp. Sig. (2-sided) .006 Similarly 64 respondents give their opinion that by doctor suggestion they will purchase common use medicines & 67 respondents give their opinion that by friend and relatives suggestion they will purchase common use medicines. 20 respondents give their opinion that by retailer suggestion they will purchase common use medicines and 26 respondents give their opinion that by news paper advertisement they will purchase common use medicines. Further in 75 respondent of joint family 28 respondent are in the opinion that by doctor suggestion they will purchase common use medicines. Similarly 25 respondent are in the opinion that television medium of advertisement act as suggestive measure for purchasing of common use medicines, 9 respondents give their opinion that by retailer suggestion they will purchase common use medicines 8 respondents give their opinion that by news paper advertisement they will purchase common use medicines & 5 respondents give their opinion that by friend and relatives suggestion they will purchase common use medicines. To know the association of family type and suggestion for purchase common use medicines Ȥ2 test statistic can be tested for the Hypothesis. Ho-There is no association of family type and suggestion by which consumer can purchase common use medicine H1- There is association of family type & suggestion by which consumer can purchase common use medicine Here Chi-Square test statistic (Ȥ2) = 14.629 Since Ȥ2 (4) =14.629, p > 0.05 at 5% level of significance then there is no significant association of family type & suggestion by which consumer can purchase common use medicine. - 129 4.2.5.2 Relation between Educational Qualification and suggestion by which consumer can purchase common use medicine:Education can be expected to lead, in the long-run, to significant changes in consumer behavior The analysis of data indicates amongst the 76 respondent of undergraduate educational qualification 27 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, where as 24 respondent give their opinion that by doctor suggestion they will purchase common use medicine. Similarly 15 respondents give their opinion that by friend and relatives suggestion they will purchase common use medicine and 8&2 respondent purchase common use medicine by retailer and news paper. Table no. 4.2.5.2:- Association of suggestion by which common use medicine are purchased with Educational qualification. Educational Qualification * By which suggestion you will purchase common use medicines Crosstabulation By which suggestion you will purchase common use medicines Educational Under Count Qualification graduate Expected News Friends & paper Relatives Doctor Retailer Television Total 24 2 27 8 15 76 21.3 6.7 23.6 7.9 16.6 76.0 31.6% 2.6% 35.5% 10.5% 19.7% 100.0% 20 14 43 7 14 98 27.4 8.6 30.4 10.1 21.4 98.0 20.4% 14.3% 43.9% 7.1% 14.3% 100.0% Count % within Educational Qualification Count Expected Graduate Count % within Educational Qualification Contd…. - 130 Educational Qualification * By which suggestion you will purchase common use medicines Cross tabulation By which suggestion you will purchase common use medicines Post Count Graduate Expected 32 News paper 19 Friends & Relatives 43 13.7 48.1 16.0 33.9 155.0 31.0% 8.4% 20.6% 12.3% 27.7% 100.0% 92 29 102 34 72 329 92.0 29.0 102.0 34.0 72.0 329.0 28.0% 8.8% 31.0% 10.3% 21.9% 100.0% Doctor Retailer Television 48 13 43.3 Total 155 Count % within Educational Qualification Total Count Expected Count % within Educational Qualification Pearson Chi-Square Degree of freedom 27.317 a Asymp. Sig. (2-sided) 8 .001 Similarly amongst 98 respondent of graduate educational qualification 43 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, where as 20 respondent give their opinion that by doctor suggestion they will purchase common use medicine. Similarly 14 respondent give their opinion that by friend and relatives suggestion they will purchase common use medicine and 14 & 7 respondent purchase common use medicine by retailer and news paper Further 155 respondent of post graduate educational qualification 32 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine where as 48 respondent give their opinion that by doctor suggestion they will purchase common use medicine. Similarly 43 respondents give their opinion that by friend and relatives suggestion they will purchase common use medicine and 13 & 19 - 131 respondent purchase common use medicine by retailer and news paper. In context to the data analysis of whole respondent of different qualification the 102 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, where as 92 respondent give their opinion that by doctor suggestion they will purchase common use medicine. Similarly 72 respondent give their opinion that by friend and relatives suggestion they will purchase common use medicine and 29, 34 respondent purchase commom use medicine by retailer and news paper suggestion. To know the association of Educational Qualification and suggestion by which consumer can purchase common use medicine Ȥ2 test statistic can be tested for the Hypothesis. Ho-There is no association of Educational Qualification and suggestion by which consumer can purchase common use medicine. H1- There is an association of Educational Qualification and suggestion by which consumer can purchase common use medicine Here Chi-Square test statistic (Ȥ2) = 27.317. Since Ȥ2 (8) =27.317, p < 0.05 at 5% level of significance then there is significant association with Educational Qualification and suggestion by which consumer can purchase common use medicine 4.2.5.3 Relation between Occupation and suggestion by which consumer can purchase common use medicine:The analysis of data indicates amongst the 49 student respondent 16 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, where as 12 respondents give their opinion that by doctor suggestion they will purchase common use medicine and 13 respondents give - 132 their opinion that news paper medium of advertisement act as suggestive measure for purchase of common use medicines. Table no.4.2.5.3:- Association of suggestion by which common use medicine are purchased with occupation. Occupation * By which suggestion you will purchase common use medicines Crosstabulation By which suggestion you will purchase common use medicines Doctor Retailer Television 12 4 16 13 Friends & Relatives 4 13.7 4.3 15.2 5.1 10.7 49 24.50% 8.20% 32.70% 26.50% 8.20% 100.00% 11 6 22 3 18 60 16.8 5.3 18.6 6.2 13.1 60 18.30% 10.00% 36.70% 5.00% 30.00% 100.00% 17 11 23 6 26 83 23.2 7.3 25.7 8.6 18.2 83 20.50% 13.30% 27.70% 7.20% 31.30% 100.00% 47 8 21 9 12 97 27.1 8.6 30.1 10 21.2 97 48.50% 8.20% 21.60% 9.30% 12.40% 100.00% 0 0 20 3 12 35 9.8 3.1 10.9 3.6 7.7 35 0.00% 0.00% 57.10% 8.60% 34.30% 100.00% 5 0 0 0 0 5 1.4 0.4 1.6 0.5 1.1 5 100.0% 0.00% 0.00% 0.00% 0.00% 100.00% News Student Count Expected paper Total 49 Count % within Occupation Business Count Expected Count % within Occupation Occupation Government Count Service Expected Count % within Occupation Professional Count Expected Count % within Occupation Housewife Count Expected Count % within Occupation Count Any Other (Please Specify) Expected Count % within Occupation Contd…… - 133 Occupation * By which suggestion you will purchase common use medicines Crosstabulation By which suggestion you will purchase common use medicines Doctor Total Retailer Television News Friends & paper Relatives Total Count 92 29 102 34 72 329 Expected 92 29 102 34 72 329 28.00% 8.80% 31.00% 10.30% 21.90% 100.00% Count % within Occupation Pearson Chi-Square Degree of freedom 88.541 a Asymp. Sig. (2-sided) 20 0 Similarly 4 respondents give their opinion that by retailer suggestion and 4 respondents by friends and relatives suggestion they purchase common use medicines. Furthermore amongst 60 respondent of business occupation, 22 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine whereas 11 respondents give their opinion that by doctor suggestion they will purchase common use medicine and 3 respondents give their opinion that news paper medium of advertisement act as suggestive measure for purchase of common use medicines. Similarly 6 respondents give their opinion that by retailer suggestion and 18 respondents by friends and relatives suggestion they purchase common use medicines. Further 83 respondent of Government service 23 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, whereas 17 respondents give their opinion that by doctor suggestion they will purchase common use medicine and 6 respondents give their opinion that news paper medium of advertisement act as suggestive measure for purchase of common use medicines. Similarly 11 respondents give their opinion that by retailer suggestion and 26 respondents by friends and relatives suggestion they purchase common use medicines. 97 respondent who are professional by occupation 21 respondent give the opinion that Television medium of - 134 advertisement act as a suggestive measure for purchase of common use medicine, where as 47 respondents give their opinion that by doctor suggestion they will purchase common use medicine and 8 respondents give their opinion that news paper medium of advertisement act as suggestive measure for purchase of common use medicines. Similarly 9 respondents give their opinion that by retailer suggestion and 12 respondents by friends and relatives suggestion they purchase common use medicines. Out of total 329 respondent, 35 respondent are housewife in which 20 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, where as no respondents give their opinion that by doctor suggestion and retailer suggestion they will purchase common use medicine and 3 respondents give their opinion that news paper medium of advertisement act as suggestive measure for purchase of common use medicines. Similarly 12 respondents give their opinion that by friends and relatives suggestions they purchase common use medicines. 5 respondent of some different profession relied on doctor suggestion they will purchase medicines. To know the association of Occupation and suggestion by which consumer can purchase common use medicine Ȥ2 test statics can be tested for the Hypothesis Ho-There is no association of Occupation and suggestion by which consumer can purchase common use medicine H1- There is an association of Occupation and suggestion by which consumer can purchase common use medicine Here Chi-Square test statistic (Ȥ2 ) = 88.541 Since Ȥ2 (20) =88.541, p < 0.05 at 5% level of significance then there is significant association Occupation and suggestion by which consumer can purchase common use medicine. - 135 4.2.5.4 Relation between Martial Status and suggestion by which consumer can purchase common use medicine:The analysis of data indicates amongst the 208 married respondent 69 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, whereas 56 respondents give their opinion that by doctor suggestion they will purchase common use medicine and 16 respondents give their opinion that newspaper medium of advertisement act as suggestive measure for Table no. 4.2.5.4:- Association of suggestion by which consumer can purchase common use medicine with Marital Status. Marital Status * By which suggestion you will purchase common use medicines Cross tabulation By which suggestion you will purchase common use medicines Friends Married News & paper Relatives Doctor Retailer Television 56 15 69 16 52 208 58.2 18.3 64.5 21.5 45.5 208.0 26.9% 7.2% 33.2% 7.7% 25.0% 100.0% 36 14 31 17 20 118 33.0 10.4 36.6 12.2 25.8 118.0 30.5% 11.9% 26.3% 14.4% 16.9% 100.0% Count 0 0 1 1 0 2 Expected .6 .2 .6 .2 .4 2.0 0.0% 0.0% 50.0% 50.0% 0.0% 100.0% Count Expected Total Count % within Marital Status Unmarried Count Expected Marital Count Status % within Marital Status Widow Count % within Marital Status Contd….. - 136 Marital Status * By which suggestion you will purchase common use medicines Cross tabulation By which suggestion you will purchase common use medicines Separated 0 Television 1 News paper 0 Friends & Relatives 0 .3 .1 .3 .1 .2 1.0 0.0% 0.0% 100.0% 0.0% 0.0% 100.0% 92 29 102 34 72 329 92.0 29.0 102.0 34.0 72.0 329.0 28.0% 8.8% 31.0% 10.3% 21.9% 100.0% Doctor Retailer Count 0 Expected Total 1 Count % within Marital Status Total Count Expected Count % within Marital Status Pearson Chi-Square 15.584 Degree of freedom a Asymp. Sig. (2-sided) 12 .211 purchase of common use medicines, 15 respondents give their opinion that by retailer suggestion and 52 unmarried respondents by friends and relatives suggestion they purchase common use medicines. Furthermore amongst 118 unmarried respondent of 31 respondent give the opinion that Television medium of advertisement act as a suggestive measure for purchase of common use medicine, whereas 36 respondents give their opinion that by doctor suggestion they will purchase common use medicine and 17 respondents give their opinion that newspaper medium of advertisement act as suggestive measure for purchase of common use medicines, 14 respondents give their opinion that by retailer suggestion and 20 respondents by friends and relatives suggestion they purchase common use medicines. Further 2 widow respondent of 1 respondent give the opinion that Television medium of advertisement act as a - 137 suggestive measure for purchase of common use medicine & 1 respondent give their opinion that newspaper medium of advertisement act as suggestive measure for purchase of common use medicines. Similarly 1 respondent give their opinion that by Newspaper medium of advertisement act as suggestive measure for purchase of common use medicines. To know the association of marital status and suggestion by which consumer can purchase common use medicine Ȥ2 test statics can be tested for the Hypothesis Ho-There is no association of marital status and suggestion by which consumer can purchase common use medicine H1- There is an association of Occupation and suggestion by which consumer can purchase common use medicine Here Chi-Square test statistic (Ȥ2 ) = 15.584 Since Ȥ2 (12) =15.584, p>0.05 at 5% level of significance then there is no significant association marital and suggestion by which consumer can purchase common use medicine. 4.2.6 Influencers for purchase of common use medicines: The drugs which can be collected without the prescription are termed as the Over the Counter (OTC) drugs. The impact of those messages on consumers is often stronger than the direct effect of advertisements, because marketing campaigns that trigger positive word of mouth have comparatively higher campaign reach and influence. Attention is the allocation of mental resources, visual or cognitive, to visible or conceptual objects. Before consumers can be affected by advertising messages, they need to first be paying attention This study is also endeavored to identify the most suitable influencing factors that influence consumer to purchase of any OTC drugs. The primary factors identified are the past experience with the drugs, corporate image - 138 of the pharmaceutical company, brand identity of the drug, insignificant side effect, and prior assumption about the drug to be used for the ailment, apart from this advertising,friend & relatives,Retailer and doctor also influence for selecting common use medicines. To know most influencing factor for selecting common use medicine an attempt has been made. The relevant data and its analysis are given below in table no.4.2.6 Table no. 4.2.6:- Influencer in selecting medicine for common diseases. Influencer in selecting medicine for common diseases S. No Description No. of Respondents Percentage 1 Advertising 102 31.00 2 Friends & relatives 101 30.70 3 Retailer 45 13.68 4 Doctor 81 24.62 329 100.00 Total Fig 4.13: Influencing factor in selecting common use medicine. The study indicates that about 31.00% respondent influence by advertising for selection/purchasing of common use medicine while 30.70% respondent influence by - 139 Friends & relatives for selection/purchasing of common use medicine 24.62% respondent influence by doctor for selection/purchasing of common use medicine. Furthermore 13.68% respondent influence by doctor for selection/purchasing of common use medicine.Thus the study highlights that advertisement act as a major influencing factor for consumer to select/ purchase commom use medicines. An attempt was also made to assess the degree of relationship of Demographic variables like family size, Educational qualification, Occupation and Marital Status of respondents with influencing factor for selecting common medicines .For this purpose the data was processed to establish the relationship of factors which are responsible for determining influencing factor for selecting common medicines with demographic profile of respondent.The information in this respect is presented in table no 4.2.6.1 to 4.2.6.5 4.2.6.1 Relation between Family type and factor influence most in selecting medicine for common diseases Buyer behavior is strongly influenced by the member of a family. Therefore marketers are trying to find the roles and influence of the husband, wife and children. If the buying decision of a particular product is influenced by wife then the marketers will try to target the women in their advertisement. The analysis of data in the table above indicates that among the 254 nuclear family 84 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases.76 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease 57 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 37 respondent give their opinion that retailer influence most for selecting medicine for common disease. - 140 Table no. 4.2.6.1:- Association of factor influencing most in selecting medicine for common disease with family type Family type * Who influenced you most in selecting medicine for common diseases Crosstabulation Who influenced you most in selecting medicine for common diseases Friends & Advertising Family Nuclear type Count Expected relatives Retailer Doctor Total 84 76 37 57 254 78.7 78.0 34.7 62.5 254.0 33.1% 29.9% 14.6% 22.4% 100.0% 18 25 8 24 75 23.3 23.0 10.3 18.5 75.0 24.0% 33.3% 10.7% 32.0% 100.0% 102 101 45 81 329 102.0 101.0 45.0 81.0 329.0 31.0% 30.7% 13.7% 24.6% 100.0% Count % within Family size Joint Count Expected Count % within Family size Total Count Expected Count % within Family size Pearson Chi-Square 4.549 Degree of freedom a Asymp. Sig. (2-sided) 3 .208 Further in 75 joint family 18 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases 25 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 24 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases - 141 and 8 respondent give their opinion that retailer influence most for selecting medicine for common disease. To know the association of family type and factor influence to purchase medicine for common disease Ȥ2 Test statistic can be tested for the Hypothesis. Ho-There is no association of family type and factor influence to purchase medicine for common disease. H1- There is association of family type & factor influence to purchase medicine for common disease. Here Chi-Square test statistic (Ȥ2 ) = 4.549 Since Ȥ2 (3) =4.549, p > 0.05 at 5% level of significance then there is no significant association of family type & factor influence to purchase medicine for common disease. 4.2.6.2 Relation between Educational Qualification and factor influence most in selecting medicine for common diseases Every society possesses some form of social class which is important to the marketers because the buying behavior of people in a given social class is similar.The analysis of data in the table below indicates that among the 76 undergraduate 14 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases. 26 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease 24 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 12 respondent give their opinion that retailer influence most for selecting medicine for common disease. - 142 Table no. 4.2.6.2:- Association of factor influences most in selecting medicine for common disease with Educational Qualification. Educational Qualification * Who influenced you most in selecting medicine for common diseases Crosstabulation Who influenced you most in selecting medicine for common diseases Friends & Educational Under Count Qualification graduate Expected Advertising relatives Retailer Doctor Total 14 26 12 24 76 23.6 23.3 10.4 18.7 76.0 18.4% 34.2% 15.8% 31.6% 100.0% 36 29 15 18 98 30.4 30.1 13.4 24.1 98.0 36.7% 29.6% 15.3% 18.4% 100.0% 52 46 18 39 155 48.1 47.6 21.2 38.2 155.0 33.5% 29.7% 11.6% 25.2% 100.0% 102 101 45 81 329 102.0 101.0 45.0 81.0 329.0 31.0% 30.7% 13.7% 24.6% 100.0% Count % within Educational Qualification Graduate Count Expected Count % within Educational Qualification Count Expected Post Count Graduate % within Educational Qualification Count Expected Count Total % within Educational Qualification Pearson Chi-Square Degree of freedom 9.631a 6 - 143 Asymp. Sig. (2-sided) .141 Further in 98 respondent of graduate qualification 36 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases, 29 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 18 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 15 respondent give their opinion that retailer influence most for selecting medicine for common disease. Similarly 155 postgraduate respondent 52 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases, 46 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 39 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 18 respondent give their opinion that retailer influence most for selecting medicine for common disease To know the association of Qualification and factor influence to purchase medicine for common disease Ȥ2test statistic can be tested for the Hypothesis Ho-There is no association of Qualification and factor influence to select medicine for common disease H1- There is association of Qualification & factor influence to select medicine for common disease Here Chi-Square test statistic (Ȥ2 ) = 9.631 Since Ȥ2 (6) =9.631, p > 0.05 at 5% level of significance then there is no significant association of qualification & factor influence to select medicine for common disease. - 144 4.2.6.3 Relation between Occupation and factor influence most in selecting medicine for common diseases:The analysis of data in the table above indicates that among the 49 student respondent 16 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases 17 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease 12 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 4 respondent give their opinion that retailer influence most for selecting medicine for common disease. Table no. 4.2.6.3:- Association between Occupation and factor influence most in selecting medicine for common diseases. Occupation * Who influenced you most in selecting medicine for common diseases Crosstabulation Occupation Student Count Expected Who influenced you most in selecting medicine for common diseases Friends & Advertising relatives Retailer Doctor 16 17 4 12 Total 49 15.2 15.0 6.7 12.1 49.0 32.7% 34.7% 8.2% 24.5% 100.0% 19 18 9 14 60 18.6 18.4 8.2 14.8 60.0 31.7% 30.0% 15.0% 23.3% 100.0% 25 22 14 22 83 25.7 25.5 11.4 20.4 83.0 30.1% 26.5% 16.9% 26.5% 100.0% Count % within Occupation Business Count Expected Count % within Occupation Count Government Service Expected Count % within Occupation Contd….. - 145 Occupation * Who influenced you most in selecting medicine for common diseases Crosstabulation Who influenced you most in selecting medicine for common diseases Friends & Advertising Professional Count Expected relatives Retailer Doctor Total 34 36 11 16 97 30.1 29.8 13.3 23.9 97.0 35.1% 37.1% 11.3% 16.5% 100.0% 6 8 6 15 35 10.9 10.7 4.8 8.6 35.0 17.1% 22.9% 17.1% 42.9% 100.0% 2 0 1 2 5 1.6 1.5 .7 1.2 5.0 40.0% 0.0% 20.0% 40.0% 100.0% 102 101 45 81 329 102.0 101.0 45.0 81.0 329.0 31.0% 30.7% 13.7% 24.6% 100.0% Count % within Occupation Housewife Count Expected Count % within Occupation Any Other Count (Please Expected Specify) Count % within Occupation Total Count Expected Count % within Occupation Pearson Chi-Square Degree of freedom 17.755 15 - 146 Asymp. Sig. (2-sided) .276 Further in 60 respondent of business occupation 19 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases,18 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease,14 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 19 respondent give their opinion that retailer influence most for selecting medicine for common disease. Similarly 83 respondent of Government service 25 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases, 22 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 22 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 14 respondent give their opinion that retailer influence most for selecting medicine for common disease. In 97 professional respondent 34 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases, 36 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 16 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 11 respondent give their opinion that retailer influence most for selecting medicine for common disease. In 35 housewife respondent 6 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases,8 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 15 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 6 respondent give their opinion that retailer - 147 influence most for selecting medicine for common disease. 5 respondent of different occupation in which 2 respondent influenced by advertisement, 2 by doctor & 1 influenced by retailer for selecting medicine for common disease. To know the association of occupation and factor influence to purchase medicine for common disease Ȥ2 test statistic can be tested for the Hypothesis Ho-There is no association of occupation and factor influence to select medicine for common disease H1- There is association of occupation & factor influence to select medicine for common disease Here Chi-Square test statistic (Ȥ2) = 17.755 Since Ȥ2 (15) =17.755, p > 0.05 at 5% level of significance then there is no significant association of occupation & factor influence to select medicine for common disease. 4.2.6.4 Relation between Marital Status and factor influence most in selecting medicine for common diseases:The analysis of data in the table above indicates that among the 208 married respondents 62 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases 64 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 56 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 26 respondent give their opinion that retailer influence most for selecting medicine for common disease. - 148 Table no. 4.2.6.4:- Association between Marital Status and factor influence most in selecting medicine for common diseases. Marital Status * Who influenced you most in selecting medicine for common diseases Cross tabulation Who influenced you most in selecting medicine for common diseases Friends & Advertising Total Retailer Doctor relatives Marital Married Count 62 64 26 56 208 Status Expected 64.5 63.9 28.4 51.2 208.0 29.8% 30.8% 12.5% 26.9% 100.0% 39 37 18 24 118 36.6 36.2 16.1 29.1 118.0 33.1% 31.4% 15.3% 20.3% 100.0% Count 0 0 1 1 2 Expected .6 .6 .3 .5 2.0 0.0% 0.0% 50.0% 50.0% 100.0% Count 1 0 0 0 1 Expected .3 .3 .1 .2 1.0 100.0% 0.0% 0.0% 0.0% 100.0% 102 101 45 81 329 102.0 101.0 45.0 81.0 329.0 31.0% 30.7% 13.7% 24.6% 100.0% Count % within Marital Status Unmarried Count Expected Count % within Marital Status Widow Count % within Marital Status Separated Count % within Marital Status Total Count Expected Count % within Marital Status Pearson Chi-Square Degree of freedom 7.936 a 9 - 149 Asymp. Sig. (2-sided) .541 Further in 118 unmarried respondent 39 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases, 37 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 24 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 18 respondent give their opinion that retailer influence most for selecting medicine for common disease. Similarly in 2 widow advertisement 1 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 1 respondent give their opinion that retailer influence most for selecting medicine for common disease To know the association of marital status and factor influence to purchase medicine for common disease Ȥ2 test statistic can be tested for the Hypothesis. Ho-There is no association of marital status and factor influence to select medicine for common disease H1- There is association of marital status & factor influence to select medicine for common disease Here Chi-Square test statistic (Ȥ2) = 7.935 Since Ȥ2 (9) =7.935, p > 0.05 at 5% level of significance then there is no significant association of marital status & factor influence to select medicine for common disease. 4.2.6.5 Relation between Age and influencing factor in selecting medicine for common disease :- The analysis of data in the table above indicates that among the 96 respondents of age group 18-28 years 39 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases - 150 28 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 17 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 12 respondent give their opinion that retailer influence most for selecting medicine for common disease. Table no. 4.2.6.5:- Association between Age and factor influence most in selecting medicine for common diseases. Age * Who influenced you most in selecting medicine for common diseases Crosstabulation Who influenced you most in selecting medicine for Total common diseases Advertising Friends & Retailer Doctor relatives Count 18-28 Expected Count % within Age Count 29-39 Expected Count % within Age Count Age 40-50 Expected Count % within Age Count 51-61 Expected Count % within Age Count > 61 Expected Count % within Age Count Total Expected Count % within Age Pearson Chi-Square 39 28 12 17 96 29.8 29.5 13.1 23.6 96.0 40.6% 29.2% 12.5% 17.7% 100.0% 34 43 18 34 129 40.0 39.6 17.6 31.8 129.0 26.4% 33.3% 14.0% 26.4% 100.0% 17 12 8 9 46 14.3 14.1 6.3 11.3 46.0 37.0% 26.1% 17.4% 19.6% 100.0% 10 16 4 15 45 14.0 13.8 6.2 11.1 45.0 22.2% 35.6% 8.9% 33.3% 100.0% 2 2 3 6 13 4.0 4.0 1.8 3.2 13.0 15.4% 15.4% 23.1% 46.2% 100.0% 102 101 45 81 329 102.0 101.0 45.0 81.0 329.0 31.0% 30.7% 13.7% 24.6% 100.0% Degree of freedom 16.952a 12 - 151 Asymp. Sig. (2-sided) .151 Further in 129 respondent of age group 34 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases, 43 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 34 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 18 respondent give their opinion that retailer influence most for selecting medicine for common disease. Similarly 46 respondent of age group 40-50 years 17 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases, 12 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 9 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 8 respondent give their opinion that retailer influence most for selecting medicine for common disease. Among 45 respondent of age group 51-61 years respondent are in the opinion that advertisement influence 10 most in selecting present medicines for common diseases, 16 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 15 respondent give their opinion that doctor suggestion influence most for purchase of medicine used for common diseases and 4 respondent give their opinion that retailer influence most for selecting medicine for common disease. Further 13 respondent of age group greater than 61, 2 respondent are in the opinion that advertisement influence most in selecting present medicines for common diseases,2 respondent give their opinion that recommendation of the friends and relatives influenced most for selecting medicine for common disease, 6 respondent give their opinion that doctor suggestion influence most for purchase of - 152 medicine used for common diseases and 3 respondent give their opinion that retailer influence most for selecting medicine for common disease To know the association of Age and factor influence to purchase medicine for common disease Ȥ2 test statistic can be tested for the Hypothesis. Ho-There is no association of Age and factor influence to select medicine for common disease H1- There is association of Age & factor influence to select medicine for common disease Here Chi-Square test statistic (Ȥ2) = 16.952 Since Ȥ2 (12) =16.952, p > 0.05 at 5% level of significance then there is no significant association of Age & factor influence to select medicine for common disease. 4.3 Lasting effect of Advertisement:Of all marketing weapons, advertising is renowned for its long lasting impact on consumer mind, as its exposure is much broader.To know the extent of lasting effect of advertisement input i.e how much time these advertisement make their lasting effect on consumer, an attempt has been made. The relevant data and its analysis are given below in table no. 4.3 Table no.4.3: Lasting effect of Advertisement Lasting effect of Advertisement S. No Description No. of Respondents Percentage 1 Few hours 54 16.41 2 One day 29 8.81 3 One week 93 28.27 4 One month 74 22.49 5 More than month 79 24.01 329 100.00 Total - 153 Fig 4.14: Lasting effect of Advertisement The study indicates that about 28.27% respondent give their opinion that input of advertisement make the lasting effect for one week. Similarly 24.01% respondent give their opinion that input of advertisement make the lasting effect for more than month and 22.49% respondent give their opinion that input of advertisement make the lasting effect for about one month.Further more 16.41% respondent give their opinion that input of advertisement make the lasting effect for few hours and 8.81% respondent give their opinion that input of advertisement make the lasting effect for about one day. Thus the study highlights that long lasting effect of advertisement is about one week for consumer. 4.4 Impact of Advertisement to create the need of pharmaceutical productPharmaceutical advertising is one of the most important kinds of advertising that can have a direct impact on the health of a consumer. In reality, it has been observed that pharmaceutical product advertisers often promoted their products to achieve their own goals at the potential risk of having an adverse effect on the consumer's health. Advertisements, at times, tend to encourage consumers to evaluate products based - 154 upon actual need. This type of advertising is most often seen in over-the-counter drug product advertisements, and not as often in the case of prescription drug advertisements, which is relatively new. Hence, this necessitates the fact that it is essential for advertisers of such products to take special care and additional responsibility when devising the promotional strategies of these products. In reality, it has been observed that pharmaceutical product advertisers often promoted their products to achieve their own goals at the potential risk of having an adverse effect on the consumer's health. This type of advertising is most often seen in over-the-counter drug product advertisements, and not as often in the case of prescription drug advertisements, which is relatively new. Keeping this into consideration, an attempt is made to assess the ability of advertisements to create the need for the product in mind of consumers. For this purpose consumer were classified into four categories:one categories includes those respondents who are of the opinion that advertisement is able to create the need of the products to a great extent, another categories includes those who are of the opinion that it is able to create a need in their to a considerable extent.Other two categories of respondents include those who are either accept to some extent or not at all. The relevant data and its analysis are given below in table no.4.4 Table no.4.4:- Impact advertisement to create need among consumer. Impact of advertisement to create need S. No Description No. of Respondents Percentage 1 To a great extent 67 20.36 2 To some extent 105 31.91 3 To a considerable extent 91 27.66 4 Not at all 66 20.06 Total 329 100.00 - 155 Fig. 4.15:- Impact advertisement to create need among consumer. The analysis of data indicates that as many as 31.91% respondent are of the opinion that advertisement of the product is able to create the need of the product in their mind to great extent.Another 27.66% respondent are of the view that it is able to create the need of for the product to considerable extent.Furthermore 20.36% of the respondent is of the opinion that it is able to create the need for the to a great extent in their mind. Remaining 20.06% respondent feel that advertising is not able to create the need for the product at all in their mind.Thus the analysis clearly indicates that most of the respondents are of the opinion that advertising plays significant role in creating the need for the product in the mind of consumers but with varying extent. 4.5 Nature of AttentionAttention is a necessary ingredient for effective advertising. The market for consumer attention (or “eyeballs”) has become so competitive that attention can be regarded as a currency.It is the most convenient route to reach to consumers.Consumers are manipulated by advertisement promise that the product will do something special for them which will transform their life.The main reasons for - 156 liking an advertisement was the information it provided regarding the discount,special gifts,brands and quality of the products. Keeping these factors into consideration an attempt was made to know nature of attention paid by the customer when they see new advertisement of pharmaceutical product like vitamin, tablets, cough syrup and contraceptive etc. The relevant data and its analysis are given below in table no.4.5 Table no. 4.5:- Nature of attention paid by consumer in pharmaceutical advertisement Nature of attention paid by consumer in pharmaceutical advertisement. S. No Description No. of Respondents Percentage 1 more attention 78 23.71 2 some attention 158 48.02 3 little attention 60 18.24 4 ignore it 33 10.03 329 100.00 Total Fig. 4.16:- Nature of attention paid by consumer in pharmaceutical advertisement - 157 The analysis indicates that 48.02% respondent revealed that they pay some attention towards advertisement whenever they seen any new pharmaceutical advertisement. 23.71% indicated that they pay more attention towards advertisement whenever they seen any new pharmaceutical advertisement. Similarly 18.24 % indicated that they pay little attention towards advertisement whenever they seen any new pharmaceutical advertisement. Remaining 10.03% respondent revealed that they ignore it. This signifies that sample is dominated by those respondents who pay some attention towards pharmaceutical advertisement. 4.6 Attributes observed in advertisement – Advertising systems serve ads directly based on demographic, psychographic, or behavioral attributes associated with the consumer(s) exposed to the ad. The pharmaceutical industry has not been as efficient in leveraging the power of their brands. This is primarily because drugs have always competed against each other based on functional attributes (clinical and product related features) In pharmaceutical advertisement some following pharmaceutical attributes like strength,dosage form,route of administration and dosing schedule are observed by consumers.To know the product pharmaceutical advertisement attribute an attempt has been made. The relevant data and its analysis are given below in table no.4.6 Table no. 4.6:- Attributes observed in advertisement Attributes observed in advertisement S. No Description No. of Respondents Percentage 1 Strength 174 52.89 2 Dosage form 79 24.01 3 Route of administration 37 11.25 4 Dosing schedule 39 11.85 Total 329 100.00 - 158 Fig. 4.17:- Attributes observed in advertisement The analysis indicates that 52.89 % respondent revealed that strength attribute in pharmaceutical advertisement are observed by him. 24.01 % indicated that Dosage form attribute in pharmaceutical advertisement are observed by him. Similarly 11.85 % indicated that Dosing schedule attribute in pharmaceutical advertisement are observed by him. Remaining 11.25 % indicated that route of administration attribute in pharmaceutical advertisement are observed by consumers. 4.7 Extent of influence of Pharmaceutical Advertisement:An attempt was made to examine the role of advertisement in the purchasing of pharmaceutical product/medicines.This attempt was directed to explain the ability of the advertisement to influence the consumer to purchase particular type of pharmaceutical product/ medicines. The result is shown in table no.4.7 Table no. 4.7:- Extent of influence of Pharmaceutical Advertisement Extent of influence of Pharmaceutical Advertisement S. No 1 2 3 4 Description To a great extent To some extent To a considerable extent Not at all Total No. of Respondents 67 105 91 66 329 - 159 - Percentage 20.36 31.91 27.66 20.06 100.00 Fig 4.18:- Extent of influence of Pharmaceutical Advertisement The analysis indicates that 31.91% respondent revealed that they influence by pharmaceutical advertisement to some extent product. Another 27.66 % indicated that in purchasing a particular type of they influence by pharmaceutical advertisement to considerable extent in purchasing a particular type of product. Similarly 20.36 % indicated that they influence by pharmaceutical advertisement to a great extent in purchasing a particular type of product. Remaining 20.06% respondent are in the opinion that pharmaceutical advertisement had not influenced them at all in purchasing the pharmaceutical products/medicine. 4.8 Relying on Pharmaceutical Advertisement in purchase decision:Over-the-counter (OTC) drugs are one of the most important and easily available public health aids for the treatment of common conditions or symptomatic relief. Although there are different means of providing the consumers with drug information, advertising seems to be one of the best ways and a powerful method of broadcasting information. Numerous changes have occurred in pharmaceutical advertising in recent times. In the past, pharmaceutical manufacturers relied on physicians and pharmacists to provide the drug information to the patients. However, with the advent of - 160 technology, medications came to be marketed to the consumers, using a variety of media, thus enabling them to make drug choices for themselves. An attempt was made to assess that consumer relied on these pharmaceutical advertisemement while making purchase decision. The respondent view regarding the relying on advertisement while making purchase decision is presented in table no 4.8 Table no.4.8 :- Relying on advertisement in purchase decision Relying on advertisement in purchase decision S. No Description No. of Respondents Percentage 1 Strongly agree 62 18.84 2 Agree to some extent 147 44.68 3 Disagree to Some extent 58 17.63 4 Strongly Disagree 62 18.84 329 100.00 Total Fig 4.19. Relying on advertisement in purchase decision The analysis of data indicates that 44.68 % respondent are of the opinion that they agree to some extent on rely upon advertisement while making purchase decision .Another 18.84% respondent are of the view that they strongly agree on rely upon - 161 advertisement while making purchase decision. Furthermore 17.63% of the respondent is of the opinion that they agree to some extent on rely upon advertisement while making purchase decision.Remaining 18.84% respondent are of the opinion that they do not rely upon advertisement while making purchase decision. 4.9 Advertising attributes that impacts in selection of medicines :Advertisement is a single component of marketing process. Pharmaceutical companies use positive emotional appeals, negative emotional appeals, and rational appeals. Positive emotional appeals target consumers by using celebratory anthems, humorous situations, and intimate moments. Rational appeals offer a factual presentation of news about the brand’s features, attributes, or benefits, comparisons with other brands, statistical information, or product usage information. Products may have peripheral or associated attribute to facilitate its identification and acceptance by the buyers. Advertising can serve for marketing well if it is suitable for marketing strategy. Advertising build brand awareness, which builds trust and credibility. Advertiser use different attribute to enhance the effectiveness of advertising in favor of the product. Keeping this into consideration, an attempt was made to know most appealing advertising attribute in favor of medicine selection. The various advertising attribute includes Theme of advertisement, visual presentation of advertisement, Strength of medicine in advertisement, Dosage form in advertisement & celebrities role in advertisement are incorporated in questionnaire and view of respondent are recorded. In questionnaire respondent response are recorded on Likert scale in which 1 stands for strongly agree, 2 stands agree, 3 stands for neutral, 4 stands for Disagree and 5 stands for strongly disagree. The information in this respect is present below in table no.4.9 - 162 Table no.4.9 :- Advertising attributes that impacts in selection of medicines S. no 1 2 3 4 5 Attributes Theme of Advertisement influence me to buy the products Visual presentation of advertisement create more attention Strength of Medicines in advertisement is also a influencing factor In Advertisement, Dosage form (tablet, capsule, liquid etc) also helps me to buy the particular medicine Pharmaceutical advertisement done by celebrities motivate me to purchase the medicine Strongly agree Agree Neutral Disagree Strongly disagree 118 (35.9%) 103 (31.3%) 65 (19.8%) 37 (11.2%) 6 (1.8%) 329 (100%) 2.12 1.077 110 (33.4%) 75 (22.8%) 85 (25.8%) 38 (11.6%) 21 (6.4%) 329 (100%) 2.35 1.230 93 (28.3%) 75 (22.8%) 90 (27.4%) 54 (16.4%) 17 (5.2%) 329 (100%) 2.47 1.207 44 (13.4%) 59 (17.9%) 78 (23.7%) 96 (29.2%) 52 (15.8%) 329 (100%) 3.16 1.272 43 (13.1%) 39 (11.9%) 59 (17.9%) 86 (26.1%) 102 (31.0%) 329 (100%) 3.50 1.377 Total Mean Fig 4.20:- Advertising attributes that impacts in selection of medicines The analysis of data indicatesa) Theme of advertisement :- The study indicates that about 35.9% respondent are strongly agree that theme of advertisement influence him to buy the products. Similarly 31.3% respondent are agree that theme of advertisement influence him to - 163 SD buy the products and 19.8 % respondent are neutral about theme of advertisement influence him to buy the products.Further more 11.20% respondent are disagree that theme of advertisement influence him to buy the products and only 1.8% respondent are strongly disagree that theme of advertisement influence him to buy the products. The mean value and standard deviation of this attributes are 2.12 and 1.077 respectively. b) Visual presentation:- The study indicates that about 33.4 % respondent are strongly agree that Visual presentation of advertisement create more attention. Similarly 22.8% respondent are agree that Visual presentation of advertisement create more attention and 25.8 % respondent are neutral about Visual presentation of advertisement create more attention. Further more 11.60% respondent are disagree that Visual presentation of advertisement create more attention and only 6.40% respondent are strongly disagree that Visual presentation of advertisement create more attention. The mean value and standard deviation of this attributes are 2.35 and 1.230 respectively. c) Strength of Medicines :- The study indicates that about 28.3 % respondent are strongly agree that Strength of Medicines in advertisement is also a influencing factor. Similarly 22.8% respondent are agree that Strength of Medicines in advertisement is also a influencing factor and 27.4 % respondent are neutral about Strength of Medicines in advertisement as influencing factor.Further more 16.4% respondent are disagree that Strength of Medicines in advertisement is also a influencing factor and only 5.2% respondent are strongly disagree that Strength of Medicines in advertisement is also a influencing factor. The mean value and standard deviation of this attributes are 2.47 and 1.207 respectively. - 164 d) Dosage form (tablet, capsule, liquid etc):- The study indicates that about 13.4 % respondent are strongly agree that In Advertisement, Dosage form (tablet, capsule, liquid etc) also helps me to buy the particular medicine. Similarly 17.9 % respondent are agree that In Advertisement, Dosage form (tablet, capsule, liquid etc) also helps me to buy the particular medicine and 23.7 % respondent are neutral about In Advertisement, Dosage form (tablet, capsule, liquid etc) also helps me to buy the particular medicine.Further more 29.2% respondent are disagree that In Advertisement, Dosage form (tablet, capsule, liquid etc) also helps me to buy the particular medicine and only 15.8% respondent are strongly disagree that In Advertisement, Dosage form (tablet, capsule, liquid etc) also helps me to buy the particular medicine. The mean value and standard deviation of this attributes are 3.16 and 1.272 respectively. e) Role of celebrities:- The study indicates that about 13.1% respondent are strongly agree that Pharmaceutical advertisement done by celebrities motivate him to purchase the medicine. Similarly 11.9% respondent are agree that Pharmaceutical advertisement done by celebrities motivate him to purchase the medicine and 17.9% respondent are neutral about Pharmaceutical advertisement done by celebrities motivate him to purchase the medicine.Further more 26.10% respondent are disagree that Pharmaceutical advertisement done by celebrities motivate him to purchase the medicine and 31.00% respondent are strongly disagree that Pharmaceutical advertisement done by celebrities motivate me to purchase the medicine. The mean value and standard deviation of this attributes are 3.50 and 1.377 respectively. The analysis indicates that Theme of Advertisement influence consumer to buy the products has scored lowest mean as compared to all other attributes. - 165 4.10 Demographic Characteristics of Respondents (Doctors):Pharmaceutical marketing differs from other types 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 behaviour reflects as a rise in the 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. The increased expenditure for drug promotion will affect the price 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. How does a doctor select a brand? What are the factors that influence the prescription behaviour of the doctor? What is the influence of pharmaceutical advertising on prescription behaviour? When the physician listens to the detailing by a sales person and later accepts the gifts or samples given by the sales person an immediate industry physician relationship is established. This puts the doctor under some obligation to prescribe the brands that are promoted. The time spent with sales personnel is associated with some benefits to - 166 the doctor like getting information and free samples but it takes away the physicians’ valuable time. The time, spend with the sales personnel should be valued against the monetary or leisure benefits gained in that time. The physician could have utilized the time for leisure activities, gained monetary benefits through consulting patients or even improve his/her knowledge by keeping up-to-date with the literature. Samples left by the sales personnel may be the only reminder to the product long after the detailing. sampling was only “some what effective” in influencing prescription practice. Drug promotion includes the activities of medical representatives, drug advertisements to physicians, provision of gifts and samples, drug package inserts, direct-to-consumer advertisements, periodicals, telemarketing, holding of conferences, symposiums and scientific meetings, sponsoring of medical education and conduct of promotional trials. It is well understood that the pharmaceutical companies do have trade interests in promoting their products for disseminating information about the drug it produces, but it should do so in a fair, accurate, and ethical manner. The blurring boundaries of what constitutes fair practices are of intense debate in issues involving drugs promotion. Pharmaceutical product advertising, in India, is regulated mainly by ‘The Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954’ and by ‘The Drugs and Cosmetics Rules, 1945’ . These acts provide for the consistency of the advertisements with the approved prescribing information, prohibition of certain types of advertisements, and penalties against any instance of breach of these mandatory requirements. The Drugs And Magic Remedies (Objectionable Advertisements) Act, 1954: The purpose of the Act is to control advertisements of drugs in certain cases and to prohibit advertisements of remedies that claim to possess magic qualities. According - 167 to this Act, advertisement includes any notice, circular, label, wrapper or other document and any announcement made orally or by means of producing or transmitting light, sound or smoke. The term drug would include medicines for internal or external use of human beings, substances used in diagnosis, cure, mitigation, treatment or prevention of disease in human beings or animals, any article that would influence the structure or organic function of the body of human beings or animals other than food and any article used as a component of any medicine substance. Magic remedy would include any talisman, mantra, kavacha and any other charm which claims to possess miraculous powers in relation to the diagnosis, cure, mitigation, treatment or prevention of any disease or influencing structure or organic function of the body.The table below provides an overview of the key promotion methods used to target doctors: Table No. 4.10 :- Doctor-directed promotion methods S.no Type Example 1 PharmaceuticalAdvertisements • Brochures • Sponsored articles • Internet •Sponsored journals subscription or textbooks 2 Personal Selling • Visits by medical representatives •Sponsored events with “key opinion leaders” in the field. Most of the time, these company sponsored guest speakers use presentation slides provided by the company for their talk. - 168 S.no Type Example 3 Trade promotion • Gifts • Gimmicks and incentive schemes based on number of prescriptions • Product samples 4 Sponsorship Academic activities • Symposiums • Exhibition booths • Registration fees • Tutoring sessions • Journal clubs • Free textbooks and journal subscriptions Non-academic activities • Entertainment • Excursions • Travelling expenses • Meals • Family-related activities • Donations or support for facilities used in offices i.e. fax machine, printer, furniture, etc. Over the counter drugs can be sold directly to the consumers / patients without any doctor's prescription. On the other hand, Prescription drugs are the drugs which are required to be dispensed under the supervisionRIDphysician. So to know the impact of advertisement on doctor prescription behavior a quessttionaire is also designed for doctors.Doctor prescription behaviour ad their decision regarding medicine prescription is also influenced by their profile like Qualification,position hold by doctor, No. of years of practice,Regional status of - 169 practice,practice hour & O.P.D frequency etc.Keeping this into consideration,an attempt was made to isolate the profile of respondents. 4.10.1 Qualification wise classification of doctors:It is established fact that doctor prescription behavior and impact of advertisement on doctor prescription behaviour varies with qualification.Keeping this into consideration an attempt was made to classify doctors (respondents) on the basis of their qualification.For this purpose, respondents included in the sample were classified into three categories which included those Graduation (M.B.B.S), Post Graduate (MD/MS) and Specialist (Mch/Diploma). The information about Qualification wise classification of respondents is presented below in table no. 4.10.1 Table no.4.10.1 :- Qualification wise classification of Doctor Qualification wise classification of Doctor S. no Qualification No. of Respondents Percentage 7 4.67 1 Graduate (MBBS) 2 Post Graduate (MD/MS) 134 89.33 3 Specialist.(Mch/Diploma) 9 6.00 150 100.0 Total Fig 4.21:- Qualification - wise classification of Doctor - 170 The analysis of data indicates that 89.33% of respondent are in the qualification of post graduate (MD/MS). Similarly 6% of respondent are in the qualification of Specialist (Mch/Diploma) and 6% of respondent are in the qualification of Graduation (MBBS). The analysis clearly reflects that the sample is dominated by those respondents who are in the qualification of post graduate (MD/MS). 4.10.2 Classification on the basis of Position hold by Doctor:The different position hold by doctor also having a different prescription behaviour about medicines.The impact of advertisement is also varies with different position hold by doctors. Keeping this into consideration an attempt was made to classify doctors (respondents) on the basis of the Position hold by respondents. For this purpose ,respondents included in the sample were classified into four categories which included those Medical Officer (M.B.B.S), Junior Resident/MD/MS), Senior resident/Super Specialist and Professor/Teacher. The information about classification on the basis of Position hold by respondents is presented below in table no. 4.10.2 Table no.4.10.2 :- Classification on the basis of Position hold by respondents Classification on the basis of Position hold by respondents S. No Position No. of Respondents Percentage 1 Medical Officer 7 4.67 2 Junior resident/MS/MD 135 90.00 Senior resident/ 3 Super specialization 5 3.33 4 Professor/Teacher 3 2.00 150 100.00 Total - 171 Fig 4.22 :- Classification on the basis of Position hold by respondents The analysis of data indicates that 90.00% of respondent hold the position of Junior Residents/MD/MS. Similarly 4.67% of respondent hold the position of Medical officer in Hospital and 3.33% of respondent hold the position of senior resident/Super specialization. Further more 2.00% of respondent hold the position of Professor/Teacher. The analysis clearly reflects that the sample is dominated by those respondents who Hold the position of Junior Residents/MD/MS. 4.10.3 Classification on the basis of No. of years of practice :No. of years of practice is also a distinguishing variable of doctors prescription behaviour. The doctor having high no. years of practice generally know the prons and cons effect of pharmaceutical advertisement. Keeping this into consideration an attempt was made to classify doctors (respondents) on the basis of No. of years of practice. For this purpose ,respondents included in the sample were classified into four groups which included those 0-2 years of practice, 2-5 years of practice, 5-10 years of practice & more than 10 years of practice. The information about classification on the basis of No. of years of practice of respondents is presented below in table no. 4.10.3 - 172 Table no.4.10.3 :- Classification on the basis of No. of years of practice Classification on the basis of no. of years of Practice S. no No. of years of Practice No. of Respondents Percentage 1 0 to 2 years 53 35.33 2 2 to 5years 72 48.00 3 5 to 10 years 8 5.33 4 >10 years 17 11.33 150 100.00 Total Fig 4.23 :- Classification on the basis of No. of years of practice The analysis of data indicates that 48.00% of respondent having 2 to 5 years of practice. Similarly 35.33 % of respondent having 0 to 2 years of practice and 11.33% of respondent having more than 10 years of practice. Further more 5.33% of respondent having 5-10 years of practice. The analysis clearly reflects that the sample is dominated by those respondents having 2 to 5 years of practice. 4.10.4 Classification on the basis of Regional Status of practice:Regional status of practice by doctors are important variable for prescription of medicine to the medicine and pharmaceutical company also make their advertising strategy according to doctor practice place . - 173 Keeping this into consideration an attempt was made to classify doctors (respondents) on the basis of regional status of practice . For this purpose ,respondents included in the sample were classified into three groups i) whose regional status of practice is in rural area,ii) whose regional status of practice is in semi urban area & iii) whose regional status of practice is in urban area. The information about classification on the basis of regional status of practice of respondents is presented below in table no.4.10.4 Table no.4.10.4 :- Classification on the basis of Regional Status of Practice Place Regional Status of Practice Place S. no Regional Status of Practice No. of Respondents Percentage 1 Rural 10 6.67 2 Semi Urban 28 18.67 3 Urban 112 74.67 150 100.0 Total Fig 4.24 :- Classification on the basis of Regional Status of Practice Place - 174 The analysis projects that 74.67 % of doctors having regional status of practice is urban . Similarly 18.67 % of doctors having regional status of practice is semi-urban and 6.67 % of doctors having regional status of practice is rural. The analysis clearly reflects that the sample is dominated by those doctors whose regional status of practice is urban. 4.10.5 Classification on the basis of practice hours by doctors:Impact of pharmaceutical advertising is closely associated with practice hours of doctors because during practice hour or clinic time medical representative routinely detail doctors, seeking them out for direct interaction to provide product information, and to use these visits as an opportunity to build product name recognition and increase market share. Keeping this into consideration an attempt was made to classify doctors (respondents) on the basis of practice hours . For this purpose ,respondents included in the sample were classified into four groups: i) whose practice houre is 4 hrs ,ii) whose practice houre is 6 hrs iii) whose practice houre is 8 hrs & iv) whose practice houre is round the clock (24 hrs) hrs. The information about classification on the basis of practice hours by doctors of respondents is presented below in table no. 4.10.5 Table no.4.10.5 :- Classification on the basis of Practice Hours Practice Hours - wise classification of doctors S. No Practice Hours No. of Respondents 1 4 hrs 4 2.67 2 6 hrs 84 56.00 3 8 hrs. 51 34.00 4 Round the clock 11 7.33 150 100.0 Total - 175 Percentage Fig 4.25 :- Classification on the basis of Practice Hours The analysis projects that 56 % of doctors having practice hours is 6 hrs . Similarly 34% % of doctors having practice hours is 8hrs and 7.33 % of doctors having practice hours is 4 hrs. Further more 2.67 % of doctors having practice hours is Round the clock (24 hrs) The analysis clearly reflects that the sample is dominated by those doctors whose practice hours is 6 hrs. 4.10.6 Classification on the basis of O.P.D frequency :- A Medical Representative is an important medium of communication with doctors/retailers. Detailing refers to the activity of pharmaceutical sales representatives when they make calls to physicians and provide them with "details” approved scientific information, benefits, side effects, or adverse events related to a drug. Pharmaceutical companies make their advertising strategy on the basis of O.P.D frequency also. Keeping this into consideration an attempt was made to classify doctors (respondents) on the basis of O.P.D frequency.For this purpose, respondents included in the sample were classified into five groups : i) whose O.P.D frequency is <15 ii) whose O.P.D frequency is in between 15 to 25 iii) whose O.P.D frequency is in between 26 to 40 iv) whose O.P.D frequency is in between 21 to 54 - 176 v) whose O.P.D frequency is > 54. The information about classification on the basis of of O.P.D frequency is presented below in table no. 4.10.6 Table no. 4.10.6 :- Classification on the basis of O.P.D Frequency O.P.D Frequency (Daily Average)-wise classification S. No O.P.D Frequency per day No. of Respondents Percentage 1 <15 3 2.00 2 15 to 25 57 38.00 3 26 to 40 42 28.00 4 40 to 54 24 16.00 5 >54 24 16.00 150 100.0 Total Fig 4.26 :- Classification on the basis of O.P.D Frequency The analysis projects that 38% of doctors having O.P.D frequency between 15 to 25. Similarly 28% of doctors having O.P.D frequency between 26 to 40 and 16 % of doctors having O.P.D frequency between 40 to 54. Furthermore 16% of doctors having O.P.D frequency >54 and 2 % of doctors having O.P.D frequency <15. The analysis clearly reflects that the sample is dominated by those doctors whose OPD frequency is between 15 to 25. - 177 4.11 Impact of Pharmaceutical Advertisement on doctor's Presrcription Behaviour : In today's competitive world consumers are exposed to thousands of voices and images in magazines, newspapers, and on billboards, websites, radio and television. Similarly doctors are exposed with different pharmaceutical medium of advertisememnts. Advertisers attempts to steal at least a fraction of a persons time to inform him or her of the amazing and different attributes of the product at hand. To know the impact of different medium of pharmaceutical advertisement factor analysis is used. This analysis was carried out on the data collected from questionnaire in which the doctor were asked to tick a number that was most suitable to their choice concerning 27 items that relate to their attitude/prescription behavior towards pharmaceutical advertisement. A five point Likert-scale was used anchored from strongly agree to strongly disagree for 27 items. The mean & standard deviation for all the 27 items were obtained and tabulated in table no.4.11.1 Table no.4.11.1 Mean and standard deviation of all 27 items S.no 1 2 3 4 5 6 Items Importance of Clinical papers providing information about medicine available for patient in the market. Importance of promotional items (Dinner for the physician and their family) provided by companies Importance of promotional items (Free samples) provided by companies Importance of Hoardings providing information about medicine available for patient in the market. Importance of “Direct-to- Consumer Advertisement” in promotion of medicines Importance of advertising agency in Consumer awareness about medicines - 178 - Mean Std. Deviation 4.33 0.79 3.61 1.15 2.77 0.84 3.55 1.19 3.59 0.91 2.87 0.8 S.No 7 8 9 10 Items Pharmaceutical advertisement are important factor in prescription of branded medicines Importance of celebrities used by companies in brand promotion. Creativity in pharmaceutical advertisement effect my prescription decision Importance of Ethical issues in Promotional activity adopted by companies. Mean Std. Deviation 2.89 0.66 2.3 0.76 3.37 1.01 2.65 0.64 3 1.22 2.93 0.59 3.16 0.74 3.06 0.87 3.01 0.9 3.05 0.77 2.77 1.06 3.33 0.96 2.11 0.62 3.64 1.15 4.11 1.05 Frequency of pharmaceutical advertisement are 11 important factor which influence my prescription decision Pharmaceutical advertisement influence me to 12 change my prescription decision from Generic medicine to Branded medicines 13 14 15 16 17 18 19 20 Importance of promotional activities adopted by companies in the growth of consumerism Importance of promotional channel used by companies convening information to consumers Importance of Regulatory Acts in your prescription Specialized promotional channels and programmes are important in the promotion of medicines. Importance of Internet providing information about medicine available for patient in the market. Patient suggestion (demand) influence my prescription decision Is Medical Representative are important key element in providing information about medicines. Importance of promotional items (Lunch for physician and staff) provided by companies Importance of Medical Journals providing 21 information about medicine available for patient in the market. - 179 - S.No Items Mean Std. Deviation 3.33 0.9 3.96 1.26 2.83 0.8 1.81 0.85 3.37 1.2 2.71 0.86 2.96 0.9091 Importance of Medical Representative providing 22 information about medicine available for patient in the market. Importance of promotional items 23 (Pens/notepads/calendars/etc) provided by companies Effectiveness of information provided through 24 specific seminars held by companies in your prescription Importance of Television/ Electronic Media 25 providing information about medicine available for patient in the market. 26 27 Importance of promotional items (Tickets to special entertainment events) provided by companies Importance of promotional items (Trips to seminars) provided by companies Overall The result indicates that the highest score of doctor opinion that "clinical papers" make an impact on prescription behavior with a mean of 4.33 followed by the “medical journals” (4.12) and “Pens/notepads/calendars/etc” (3.96). The pharmaceutical advertisements on doctor prescription behavior “Television/ Electronic Media” (1.81) scored the lowest followed by “Medical Representative are important key element in providing information about medicines” (2.11) and “Importance of celebrities used by companies in brand promotion” ( 2.25). 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. 27 items included for impact of - 180 pharmaceutical advertisement study. The above mentioned statements having five point Likert scales were subjected to factor analysis. Before the application of factor analysis the following five techniques were also used for the analysis of data. (1) The correlation matrix revealed that there is a strong positive correlation between the pharmaceutical advertisement statements/methods. These statements were considered appropriate for factor analysis procedure. (2) After correlation matrix, anti correlation matrix was also constructed. This matrix shows that partial correlations among the statements are low for example anti- image correlation of statement 1 with respect to statements 1 to 27. Similarly most of the off diagonal elements are small indicating that real factors exist in the data which is necessary for factor analysis. (3) Kaiser Meyer Olkin measure of sampling adequacy focuses on the diagonal elements of partial correlation matrix. It is clear that all of the diagonal elements of partial correlation matrix were sufficiently high for factor analysis. (4) Test of sampling adequacy was then performed. Sum of the values of diagonal elements of partial correlation matrix from statement no. 1 to 27 was 0.665. This shows that statements are good enough for sampling. (5) Bartlett’s Test of Sphericity was also conducted to check the overall significance of the correlation matrices. The value of Kaiser-MeyerOlkin Measure of Sampling Adequacy is 0.695.The test value of Bartlett’s Test of Sphericity was significant and it is indicating that correlation matrix is not an identity matrix. Table no.4.11.2:- KMO and Bartlett's Test KMO and Bartlett's Test Kaiser-Meyer-Olkin Measure of Sampling Adequacy. Approx. Chi-Square Bartlett's Test of Sphericity 2187.699 Df 351 Sig. .000 - 181 - .695 Fig 4.27 :- Scree plot Scree Plot: This scree plot determined the eigenvalues of 27 factors of the factors of pharmaceutical advertisement and for the purpose of this study, the researcher selected five factors whose values greater than 1.81. Principal component analysis (Varimax rotation Matrix): Principal Component analysis was employed for extracting factors and orthogonal rotation with Varimax was applied and shown in table no.4.11.3 Table no.4.11.3: Principal component analysis: Varimax rotation Matrix Statements 1 Factor-1 Factor-2 Factor-3 Factor-4 Factor-5 Communalities 3 4 5 6 7 8 1 0.649 0.115 0.119 -0.568 0.168 0.799 2 0.763 0.068 0.352 0.213 -0.036 0.758 3 0 -0.108 0.53 0.456 0.506 0.756 4 -0.41 0.073 -0.176 -0.053 0.547 0.507 5 0.437 0.179 -0.489 0.205 0.224 0.554 6 0.449 0.014 -0.455 0.292 0.112 0.506 7 -0.073 -0.073 -0.05 0.197 -0.408 0.219 8 -0.412 0.012 0.513 -0.167 -0.135 0.479 9 0.237 0.657 -0.492 - 182 - 0.192 0.076 0.773 Statements 10 Factor-1 Factor-2 Factor-3 Factor-4 Factor-5 Communalities 0.09 0.101 0.119 -0.041 -0.453 0.239 11 0.129 0.69 -0.376 0.228 0.043 0.688 12 0.159 0.071 -0.108 -0.026 0.448 0.244 13 -0.309 0.833 0.232 -0.063 -0.045 0.849 14 -0.204 0.792 0.321 0.061 -0.044 0.777 15 -0.076 0.737 0.012 0 -0.033 0.55 16 -0.17 0.818 0.092 0.016 -0.027 0.708 17 -0.172 0.128 0.15 -0.406 0.527 0.511 18 0.537 -0.163 -0.611 0.05 0.15 0.714 19 -0.198 -0.05 -0.052 0.398 -0.05 0.206 20 0.761 0.044 0.341 0.272 -0.076 0.778 21 0.544 0.082 0.077 -0.519 -0.004 0.579 22 0.422 0.048 0.287 -0.538 0.193 0.493 23 0.57 0.177 0.396 -0.026 0.035 0.515 24 -0.043 -0.04 -0.264 -0.455 0.065 0.284 25 -0.765 -0.102 -0.147 0.033 0.108 0.63 26 0.687 -0.053 0.269 0.261 -0.086 0.623 27 -0.156 -0.146 0.515 0.497 0.46 0.769 Explanation of Variance: Total variance has been explained by table no. 4.11.4. As latent root criterion was used for extraction of factors, only the factors having latent roots or eigenvalues greater than 1.81 were considered significant; all other factors with latent roots less 1.75 were considered insignificant and disregarded. Table-4.11.4: Total variance explained (Rotation) Total Variance Explained Initial Eigenvalues Rotation Sums of Squared Loadings % of Component Total % of Variance Cumulative% Total Variance 1 4.838 17.92 17.92 3.936 14.579 14.579 2 3.652 13.526 31.446 3.669 13.588 28.166 3 2.926 10.836 42.282 3.313 12.272 40.438 4 2.258 8.362 50.644 2.704 10.015 50.453 5 1.833 6.788 57.432 1.884 6.979 - 183 Cumulative % 57.432 The Eigen values for factor-1, 2, 3, 4, & 5 are 4.838, 3.652, 2.926, 2.258 and 1.833 respectively. Percentages of variance for factor-1, 2, 3, 4, & 5 are 14.579, 13.588, 12.272, 10.015, and 6.979 respectively. It indicates that five factors extracted from 27 pharmaceutical advertisement items have cumulative percentages up to 57.432% of the total variance. This is pretty good bargain, because researcher is able to economize on the number of variables (from 27 items reduced them into 5 underlying factors). Criteria for significant factor loading: Now the role of factor loadings becomes important for interpretation of the factors. Factor loading represent a correlation between statement no.1 and factor-1. The criteria given by J. Hair where factor loadings based on sample size are taken as the basis for decision about significant factor loading was adopted. This research had 150 respondents as sample, a factor loading of 0.500 has been considered significant. The Twenty statements no. 1, 2, 3, 4, 8, 9, 11, 13, 14, 15, 16, 17, 18, 20, 21, 22, 23, 25, 26, & 27 have high factor loading. Rest of the statements have low factor loading “Importance of “Direct-to- Consumer Advertisement” in promotion of medicines” (.437), “Importance of advertising agency in Consumer awareness about medicines” (.449), “Pharmaceutical advertisement are important factor in prescription of branded medicines” (-0.073),“Importance of Ethical issues in Promotional activity adopted by companies.” (0.09), “Pharmaceutical advertisement influence me to change my prescription decision from Generic medicine to Branded medicines” (0.159), “Is Medical Representative are important key element in providing information about medicines” (-0.198), “Specific Seminars held by companies” (-0.043) were having factor loading below 0.500 except three items. These statements were not considered for naming. - 184 Naming of factors: After a factor solution has been obtained, all variables have a significant loading on a factor, the researcher attempt to assign some meaning to the pattern of factor loadings. Variable with higher loadings are considered more important and have greater influence on the name or label selected to represent a factor. Researcher examined all the underlined variables for a particular factor and placed greater emphasis on those variables with higher loadings to assign a name or label to a factor that accurately reflected the variables loading on that factor. The names or label is not derived or assigned by the factor analysis; rather, the label is intuitively developed by the factor analyst based on its appropriateness for representing the underlying dimension of a particular factor. All five factors have been given appropriate names on the basis of variables represented in each case. Table-4.11.5: Naming of factors Factor Number Name factor of Label Statement Factor Loading Cronbach’ s alpha Importance of Clinical papers 1 providing information about medicine available for patient in 0.649 the market. Importance 2 of promotional items (Dinner for the physician and their family) provided by 0.763 companies 0.751 Patient 18 suggestion influence my decision - 185 (demand) prescription 0.537 Importance Factor-1 Detailing 20 of promotional items (Lunch for physician and 0.761 staff) provided by companies Importance of Medical Journals 21 providing information about 0.544 medicine available for patient in the market. Importance 23 of promotional items(Pens/notepads/calendars/e 0.57 tc) provided by companies 25 Importance of Electronic Media information Television/ providing about medicine -0.765 available for patient in the market. 26 Importance items of promotional (Tickets to special 0.687 entertainment events) provided by companies Creativity 9 in pharmaceutical advertisement effect my 0.657 prescription decision Frequency of pharmaceutical 11 important 0.690 advertisement are factor influence which my prescription decision 0.721 Importance 13 of promotional activities adopted by companies 0.833 in the growth of consumerism - 186 - Factor-2 Advertising effectiveness 14 Importance of promotional channel used by companies 0.792 convening information to consumers 15 Importance of Regulatory Acts 0.737 in your prescription 16 Specialized promotional channels and programmes are important in the promotion of 0.818 medicines. Brand Factor-3 positioning Importance 3 of promotional items (Free samples) provided 0.53 by companies 0.708 Importance of celebrities used 8 by companies in brand 0.513 promotion. 27 Importance items (Trips promotional 0.515 of to seminars) provided by companies 22 Factor-4 Influence Importance of Representative information Medical -0.538 providing about medicine available for patient in the market. - 187 0.718 Importance 4 providing of Hoardings information about 0.547 medicine available for patient in Factor-5 Informative the market. 0.785 17 Importance providing of information Internet about medicine available for patient in 0.527 the market. (a) Factor-1: Detailing - This factor is most important factor which explained 14.579% of the variation. The statements as “Importance of Clinical papers providing information about medicine available for patient in the market.” (0.649), “Importance of promotional items (Dinner for the physician and their family) provided by companies” (0.763), “Patient suggestion (demand) influence my prescription decision” (0.537), “Importance of promotional items (Lunch for physician and staff) provided by companies” (0.761), "Importance of Medical Journals providing information about medicine available for patient in the market" (0.544), " Importance of promotional items (Pens/notepads/calendars/etc) provided by companies" (0.570), "Importance of Television/ Electronic Media providing information about medicine available for patient in the market" (-0.765) , and " Importance of promotional items (Tickets to special entertainment events) provided by companies" (0.687), are highly correlated with each other. These eight medium of advertisements reflects that pharmaceutical companies to educate a physician about a vendor's products in hopes that the physician will prescribe the company’s products more often; hence, the researcher names this segment as Detailing. - 188 (b) Factor-2: Advertising effectiveness – Second kind of factor explained 13.588% of the variances. In this segment, researcher took the six important variables such as “Creativity in pharmaceutical advertisement effect my prescription decision” (0.657), "Frequency of pharmaceutical advertisement is important factor which influence my prescription decision."(0.690) “Importance of promotional activities adopted by companies in the growth of consumerism” (0.833), " Importance of promotional channel used by companies convening information to consumers" (0.792), " Importance of Regulatory Acts in your prescription" (0.737) and " Specialized promotional channels and programmes are important in the promotion of medicines (0.818). These statements revealed the effectiveness of advertisement that’s why researcher named these variables advertising effectiveness. (c) Factor-3: Brand positioning - This factor explained 12.272% of the variations. “Importance of promotional items (Free samples) provided by companies” (0.530), “Importance of celebrities used by companies in brand promotion.” (0.513), and “Importance of promotional items (Trips to seminars) provided by companies” (0.515). These statements shows promotional items hence researchers named this segment as Brand positioning. (d) Factor-4: Influence - This factor explained 10.015 % of the variations. “Importance of Medical Representative providing information about medicine available for patient in the market” (-0.538), statements shows influence for prescription of medicine hence researchers named this segment as Influence. (e) Factor-5: Informative - This factor explained 6.979% of the variations. “Importance of Hoardings providing information about medicine available for patient in the market” (0.547) and “Importance of Internet providing information about - 189 medicine available for patient in the market” (0.527) .These statements show information of advertisements hence researchers named this segment as Informative. Reliability and validity of the construct: The analysis began with measuring the reliability of the advertisements’ construct. First of all, internal reliability of the scale (27 items) was examined using Cronbach’s alpha coefficient. Value of the reliability are 0.7 and above as an indicator of good reliability. This pharmaceutical advertisement research has been found value of Cronbach’s alpha coefficient greater than 0.700 which is good. After that convergent validity can be assessed from the proposed model by determining whether each indicator’s estimated maximum likelihood loading on the underlying construct is significant. In the table 4.11.3 all factor loading exceed 0.500 except seven items. This shows evidence of convergence validity of this research. Composite reliability coefficients for each construct are also finding out. Composite reliability should be greater than 0.7 to indicate reliable factors (Hair et. al., 2011). This research study showed that composite reliability coefficient are greater than 0.7 indicating reliability of all 27 items. Now, composite reliability, variance extracted and Cronbach’s alpha coefficient values for all 27 items greatly exceeded the minimum acceptable values. This research indicated that measures were free from error and therefore yielding very consistent results. These tests showed that our data are reliable and valid for this research. 4.12 Importance of medium providing information about medicine available for patient in the market:In the 21st century, media such as television, print and radio attract the public by imparting knowledge and awareness of products and services companies. Advertising has become an essential marketing activity in the modern era of large scale production and serve competition in the market.There are various medium of advertisement - 190 which provide information about medicine available for patient in the market. Keeping this into consideration an attempt was made to find out the importance of various medium of pharmaceutical advertisememnt for doctors . The information about Importance of medium providing information about medicine available for patient in the market is presented below in table no 4.12 Table-4.12: Importance of medium providing information about medicines S. Medium of Strongly no Advertisement agree 2 3 Agree Undecided Disagree disagree Total 2 26 53 58 11 150 (1.3%) (17.3%) (35.3%) (38.7%) (7.3%) (100%) Medical 4 12 14 52 68 150 Journals (2.7%) (8.0%) (9.3%) (34.7%) (45.3%) (100%) 0 8 6 64 72 150 (0%) (5.3%) (4%) (42.7%) (48%) (100%) 56 77 10 3 4 150 (37.3%) (51.3%) (6.7%) (2%) (2.7%) (100%) 11 59 48 18 14 150 (13.1%) (11.9%) (17.9%) (26.1%) (31.0%) (100%) 13 22 10 79 26 150 (8.7%) (14.7%) (6.7%) (52.7%) (17.3%) (100%) Seminars held 3 50 69 25 3 150 by companies (2%) (33.3%) (46%) (16.7%) (2.0 %) (100%) Medical 1 Strongly Representative Clinical papers Mean SD 3.13 0.895 4.12 1.049 4.33 0.791 1.81 0.854 2.77 1.064 3.55 1.190 2.83 0.798 Television/ Electronic 4 5 6 Media Internet Hoardings Specific 7 Fig 4.28: Importance of medium providing information about medicines - 191 Respondents were asked to rate statements concerning theeir views on 5 point scale ranging from strongly agree to strongly disagree. The higher the number ,the greater the disagreement.Since the neutral point/undecided point is 3,those means above 3 suggests overall disagreement with statement and those below 3 reflects agreement.The analysis of data indicatesa) Importance of Medical representative in providing information about medicine available for patient in the market:- The study indicates that only 1.3% respondent are strongly agree that Medical representative play important role in providing information about medicine available for patient in the market. Similarly 17.3% respondent are agree that Medical representative play important role in providing information about medicine available for patient in the market and 35.3 % respondent are undecided that Medical representative play important role in providing information about medicine available for patient in the market.Further more 38.70% are disagree that Medical representative play important role in providing information about medicine available for patient in the market and 7.3% respondent are strongly disagree that Medical representative play important role in providing information about medicine available for patient in the market. The mean value and standard deviation of this medium of advertisement are 3.13 and 0.895 respectively.As revealed from the mean score, respondent disagree (3.13) on the fact that Medical representative play important role in providing information about medicine available for patient in the market. b) Importance of Medical Journals in providing information about medicine available for patient in the market:- The study indicates that only 2.7% respondent are strongly agree that Medical journals play important role in providing information about medicine available for patient in the market. Similarly 8.00 % respondent are - 192 agree that Medical journals play important role in providing information about medicine available for patient in the market and 9.3 % respondent are undecided that Medical journals play important role in providing information about medicine available for patient in the market.Further more 34.7% are disagree that Medical journals play important role in providing information about medicine available for patient in the market and 45.3% respondent are strongly disagree that Medical journals play important role in providing information about medicine available for patient in the market. The mean value and standard deviation of this medium of advertisement are 4.12 and 1.049 respectively. As revealed from the mean score, respondent strongly disagree (4.12) on the fact that Medical journals play important role in providing information about medicine available for patient in the market c) Importance of Clinical papers in providing information about medicine available for patient in the market:- The study indicates that no any respondent are strongly agree that Clinical papers play important role in providing information about medicine available for patient in the market. Similarly 5.30 % respondent are agree that Clinical papers play important role in providing information about medicine available for patient in the market and 4.0 % respondent are undecided that Clinical papers play important role in providing information about medicine available for patient in the market.Further more 42.7 % are disagree that Clinical papers play important role in providing information about medicine available for patient in the market and 48% respondent are strongly disagree that Clinical papers play important role in providing information about medicine available for patient in the market. The mean value and standard deviation of this medium of advertisement are 4.33 and 0.791 respectively. As revealed from the mean score, respondent strongly disagree - 193 (4.33) on the fact that Clinical papers play important role in providing information about medicine available for patient in the market d) Importance of Television/Electronic Media in providing information about medicine available for patient in the market:- The study indicates that 37.3% respondent are strongly agree that Television/Electronic play important role in providing information about medicine available for patient in the market. Similarly 51.3 % respondent are agree that Television/Electronic play important role in providing information about medicine available for patient in the market and 6.7 % respondent are undecided that Television/Electronic play important role in providing information about medicine available for patient in the market.Further more 2 % are disagree that Television/Electronic play important role in providing information about medicine available for patient in the market and 2.7% respondent are strongly disagree that Television/Electronic play important role in providing information about medicine available for patient in the market. The mean value and standard deviation of this medium of advertisement are 1.81 and 0.854 respectively. As revealed from the mean score, respondent strongly agree (1.81) on the fact that Television/Electronic play important role in providing information about medicine available for patient in the market e) Importance of Internet in providing information about medicine available for patient in the market:- The study indicates that 13.1% respondent are strongly agree that Internet play important role in providing information about medicine available for patient in the market. Similarly 11.9% respondent are agree that Internet play important role in providing information about medicine available for patient in the market and 17.9% respondent are undecided that Internet play important role in providing information about medicine available for patient in the market.Further more - 194 26.1 % are disagree that Internet play important role in providing information about medicine available for patient in the market and 31% respondent are strongly disagree that Internet play important role in providing information about medicine available for patient in the market. The mean value and standard deviation of this medium of advertisement are 2.77 and 1.064 respectively. As revealed from the mean score, respondent agree (2.77) on the fact that that Internet play important role in providing information about medicine available for patient in the market f) Importance of Hoardings in providing information about medicine available for patient in the market:- The study indicates that 2% respondent are strongly agree that Hoardings play important role in providing information about medicine available for patient in the market. Similarly 33.3% respondent are agree that Hoardings play important role in providing information about medicine available for patient in the market and 6.7% respondent are undecided that Hoardings play important role in providing information about medicine available for patient in the market.Further more 52.7 % are disagree that Hoardings play important role in providing information about medicine available for patient in the market and 17.3% respondent are strongly disagree that Hoardings play important role in providing information about medicine available for patient in the market. The mean value and standard deviation of this medium of advertisement are 3.55 and 1.190 respectively. As revealed from the mean score, respondent disagree (3.55) on the fact that Hoardings play important role in providing information about medicine available for patient in the market g) Importance of Specific Seminars held by companies in providing information about medicine available for patient in the market:- The study indicates that 8.7% respondent are strongly agree that Specific Seminars conducted - 195 by companies play important role in providing information about medicine available for patient in the market. Similarly 14.7% respondent are agree that Specific Seminars conducted by companies play important role in providing information about medicine available for patient in the market and 46 % respondent are undecided that Specific Seminars conducted by companies play important role in providing information about medicine available for patient in the market.Further more 16.7 % are disagree that Specific Seminars conducted by companies play important role in providing information about medicine available for patient in the market and 2% respondent are strongly disagree that Specific Seminars conducted by companies play important role in providing information about medicine available for patient in the market. The mean value and standard deviation of this medium of advertisement are 2.83 and 0.798 respectively. As revealed from the mean score, respondent agree (2.83) on the fact that Hoardings play important role in providing information about medicine available for patient in the market.The analysis indicates that Television/Electronic media play important role in providing information about medicine available for patient in the market has scored lowest mean as compared to all other medium of advertisement. 4.13 Reliability of information provided through different media about medicines:- Medical representatives,Medical journals,clinical papers etc. provide physicians with good information about drug indication and weak information about drug contraindications and side effects. There are many tactics that were adopted by pharmaceutical companies for drug promotion including physician targeted promotion, direct to consumer advertisement, and data manipulation in clinical trials .However physician targeted promotion is the most common tactic in this regard, since physicians have the largest power to shift prescribing from one company to - 196 another. There is a debate about the accuracy and reliability of information that was given from drug companies through various pharmaceutical advertisement medium. Keeping this into consideration an attempt was made to find out reliability of information provided through different media about medicines.The reliability of information provided through different media about medicines to doctors are presented below in table no 4.13 Table-4.13: Reliability of information provided through different medium S. no 4 Medium of advertisement Medical Representative Medical Journals Clinical papers Television/ Electronic Media 5 Internet 6 Hoardings Specific Seminars held by companies 1 2 3 7 Strongly agree 4 (2.7%) 108 (72%) 113 (75.3%) Agree 28 (18.7%) 25 (16.7%) 14 (9.3%) Undecided 97 (64.7%) 2 (1.3%) 4 (2.7%) Disagree 17 (11.3%) 15 (10%) 19 (12.7%) Strongly disagree 4 (2.7%) 0 (0%) 0 (0%) Total 150 (100%) 150 (100%) 150 (100%) 0 (0%) 0 (0%) 0 (0%) 17 (11.3%) 17 (11.3%) 12 (8.0%) 11 (7.3%) 58 (38.7%) 8 (5.3%) 3 (2%) 51 (34%) 73 (48.7%) 4 (2.7%) 24 (16%) 57 (38%) 150 (100%) 150 (100%) 150 (100%) 4 (2.7%) 75 (50%) 54 (36%) 13 (8.7%) 4 (2.7 %) 150 (100%) Mean 2.93 0.715 1.49 0.939 1.53 1.034 3.92 0.863 3.74 2.640 4.17 0.855 2.59 0.796 Fig 4.29: Reliability of information provided through different medium - 197 SD The analysis of data indicatesa) Reliability of information provided by Medical representative about medicines:The study indicates that only 2.7% respondent are strongly agree that information provided by Medical representative for medicines are reliable. Similarly 18.7% respondent are agree that information provided by Medical representative for medicines are reliable and 64.7% respondent are undecided about information provided by Medical representative for medicines are reliable.Further more 11.3% are disagree that information provided by Medical representative for medicines are reliable and 7.3% respondent are strongly disagree information provided by Medical representative for medicines are reliable. The mean value and standard deviation of this medium of advertisement are 3.13 and 0.895 respectively. As revealed from the mean score, respondent disagree (3.13) on the fact that information provided by Medical representative for medicines are reliable. b) Reliability of information provided by Medical Journals about medicines:- The study indicates that only 72% respondent are strongly agree that information provided by Medical Journals for medicines are reliable. Similarly 25% respondent are agree that information provided by Medical Journalsfor medicines are reliable and 2 % respondent are undecided about information provided by Medical Journals for medicines are reliable.Further more 15% are disagree that information provided by Medical Journals for medicines are reliable and no any respondent are strongly disagree that information provided by Medical Journals for medicines are reliable. The mean value and standard deviation of this medium of advertisement are 1.49 and 0.939 respectively. As revealed from the mean score, respondent agree (1.49) on the fact that information provided by Medical Journals for medicines are reliable. - 198 c) Reliability of information provided by Clinical papers about medicines:- The study indicates that only 75.3% respondent are strongly agree that information provided by Clinical papers for medicines are reliable. Similarly 9.3% respondent are agree that information provided by Clinical papers for medicines are reliable and 2.7 % respondent are undecided about information provided by Clinical papers for medicines are reliable.Further more 12.7% are disagree that information provided by Clinical papers for medicines are reliable and no any respondent are strongly disagree that information provided by Clinical papers for medicines are reliable. The mean value and standard deviation of this medium of advertisement are 1.53 and 1.034 respectively. As revealed from the mean score, respondent agree (1.53) on the fact that information provided by Clinical papers for medicines are reliable. d) Reliability of information provided by Television/Electronic Media about medicines:- The study indicates that no any respondent are strongly agree that information provided by Television/Electronic Media for medicines are reliable. Similarly 11.3% respondent are agree that information provided by Television/Electronic Media for medicines are reliable and 7.3 % respondent are undecided about information provided by Television/Electronic Media for medicines are reliable.Further more 59.3% are disagree that information provided by Teleivision/Electronic Media for medicines are reliable and 22% respondent are strongly disagree information provided by Television/Electronic Media for medicines are reliable. The mean value and standard deviation of this medium of advertisement are 3.82 and 0.863 respectively. As revealed from the mean score, respondent disagree (3.82) on the fact that information provided by Television/Electronic Media for medicines are reliable - 199 e) Reliability of information provided by Internet about medicines:- The study indicates that no any respondent are strongly agree that information provided by Internet for medicines are reliable. Similarly 11.3% respondent are agree that information provided by Internet for medicines are reliable and 38.7 % respondent are undecided about information provided by Internet for medicines are reliable.Further more 34% are disagree that information provided by Internet for medicines are reliable and 16% respondent are strongly disagree information provided by Internet for medicines are reliable. The mean value and standard deviation of this medium of advertisement are 3.74 and 2.640 respectively. As revealed from the mean score, respondent disagree (3.74) on the fact that information provided by Internet for medicines are reliable f) Reliability of information provided by Hoardings about medicines:- The study indicates that no any respondent are strongly agree that information provided by Hoardings for medicines are reliable. Similarly 8% respondent are agree that information provided by Hoardings for medicines are reliable and 5.3 % respondent are undecided about information provided by Hoardings for medicines are reliable.Further more 48.7% are disagree that information provided by Hoardings for medicines are reliable and 38% respondent are strongly disagree information provided by Hoardings for medicines are reliable. The mean value and standard deviation of this medium of advertisement are 4.17 and 0.855 respectively. As revealed from the mean score, respondent strongly disagree (4.17) on the fact that information provided by Hoardings for medicines are reliable g) Reliability of information provided by Specific Seminars conducted by companies about medicines:- The study indicates that only 2.7% respondent are strongly agree that information provided by Specific Seminars conducted by - 200 companies for medicines are reliable. Similarly 50% respondent are agree that information provided by Specific Seminars conducted by companies for medicines are reliable and 36 % respondent are undecided about information provided by Specific Seminars conducted by companies for medicines are reliable.Further more 8.7% are disagree that information provided by Specific Seminars conducted by companies for medicines are reliable and 2.7% respondent are strongly disagree information provided by Specific Seminars conducted by companies for medicines are reliable. The mean value and standard deviation of this medium of advertisement are 2.59 and 0.796 respectively. As revealed from the mean score ,respondent agree (2.59) on the fact that information provided by Specific Seminars conducted by companies for medicines are reliable .The analysis indicates that information provided Medical journals for medicines are reliable has scored lowest mean as compared to all other medium of advertisement follwed by information provided clinical papers for medicines are reliable. 4.14 Impact of Medical Representative on Doctor Prescription behaviour :- Drug promotion refers to all informational and persuasive activities by manufacturers and distributors, the effect of which is to induce the prescription, supply, purchase and/or use of medicinal drugs.Pharmaceutical companies use the service of medical sales representatives in marketing their products. These sales representatives need to be adequately trained and possess sufficient medical and technical knowledge to present information about the products in an accurate and responsible manner. The medical representative (MRs) should not only be able to provide accurate information, but should also not to exaggerate the capabilities of the product . To support their sales activity, these sales agents acquire and use detailed personal information on doctors such as names of family members, golf handicaps, and even clothing preferences; - 201 along with what prescriptions the doctor is writing. Doctors can receive small gifts, such as free dinners, event or travel tickets, clocks, free drug samples by Medical Representatives. Keeping this into consideration an attempt was made to know whether the MRs are visited to doctor clinic during practice hour. The information about visit of MRs during practice hours visited per day are presented below in table no 4.14 Table-4.14: Visit of Medical Representative in practice hours. Is Medical Representative (MR) visiting in practice hours? S. no Description No. of Respondents Percentage 1 Yes 117 78.0 2 No 33 22.0 150 100.0 Total Fig 4.30: Visit of Medical Representative in practice hours The analysis of data indicated that 78% of respondent agreed that MRs are visited in clinic during their practice hours and 22% of respondent disagreed that MRs are visited in clinic during their practice hours.Similarly the information regarding frequency of MRs visited per day in clinic during practice hour are given below 4.14.1 - 202 Table-4.14.1:- Frequency of MR Visited per day Frequency of MR Visited per day S. no MRs visited per day No. of Respondents Percentage 1 <5 55 36.7 2 5 -10 95 63.3 3 11-15 0 0.0 4 16-20 0 0.0 5 >20 0 0.0 150 100.0 Total Fig 4.31: Frequency of MR Visited per day The analysis of data indicated that 36.7% of respondent agreed that < 5 MRs are visited in clinic during their practice hours and 63.3% of respondent agreed that 5-10 MRs are visited in clinic during their practice hours. 4.15. Medical Representative as key element for providing information about medicines:- The term “medical representative” or “pharmaceutical representative” refers to people who are hired by pharmaceutical companies based on some specific criteria suitable for working as seller. They interact with doctor through activities of providing drug’s information and persuading to use their drugs. Printed product - 203 literatures, drug samples and gifts are supporting tools for their work. Medical representatives may provide incomplete medical information to influence prescribing practices; they also offer incentives including conference, Seminars, national and aboard sponsorship. So it is necessary to find out how much doctor agreed to Medical Representative as key element for providing information about medicines. The information about Medical Representative as key element for providing information about medicines are presented below in table no 4.15 Table-4.15 Medical Representative as key element Medical Representative as key element for providing information about medicines. S. no Description 1 Strongly agree 2 Agree 3 Undecided 4 5 No. of Respondents Percentage 17 11.33 103 68.67 26 17.33 Disagree 4 2.67 Strongly Disagree 0 0.00 150 100.00 Total The study indicates that only 11.33% respondent are strongly agree that Medical Representative act as a key element for providing information about medicines. Similarly 68.67% respondent are agree that Medical Representative act as a key element for providing information about medicines and 17.33% respondent are undecided about Medical Representative as a key element for providing information about medicines.Further more 2.67% are disagree that Medical Representative act as a key element for providing information about medicines and no any respondent are strongly disagree that Medical Representative act as a key element for providing information about medicines. The mean value of Medical Representative as key - 204 element for providing information about medicines is 2.11. As revealed from the mean score ,respondent agree (2.11) on the fact that Medical Representative act as a key element for providing information about medicines. 4.16 Importance of promotional items /other facilities distributed /provided by companies for doctors:The interaction between physicians and the pharmaceutical industry can be viewed in terms of supply and demand. The pharmaceutical industry has the money, which it can supply to physicians in various forms such as promotional gifts, entertainment, free drug samples, and funding for continuing medical education.To know the importance of promotional items for doctors an attempt was made to know whether these promotional items provided by companies are important for them to prescribe the medicine . The information about Importance of promotional items /other facilities distributed / provided by companies for doctors are presented below in table no 4.16 Table-4.16: Importance of promotional items S. no Promotional items Strongly agree Agree Undecide d Disagree Strongly disagree Total Mean SD 1 Free samples 11 (7.3%) 36 (24%) 85 (56.7%) 13 (8.7%) 5 (3.3%) 150 (100%) 2.77 0.839 2 Trips to seminars 8 (5.3%) 54 (36%) 66 (44%) 17 (11.3%) 5 (3.3%) 150 (100%) 2.71 0.862 3 Pens/ notepads/ calendars/etc Lunch for physician and staff Tickets to special entertainment events Dinner for the physician and their family 5 (3.3%) 25 (16.7%) 17 (11.3%) 27 (18%) 76 (50.7%) 150 (100%) 3.96 1.263 9 (6%) 15 (10%) 37 (24.7%) 49 (32.7%) 40 (26.7%) 150 (100%) 3.64 1.154 12 (8%) 19 (12.7%) 55 (36.7%) 26 (19.3%) 35 (23.3%) 150 (100%) 3.37 1.201 10 (6.7%) 10 (6.7%) 49 (32.7%) 40 (26.7%) 41 (27.3%) 150 (100%) 3.61 1.152 4 5 6 - 205 Fig 4.32: Importance of promotional items The analysis of data indicatesa) Importance of free samples as promotional items:- The study indicates that only 7.3% respondent are strongly agree that free samples are important promotional items for prescription of medicines. Similarly 24% respondent are agree that free samples are important promotional items for prescription of medicines and 56.7 % respondent are undecided about free samples are important promotional items for prescription of medicines.Further more 8.7% are disagree that free samples are important promotional items for prescription of medicines and 3.3% respondent are strongly disagree that free samples are important promotional items for prescription of medicines. The mean value and standard deviation of this medium of advertisement are 2.77 and 0.839 respectively. As revealed from the mean score, respondent agree (2.77) on the fact that free samples are important promotional items for prescription of medicines b) Importance of Trips to seminar as promotional items:- The study indicates that only 5.3% respondent are strongly agree that Trips to seminar are important promotional items for prescription of medicines. Similarly 36% respondent are agree - 206 that Trips to seminar are important promotional items for prescription of medicines and 44 % respondent are undecided about Trips to seminar are important promotional items for prescription of medicines.Further more 11.3% are disagree that Trips to seminar are important promotional items for prescription of medicines and 3.3% respondent are strongly disagree that Trips to seminar are important promotional items for prescription of medicines. The mean value and standard deviation of this medium of advertisement are 2.71 and 0.862 respectively. As revealed from the mean score, respondent agree (2.71) on the fact that Trips to seminar are important promotional items for prescription of medicines c) Importance of Pens /Note pads/calendars etc as promotional items:- The study indicates that only 3.3% respondent are strongly agree that Pens /Note pads/calendars etc are important promotional items for prescription of medicines. Similarly 16.7% respondent are agree that Pens /Note pads/calendars etc are important promotional items for prescription of medicines and 11.3 % respondent are undecided about Pens /Note pads/calendars etc are important promotional items for prescription of medicines.Further more 18% are disagree that Pens /Note pads/calendars etc are important promotional items for prescription of medicines and 50.7% respondent are strongly disagree that Pens /Note pads/calendars etc are important promotional items for prescription of medicines. The mean value and standard deviation of this medium of advertisement are 3.96 and 1.263 respectively. As revealed from the mean score, respondent disagree (3.96) on the fact that Pens /Note pads/calendars etc are important promotional items for prescription of medicines d) Importance of Lunch for physician and staff as promotional items:- The study indicates that only 6% respondent are strongly agree that Lunch for physician and staff are important promotional items for prescription of medicines. Similarly 10 % - 207 respondent are agree that Lunch for physician and staff are important promotional items for prescription of medicines and 24.7 % respondent are undecided about Lunch for physician and staff are important promotional items for prescription of medicines.Further more 32.7% are disagree that Lunch for physician and staff are important promotional items for prescription of medicines and 26.7% respondent are strongly disagree that Lunch for physician and staff are important promotional items for prescription of medicines. The mean value and standard deviation of this medium of advertisement are 3.64 and 1.154 respectively. As revealed from the mean score , respondent disagree (3.64) on the fact that Lunch for physician and staff are important promotional items for prescription of medicines e) Importance of Tickets to special entertainment events as promotional items:- The study indicates that only 8% respondent are strongly agree that Tickets to special entertainment events are important promotional items for prescription of medicines. Similarly 12.7 % respondent are agree that Tickets to special entertainment events are important promotional items for prescription of medicines and 36.7 % respondent are undecided about Tickets to special entertainment events are important promotional items for prescription of medicines.Further more 19.3% are disagree that Tickets to special entertainment events are important promotional items for prescription of medicines and 23.3% respondent are strongly disagree that Tickets to special entertainment events are important promotional items for prescription of medicines. The mean value and standard deviation of this medium of advertisement are 3.37 and 1.201 respectively. As revealed from the mean score, respondent disagree (3.37) on the fact that Tickets to special entertainment events are important promotional items for prescription of medicines. - 208 f) Importance of Dinner for the physician and their family as promotional items:The study indicates that only 6.7% respondent are strongly agree that Dinner for the physician and their family are important promotional items for prescription of medicines. Similarly 6.7 % respondent are agree that Dinner for the physician and their family are important promotional items for prescription of medicines and 32.7 % respondent are undecided about Dinner for the physician and their family are important promotional items for prescription of medicines.Further more 26.7% are disagree that Dinner for the physician and their family are important promotional items for prescription of medicines and 27.3% respondent are strongly disagree that Dinner for the physician and their family are important promotional items for prescription of medicines. The mean value and standard deviation of this medium of advertisement are 3.61 and 1.152 respectively. As revealed from the mean score , respondent disagree (3.61) on the fact that Dinner for the physician and their family are important promotional items for prescription of medicines. 4.17 Effectiveness of information provided through different media in doctor prescription:- There are various medium of advertisememnt by which pharmaceutical companies make their advertisememnt.Through advertisement they provide information about medicines like dosing schedule,adverse effect of drug, chemical constitutents etc. But it is not necessary that information provided by companies may effect doctor on their prescription decision. To know the effectivness of information provided through different media in doctor prescription an attempt was made to know whether information provided by companies may effect the doctor to prescribe the particular medicine or change their prescription decision. The information about effectiveness of information provided through different media in doctor prescription are presented below in table no 4.17 - 209 Table-4.17: Effectiveness of information provided through different media S. no Medium of advertisement Strongly agree Agree Undecided Disagree Strongly disagree Total Mean SD 1 Medical Representative Medical Journals Clinical papers 0 (0%) 36 (24%) 39 (26%) 0 (0%) 52 (34.7%) 92 (61.3%) 89 (59.3%) 20 (13.3%) 62 (41.3%) 13 (8.7%) 13 (8.7%) 10 (6.9%) 36 (24%) 9 (6%) 9 (6%) 98 (65.3%) 0 (0%) 0 (0%) 0 (0%) 22 (14.7%) 150 (100%) 150 (100%) 150 (100%) 150 (100%) 2.89 0.761 1.97 0.755 1.95 0.767 3.81 0.847 0 (0%) 0 (0%) 0 (0%) 13 (8.7%) 18 (12%) 71 (47.3%) 75 (50%) 10 (6.9%) 63 (42%) 55 (36.7%) 73 (48.7%) 16 (10.7%) 7 (4.7%) 49 (32.7%) 0 (0%) 150 (100%) 150 (100%) 150 (100%) 3.37 0.710 4.02 0.937 2.63 0.670 2 3 4 5 Television/ Electronic Media Internet 6 Hoardings 7 Specific Seminars held by companies Fig 4.33: Effectiveness of information provided through different media a) Effectivness of information provided by Medical Representative:- The study indicates that no any respondent are strongly agree that information provided by Medical representative may effect doctor to their prescription decision.Similarly 34.7% respondent are agree that information provided by Medical representative may effect doctor to their prescription decision and 41.3 % respondent are undecided that - 210 information provided by Medical representative may effect doctor to their prescription decision.Further more 24% are disagree that information provided by Medical representative may effect doctor to their prescription decision and no any respondent are strongly disagree that information provided by Medical representative may effect doctor to their prescription decision. The mean value and standard deviation of this medium of advertisement are 2.89 and 0.761 respectively.As revealed from the mean score, respondent agree (2.89) on the fact that information provided by Medical representative may effect doctor to their prescription decision. b) Effectivness of information provided by Medical Journals:- The study indicates that 24% respondent are strongly agree that information provided by Medical journals may effect doctor to their prescription decision. Similarly 61.3% respondent are agree that information provided by Medical journals may effect doctor to their prescription decision and 8.7 % respondent are undecided that information provided by Medical journals may effect doctor to their prescription decision.Further more 6% are disagree that information provided by Medical journals may effect doctor to their prescription decision and no any respondent are strongly disagree that information provided by Medical journals may effect doctor to their prescription decision. The mean value and standard deviation of this medium of advertisement are 1.97 and 0.755 respectively.As revealed from the mean score, respondent agree (1.97) on the fact that information provided by Medical journal may effect doctor to their prescription decision. c) Effectivness of information provided by Clinical papers:- The study indicates that 26% respondent are strongly agree that information provided by clinical papers may effect doctor to their prescription decision.Similarly 59.3% respondent are agree that information provided by clinical papers may effect doctor to their prescription - 211 decision and 8.7 % respondent are undecided that information provided by clinical papers may effect doctor to their prescription decision.Further more 6% are disagree that information provided by clinical papers may effect doctor to their prescription decision and no any respondent are strongly disagree that information provided by clinical papers may effect doctor to their prescription decision. The mean value and standard deviation of this medium of advertisement are 1.95 and 0.767 respectively. As revealed from the mean score, respondent agree (1.95) on the fact that information provided by clinical papers may effect doctor to their prescription decision. d) Effectivness of information provided by Television/Electronic media:- The study indicates that no any respondent are strongly agree that information provided by Television/Electronic media may effect doctor to their prescription decision.Similarly 13.3% respondent are agree that information provided by Television/Electronic media may effect doctor to their prescription decision and 6.9% respondent are undecided that information provided by Television/Electronic media may effect doctor to their prescription decision.Further more 65.3% are disagree that information provided by Television/Electronic media may effect doctor to their prescription decision and 14% respondent are strongly disagree that information provided by Television/Electronic media may effect doctor to their prescription decision. The mean value and standard deviation of this medium of advertisement are 3.81 and 0.847 respectively.As revealed from the mean score, respondent disagree (3.81) on the fact that information provided by Television/Electronic media may effect doctor to their prescription decision. e) Effectivness of information provided by Internet:- The study indicates that no any respondent are strongly agree that information provided by Internet may effect doctor to their prescription decision.Similarly 8.7% respondent are agree that information - 212 provided by Internet may effect doctor to their prescription decision and 50% respondent are undecided that information provided by Internet may effect doctor to their prescription decision.Further more 36.7% are disagree that information provided by Internet may effect doctor to their prescription decision and 4.7% respondent are strongly disagree that information provided by Internet may effect doctor to their prescription decision. The mean value and standard deviation of this medium of advertisement are 3.37 and 0.710 respectively. As revealed from the mean score, respondent disagree (3.37) on the fact that information provided by Internet may effect doctor to their prescription decision. f) Effectivness of information provided by Hoardings:- The study indicates that no any respondent are strongly agree that information provided by Hoardings may effect doctor to their prescription decision.Similarly 12% respondent are agree that information provided by Hoardings may effect doctor to their prescription decision and 6.7% respondent are undecided that information provided by Hoardings may effect doctor to their prescription decision.Further more 48.7% are disagree that information provided by Hoardings may effect doctor to their prescription decision and 32.7% respondent are strongly disagree that information provided by Hoardings may effect doctor to their prescription decision. The mean value and standard deviation of this medium of advertisement are 4.02 and 0.937 respectively. As revealed from the mean score, respondent disagree (4.02) on the fact that information provided by Hoardings may effect doctor to their prescription decision. g) Effectivness of information provided by Specific seminars held by companies:The study indicates that no any respondent are strongly agree that information provided by specific seminars held by companies may effect doctor to their prescription decision.Similarly 12% respondent are agree that information provided - 213 by specific seminars held by companies may effect doctor to their prescription decision and 6.7% respondent are undecided that information provided by specific seminars held by companies may effect doctor to their prescription decision.Further more 48.7% are disagree that information provided by specific seminars held by companies may effect doctor to their prescription decision and 32.7% respondent are strongly disagree that information provided by specific seminars held by companies may effect doctor to their prescription decision. The mean value and standard deviation of this medium of advertisement are 2.63 and 0.670 respectively. As revealed from the mean score, respondent agree (2.67) on the fact that information provided by specific seminars held by companies may effect doctor to their prescription decision. 4.18 Importance of promotional channels used by companies and their long lasting effect on the mind of doctors. Traditionally prescription drugs were marketed directly towards medical professionals; it proves that physicians maintain their authority to choose a drug. Physicians believe that patients understand that they need to consult a health care expert about treatment appropriate to them.Only a doctor remains a person who possesses full responsibility of deciding whether a drug is right for their patients. It is extremely difficult to approach and convince physicians by simple means such as knowledge sharing, pamphlet distribution, or medical alerts as these will not be helpful in many situations to change the current practices. On the other hand, a medical representative will be able to change the practices from one visit only. The primary purpose of pharmaceutical promotion is conveying objective and balanced information to the target auditorium. The promotional message meets the needs of prescribers (as well as other stakeholders) for appropriate information, and its content - 214 becomes the basic element of understanding promotion in the market. Regarding prescription drugs pharmaceutical industry primarily engaged in personal selling (detailing), followed by mass use of samples, and also investing in scientific conferences and publications. Pharmaceutical companies used various promotional channels to make the long lasting effect on the doctor mind about prescription medicines . But it is not possible that all promotional channel make their impact on doctor mind .So it is necessary to find out the most suitable promotional channel that make their long lasting effect on doctor because these long lasting effect may reflects during the prescription of medicines.An attempt was made to know about promotional channels used by companies and their long lasting effect on the mind of doctors.The information regarding this are presented below in table no.4.18 Table No. 4.18:- Importance of promotional channels used by companies and their long lasting effect on the mind of doctors S. Medium of no advertisement agree Medical Representative 1 2 3 4 Strongly Strongly Agree Undecided Disagree 14 20 34 33 49 150 (9.3%) (13.3%) (22.7%) (22%) (32.7%) (100%) 10 19 38 33 50 150 (6.7%) (12.7%) (25.3%) (22%) (33.3%) (100%) Medical 14 20 34 33 49 150 Journals (9.3%) (13.3%) (22.7%) (22%) (32.7%) (100%) Television 42 46 10 41 11 150 advertisement (28%) (30.7%) (6.7%) (27.3%) (7.3%) (100%) 1 5 57 71 16 150 (0.7%) (3.3%) (38%) (47.3%) (10.7%) (100%) Clinical Paper 5 Internet 6 Hoarding disagree Total 5 13 53 40 39 150 (3.3%) (8.7%) (35.3%) (26.7%) (26%) (100%) 14 65 54 10 7 150 (9.3%) (43.3%) (36%) (6.7%) (4.7%) (100%) Mean SD 2.40 1.221 3.63 1.251 3.55 1.319 2.55 1.344 3.64 0.744 3.63 1.064 2.54 0.924 Specific 7 Seminars held by companies - 215 Fig 4.34: Importance of promotional channels used by companies and their long lasting effect on the mind of doctors a) Importance of medical representative as promotional channel and their long lasting effect:- The study indicates that 9.3% respondent are strongly agree that Medical representative as promotional channel make long lasting effect on their mind. Similarly 13.3% respondent are agree that Medical representative as promotional channel make long lasting effect on their mind and 22.7 % respondent are undecided that Medical representative as promotional channel make long lasting effect on their mind.Further more 22% respondent are disagree that Medical representative as promotional channel make long lasting effect on their mind and 32.7% respondent are strongly disagree that Medical representative as promotional channel make long lasting effect on their mind. The mean value and standard deviation of this promotional channel are 2.40 and 1.221 respectively. As revealed from the mean score, respondent agree (2.40) on the fact that Medical representative as promotional channel make long lasting effect on their mind. b) Importance of Clinical paper as promotional channel and their long lasting effect:- The study indicates that 6.7% respondent are strongly agree that Clinical paper as promotional channel make long lasting effect on their mind .Similarly 12.7% - 216 respondent are agree that Clinical paper as promotional channel make long lasting effect on their mind and 25.3 % respondent are undecided that Clinical paper as promotional channel make long lasting effect on their mind.Further more 22% respondent are disagree that Clinical paper as promotional channel make long lasting effect on their mind and 33.3% respondent are strongly disagree that Clinical paper as promotional channel make long lasting effect on their mind. The mean value and standard deviation of this promotional channel are 3.63 and 1.251 respectively.As revealed from the mean score, respondent disagree (3.63) on the fact that clinical paper as promotional channel make long lasting effect on their mind. c) Importance of Medical Journals as promotional channel and their long lasting effect:- The study indicates that 9.3% respondent are strongly agree that Medical Journals as promotional channel make long lasting effect on their mind . Similarly 13.3% respondent are agree that Medical Journals as promotional channel make long lasting effect on their mind and 22.7% respondent are undecided that Medical Journals as promotional channel make long lasting effect on their mind.Further more 22% respondent are disagree that Medical Journals as promotional channel make long lasting effect on their mind and 32.7% respondent are strongly disagree that Medical Journals as promotional channel make long lasting effect on their mind. The mean value and standard deviation of this promotional channel are 3.55 and 1.319 respectively.As revealed from the mean score, respondent disagree (3.55) on the fact that Medical Journals as promotional channel make long lasting effect on their mind. d) Importance of Television advertisement as promotional channel and their long lasting effect:- The study indicates that 28% respondent are strongly agree that Television advertisement as promotional channel make long lasting effect on their mind . Similarly 30.7% respondent are agree that Television advertisement as - 217 promotional channel make long lasting effect on their mind and 6.7% respondent are undecided that Television advertisement as promotional channel make long lasting effect on their mind.Further more 27.3% respondent are disagree that Television advertisement as promotional channel make long lasting effect on their mind and 7.3% respondent are strongly disagree that Television advertisement as promotional channel make long lasting effect on their mind. The mean value and standard deviation of this promotional channel are 2.55 and 1.344 respectively. As revealed from the mean score, respondent agree (2.55) on the fact that Television advertisement as promotional channel make long lasting effect on their mind. e) Importance of Internet as promotional channel and their long lasting effect:The study indicates that only 0.7% respondent are strongly agree that Internet as promotional channel make long lasting effect on their mind . Similarly 3.3% respondent are agree that Internet as promotional channel make long lasting effect on their mind and 38% respondent are undecided that Internet as promotional channel make long lasting effect on their mind.Further more 47.3% respondent are disagree that Internet as promotional channel make long lasting effect on their mind and 10.7% respondent are strongly disagree that Internet as promotional channel make long lasting effect on their mind. The mean value and standard deviation of this promotional channel are 3.64 and 0.744 respectively. As revealed from the mean score, respondent disagree (3.64) on the fact that Internet as promotional channel make long lasting effect on their mind. f) Importance of Hoardings as promotional channel and their long lasting effect:The study indicates that only 3.3% respondent are strongly agree that Hoardings as promotional channel make long lasting effect on their mind. Similarly 8.7% respondent are agree that Hoardings as promotional channel make long lasting effect - 218 on their mind and 35.3% respondent are undecided that Hoardings as promotional channel make long lasting effect on their mind.Further more 26.7% respondent are disagree that Hoardings as promotional channel make long lasting effect on their mind and 26% respondent are strongly disagree that Hoardings as promotional channel make long lasting effect on their mind. The mean value and standard deviation of this promotional channel are 3.63 and 1.064 respectively. As revealed from the mean score, respondent disagree (3.63) on the fact that Hoardings as promotional channel make long lasting effect on their mind. g) Importance of Specific Seminars held by companies as promotional channel and their long lasting effect:- The study indicates that only 3.3% respondent are strongly agree that Specific Seminars held by companies as promotional channel make long lasting effect on their mind . Similarly 8.7% respondent are agree that Specific Seminars held by companies as promotional channel make long lasting effect on their mind and 35.3% respondent are undecided that Specific Seminars held by companies as promotional channel make long lasting effect on their mind.Further more 26.7% respondent are disagree that Specific Seminars held by companies as promotional channel make long lasting effect on their mind and 26% respondent are strongly disagree that Specific Seminars held by companies as promotional channel make long lasting effect on their mind. The mean value and standard deviation of this promotional channel are 2.54 and 0.924 respectively. As revealed from the mean score, respondent agree (2.54) on the fact that Specific Seminars held by companies as promotional channel make long lasting effect on their mind. - 219 4.19 Influence of prescription decision of doctor w.r.t Branded medicine, Generic medicine and patient demand. Generic drug, a drug sold or prescribed under the non-proprietary name of its active ingredients or under a generally descriptive name rather than under a brand or trade name. There are generic versions of both over-the-counter and prescription medications, but not all drugs have generic equivalents. Generic drugs can only be produced when a patent on a brand name drug expires or when a patent has never existed. They are generally cheaper than the equivalent brand name drug because of much lower marketing and development costs. Branded drug has a trade name and is protected by a patent (can be produced and sold only by the company holding the patent). There are so many pharmaceutical companies which advertise their pharmaceutical products through different media like Medical representative ,Clinical papers,Medical journals etc for prescription of their branded medicine to the patient.As stated above generic medicines are generally cheaper than the equivalent brand name drug because of much lower marketing and development costs,so it may be possible that various pharmaceutical advertising media influence the doctor prescription decision from generic medicine to Branded medicine. Sometimes free samples have been shown to affect physician prescribing behaviour. Physicians with access to free samples are more likely to prescribe brand name medication over equivalent generic medications Similarly sometime it is also possible that patient demand about particular medicine also influence prescription decision of doctor.So it is nececessary to know that whether advertising for branded drug over generic medicine and patient demand influence their prescription decision are not. The information regarding this are presented below in table no. 4.19 - 220 Table No. 4.19:- Influence of prescription decision of doctor S. Statement no Pharmaceutical 1 advertisement N Mean SD 150 2.89 0.661 150 2.93 0.587 150 3.33 0.959 are important factor in prescription of branded medicines Pharmaceutical 2 influence advertisement me to change my prescription decision from Generic medicine to Branded medicines 3 Patient suggestion (demand) influence my prescription decision The information presented in the above table indicates the mean and standard deviation of the statement "Pharmaceutical advertisement are important factor in prescription of branded medicines", " Pharmaceutical advertisement influence me to change my prescription decision from Generic medicine to Branded medicines" and " Patient suggestion (demand) influence my prescription decision". The analysis indicates that statement "Pharmaceutical advertisement are important factor in prescription of branded medicines" has scored lowest mean as compared to all other statement.However statement " Pharmaceutical advertisement influence me to change my prescription decision from Generic medicine to Branded medicines" has scored lowest standard deviation amongest all. 4.20 Influence of prescription decision of doctor w.r.t specialized promotional channels,creativity in pharmaceutical advertisement and frequency of pharmaceutical advertisement Pharmaceutical marketing is unique as the decision making of buying the medicine lies in the hand of intermediate customer (doctor) rather than final consumer (patient). Thus pharmaceutical companies try to influence the customer (doctor) rather than - 221 final consumer (Patient). Thus doctors are the most important players in pharmaceutical marketing system. Doctors write the prescriptions that determine which drugs (brands) will be used by the consumer (patient). Thus influencing the doctor is a key to the pharmaceutical sales. Pharmaceutical companies try to influence prescription pattern of doctors in favor of their brands by offering various kinds of promotional inputs like samples, gifts and sponsorships etc. Doctors have regular contact with the pharmaceutical industry and its sales representatives, who spend a large sum of money each year promoting to them by way of gifts, free meals, travel subsidies, sponsored teachings, and symposia. Similarly the medium of communication must be creative for example the medical representative is the face of the pharmaceutical company and only he can create an impact on the prescriber of the medicine. It is very important to see that the medical representative delivers the message appropriately. Pharmaceutical companies direct all their efforts to promote their medicine to these distinct classes of customers and train the field sales force to take on the task of promoting medicines to highly skilled and knowledgeable customers (doctors). Hence pharmaceutical selling is distinct from other kinds of selling so there is a importance of simple, creative, and effective communication in pharmaceutical selling/promoting.Apart from above frequency of advertisement, frequency is a well-established variable in advertising effectiveness. It has been well documented that repeated exposure to an advertising campaign will increase the likelihood of changing consumer awareness and attitudes towards a brand. However, the time span over which multiple exposures occur is very important, as inundating someone with a high number of exposures in a short period of time can have an adverse effect. Awareness levels steadily increase by frequency when the ads are viewed over a longer period of time, such as a month.But pharmaceutical - 222 advertisement of prescription medicine is different from advertisement of other product because, here is the doctor who takes the decision on the behalf of patient/consumer regarding the prescription of medicines and finally purchase of medicines. Table No. 4.20 Influence of prescription decision of doctor w.r.t specialized promotional channels S. no 1 2 3 Statement Specialized promotional channels and programmes are important in the promotion of medicines. Creativity in pharmaceutical advertisement effect my prescription decision Frequency of pharmaceutical advertisement are important factor which influence my prescription decision N Mean SD 150 3.05 0.767 150 3.37 1.014 150 3.00 1.215 The information presented in the above table indicates the mean and standard deviation of the statement "Specialized promotional channels and programmes are important in the promotion of medicines", "Creativity in pharmaceutical advertisement effect my prescription decision" and " Frequency of pharmaceutical advertisement are important factor which influence my prescription decision". The analysis indicates that statement " Frequency of pharmaceutical advertisement are important factor which influence my prescription decision " has scored lowest mean as compared to all other statement.However statement " Specialized promotional channels and programmes are important in the promotion of medicines." has scored lowest standard deviation amongest all. - 223 4.21 Impact and extent of impact of Pharmaceutical advertisement: - It depends on the various variables, due to different variables impact also differs. Qualification of doctor is also one of the variable in which there is a difference in impact of advertisement when compared with different dimensions. ANOVA is applied on the data to check whether difference exists in impact of advertisement perceived by various educations of doctors among all the dimensions. Table no. 4.21:- ANOVA by Doctor Educational Qualification ANOVA IN DOCTOR EDUCATIONAL QUALIFICATION Sum of Squares Mean Square df F Sig. Importance of medium providing information about medicine available for patient in the market. Between Groups .366 2 .183 .226 .798 Medical Within Groups 118.967 147 .809 Representative Total 119.333 149 Between Groups Medical Journals 3.060 2 1.530 Within Groups 160.780 147 1.094 Total 163.840 149 .902 2 .451 Within Groups 92.431 147 .629 Total 93.333 149 .438 2 .219 Within Groups 108.336 147 .737 Total 108.773 149 .062 2 .031 Within Groups 168.771 147 1.148 Total 168.833 149 1.640 2 .820 Within Groups 209.433 147 1.425 Total 211.073 149 .033 2 .016 Within Groups 94.801 147 .645 Total 94.833 149 Between Groups Clinical papers Between Groups Television/ Electronic Media Between Groups Internet Between Groups Hoardings Between Groups Specific Seminars held by companies 1.399 .250 .717 .490 .297 .744 .027 .973 .576 .564 .025 .975 1.647 .196 Reliability of information provided through different media about medicines Between Groups Medical Representative 1.670 2 .835 Within Groups 74.524 147 .507 Total 76.193 149 - 224 ANOVA IN DOCTOR EDUCATIONAL QUALIFICATION Sum of Squares Between Groups Medical Journals Television/ Electronic Media 2 .583 Within Groups 130.327 147 .887 Total 131.493 149 .821 2 .411 Within Groups 158.572 147 1.079 Total 159.393 149 2.991 2 1.496 Within Groups 108.049 147 .735 Total 111.040 149 8.270 2 4.135 Within Groups 1030.590 147 7.011 Total 1038.860 149 6.121 2 3.061 Within Groups 102.712 147 .699 Total 108.833 149 4.136 2 2.068 Within Groups 90.238 147 .614 Total 94.373 149 1.620 2 .810 .377 Between Groups Between Groups Internet Between Groups Hoardings Specific Seminars held by companies Square 1.166 Between Groups Clinical papers Mean df Between Groups Medical Between Groups Representative as key Within Groups 55.453 147 Total 57.073 149 element in providing information F Sig. .658 .520 .381 .684 2.035 .134 .590 .556 4.380 .014 3.369 .037 2.148 .120 Importance of promotional items /other facilities distributed /provided by companies Between Groups Free samples 6.067 2 3.033 98.767 147 .672 104.833 149 1.586 2 .793 Within Groups 109.087 147 .742 Total 110.673 149 2.285 2 1.143 Within Groups 235.475 147 1.602 Total 237.760 149 Within Groups Total Between Groups Trips to seminars Pens/notepads/calend ars/etc Between Groups - 225 4.515 .013 1.069 .346 .713 .492 ANOVA IN DOCTOR EDUCATIONAL QUALIFICATION Sum of Squares Lunch for physician and staff Tickets to special entertainment events Dinner for the physician and their family Between Groups Mean Square df 2.690 2 1.345 Within Groups 195.870 147 1.332 Total 198.560 149 4.911 2 2.456 Within Groups 210.182 147 1.430 Total 215.093 149 5.047 2 2.523 Within Groups 192.526 147 1.310 Total 197.573 149 Between Groups Between Groups F Sig. 1.010 .367 1.717 .183 1.927 .149 .978 .379 .238 .788 .444 .642 .224 .799 .292 .747 .214 .807 .454 .636 .223 .800 Effectiveness of information provided through different media in your prescription Between Groups Medical Representative 1.133 2 .566 Within Groups 85.161 147 .579 Total 86.293 149 .274 2 .137 Within Groups 84.559 147 .575 Total 84.833 149 .526 2 .263 Within Groups 87.047 147 .592 Total 87.573 149 .325 2 .162 Within Groups 106.449 147 .724 Total 106.773 149 .297 2 .148 Within Groups 74.796 147 .509 Total 75.093 149 .381 2 .190 Within Groups 130.559 147 .888 Total 130.940 149 .411 2 .205 Within Groups 66.423 147 .452 Total 66.833 149 .197 2 .098 .441 Between Groups Medical Journals Between Groups Clinical papers Television/ Electronic Media Between Groups Between Groups Internet Between Groups Hoarding. Specific Seminars held by companies Between Groups Pharmaceutical Between Groups advertisement in Within Groups 64.876 147 Total 65.073 149 prescription of branded medicines - 226 ANOVA IN DOCTOR EDUCATIONAL QUALIFICATION Sum of Squares Pharmaceutical advertisement to change prescription decision from Generic medicine to Branded medicines Between Groups Patient suggestion (demand) influence prescription decision Between Groups “Direct-to- Consumer Advertisement” are important in promotion of medicines Between Groups Ethical issues in Promotional activity adopted by companies. Between Groups Mean Square df .080 2 .040 Within Groups 51.254 147 .349 Total 51.333 149 3.333 2 1.666 Within Groups 133.661 147 .909 Total 136.993 149 .304 2 .152 Within Groups 121.890 147 .829 Total 122.193 149 .489 2 .244 Within Groups 59.785 147 .407 Total 60.273 149 F Sig. .114 .892 1.833 .164 .183 .833 .601 .550 Advertising agency Between Groups 1.022 2 .511 .796 .453 Importance in Consumer Within Groups 94.312 147 .642 awareness about Total 95.333 149 medicines Importance of promotional channels used by companies and their long lasting effect on the mind Between Groups 6.971 2 3.486 2.383 .096 Medical Representative Within Groups 215.029 147 Total 222.000 149 2.832 2 1.416 Within Groups 230.261 147 1.566 Total 233.093 149 13.479 2 6.740 Within Groups 245.594 147 1.671 Total 259.073 149 4.935 2 2.467 Within Groups 264.138 147 1.797 Total 269.073 149 .331 2 .165 Within Groups 82.229 147 .559 Total 82.560 149 .890 2 .445 Within Groups 167.943 147 1.142 Total 168.833 149 Between Groups Clinical Paper Between Groups Medical Journals Between Groups Television advertisement Between Groups Internet Between Groups Hoarding - 227 1.463 .904 .407 4.034 .020 1.373 .257 .296 .744 .389 .678 ANOVA IN DOCTOR EDUCATIONAL QUALIFICATION Sum of Squares Specific Seminars held by companies Between Groups Mean df Square .962 2 .481 Within Groups 126.298 147 .859 Total 127.260 149 .230 2 .115 .586 Celebrities Between Groups Importance in brand Within Groups 86.143 147 promotion. Total 86.373 149 Specialized Between Groups .709 2 .354 promotional channels Within Groups 86.865 147 .591 Total 87.573 149 1.308 2 .654 .550 F Sig. .560 .572 .197 .822 .600 .550 1.189 .307 1.709 .185 1.524 .221 1.104 .334 .772 .464 and programmes in promotion of medicines. promotional activities Between Groups and growth of Within Groups 80.852 147 consumerism Total 82.160 149 promotional channel Between Groups 2.556 2 1.278 and companies Within Groups 109.904 147 .748 Total 112.460 149 2.437 2 1.219 .800 convening information to consumers Importance of Between Groups Regulatory Acts in Within Groups 117.536 147 prescription Total 119.973 149 Creativity in Between Groups 2.265 2 1.133 pharmaceutical Within Groups 150.828 147 1.026 Total 153.093 149 2.286 2 1.143 1.481 advertisement effect prescription decision Frequency of Between Groups pharmaceutical Within Groups 217.714 147 Total 220.000 149 advertisement influence prescription decision a) Importance of medium providing information about medicine available for patient in the market and Qualification of doctor- In the above table having - 228 variables Medical Representative, Medical Journals, Clinical papers, Television/ Electronic Media, Internet, Hoardings and Specific Seminars held by companies the value of significant is 0.798, 0.250, 0.490, 0.744, 0.97, 0.564 and 0.975 respectively which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no impact on this variables b) Reliability of information provided through different media about medicines and Qualification of doctor- In the above table having variables Medical Representative, Medical Journals, Clinical papers, Television/ Electronic Media, and Internet the value of significant is 0.196, 0.520, 0.684, 0.134, and 0.556 respectively which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no impact on these variables where as Hoardings and Specific Seminars held by companies the significant value is 0.014 and 0.037 respectively which is significant (p<0.05) and alternative hypothesis accepted and null hypothesis rejected. It means that Doctor Qualification has impact on this variables c) Medical Representative as key element in providing information and Qualification of doctor: - In the above table the value of significant is 0.120 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variables d) Importance of promotional items /other facilities distributed /provided by companies and Qualification of doctor- In the above table having variables Free samples, Trips to seminars, Pens/notepads/calendars/etc, Lunch for physician and staff, Tickets to special entertainment events and Dinner for the physician and their family, the value of significant is 0.346, 0.492, 0.367, 0.183 and 0.149 respectively which is significant (p>0.05) and tells us that null hypothesis is accepted. It means - 229 that Doctor Qualification has no effect on these variables where as free samples the significant value is 0.013 (p<0.05) which is significant and alternative hypothesis accepted and null hypothesis rejected. It means that Doctor Qualification has effect on this variables e) Effectiveness of information provided through different media in prescription and Qualification of doctor:- In the above table having variables Medical Representative, Medical Journals, Clinical papers, Television/ Electronic Media, Internet, Hoardings and Specific Seminars held by companies the value of significant is 0.379, 0.788, 0.642, 0.799, 0.747, 0.807 and 0.636 respectively which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variables. f) Pharmaceutical advertisement in prescription of branded medicines and Qualification of doctor:- In the above table the value of significant is 0.800 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variables g) Pharmaceutical advertisement to change prescription decision from Generic medicine to Branded medicines and Qualification of doctor: - In the above table the value of significant is 0.892 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. h) Patient suggestion (demand) influence prescription decision and Qualification of doctor: - In the above table the value of significant is 0.164 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. - 230 i) “Direct-to- Consumer Advertisement” are important in promotion of medicines and Qualification of doctor: - In the above table the value of significant is 0.833 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. j) Ethical issues in Promotional activity adopted by companies and Qualification of doctor: - In the above table the value of significant is 0.550 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. k) Advertising agency Importance in Consumer awareness about medicines and Qualification of doctor: - In the above table the value of significant is 0.453 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. l) Importance of promotional channels used by companies and their long lasting effect on the mind and Qualification of doctor- In the above table having variables Medical Representative, Clinical papers, Television/ Electronic Media, Internet, Hoardings and Specific Seminars held by companies the value of significant is 0.096, 0.407, 0.257, 0.744, 0.678, and 0.572 respectively which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on these variables where as medical journals, the significant value is 0.020 which is significant (p<0.05) and alternative hypothesis accepted and null hypothesis rejected. It means that Doctor Qualification has effect on this variables m) Celebrities Importance in brand promotion and Qualification of doctor:- In the above table the value of significant is 0.822 which is insignificant (p>0.05) and - 231 tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variables n) Specialized promotional channels and programmes in promotion of medicines and Qualification of doctor: - In the above table the value of significant is 0.550 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. o) Promotional activities and growth of consumerism and Qualification of doctor:- In the above table the value of significant is 0. 307 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. p) Promotional channel and companies convening information to consumers and Qualification of doctor: - In the above table the value of significant is 0. 185 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. q) Importance of Regulatory Acts in prescription and Qualification of doctor: - In the above table the value of significant is 0.221 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. r) Creativity in pharmaceutical advertisement effect prescription decision and Qualification of doctor: - In the above table the value of significant is 0.334 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Doctor Qualification has no effect on this variable. s) Frequency of pharmaceutical advertisement influence prescription decision and Qualification of doctor: - In the above table the value of significant is 0.464 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It - 232 means that Doctor Qualification has no effect on this variable.Similarly Regional status of practice is also one of the variable in which there is a difference in impact of advertisement when compared with different dimensions. ANOVA is applied on the data to check whether difference exists in impact of advertisement perceived by various educations of doctors among all the dimensions Table no. 4.22:- ANOVA by Regional Status of Practice Place ANOVA IN REGIONAL STATUS OF PRACTICE PLACE Sum of Mean df F Sig. Squares Square Importance of medium providing information about medicine available for patient in the market. 9.226 2 4.613 6.159 .003 Between Groups Medical Representative Within Groups Total Between Groups Medical Journals Within Groups Total Between Groups Clinical papers Within Groups Total Between Groups Television/ Electronic Media Within Groups Total Between Groups Internet Within Groups Total Between Groups Hoardings Within Groups Total 110.107 147 119.333 149 21.813 2 10.907 142.027 147 .966 163.840 149 10.755 2 5.377 82.579 147 .562 93.333 149 .539 2 .270 108.234 147 .736 108.773 149 13.505 2 6.752 155.329 147 1.057 168.833 149 .866 2 .433 210.207 147 1.430 211.073 149 - 233 .749 11.289 .000 9.572 .000 .366 .694 6.390 .002 .303 .739 ANOVA IN REGIONAL STATUS OF PRACTICE PLACE Between Groups Specific Seminars held by companies Within Groups Total Sum of Squares 10.126 2 Mean Square 5.063 84.707 147 .576 94.833 149 df Reliability of information provided through different media about medicines 8.352 2 4.176 Between Groups Medical Representative Within Groups Total Between Groups Medical Journals Within Groups Total Between Groups Clinical papers Within Groups Total Between Groups Television/ Electronic Media Within Groups Total Between Groups Internet Within Groups Total Between Groups Hoardings Within Groups Total Between Groups Specific Seminars held by companies Within Groups Total 67.841 147 76.193 149 4.236 2 2.118 127.257 147 .866 131.493 149 5.574 2 2.787 153.820 147 1.046 159.393 149 13.833 2 6.916 97.207 147 .661 111.040 149 6.190 2 3.095 1032.670 147 7.025 1038.860 149 13.814 2 6.907 95.020 147 .646 108.833 149 1.697 2 .848 92.677 147 .630 94.373 149 - 234 F Sig. 8.786 .000 9.049 .000 2.447 .090 2.663 .073 10.459 .000 .441 .644 10.685 .000 1.345 .264 .462 ANOVA IN REGIONAL STATUS OF PRACTICE PLACE Medical Representative as key element in providing information Between Groups Sum of Squares 4.966 2 Mean Square 2.483 .354 df Within Groups 52.107 147 Total 57.073 149 F 7.005 Sig. .001 Importance of promotional items /other facilities distributed /provided by companies Free samples Between Groups 17.369 2 8.685 Within Groups 87.464 147 .595 104.833 149 Between Groups 13.425 2 6.713 Within Groups 97.248 147 .662 110.673 149 17.026 2 8.513 Within Groups 220.734 147 1.502 Total 237.760 149 2.540 2 1.270 Within Groups 196.020 147 1.333 Total 198.560 149 4.950 2 2.475 Within Groups 210.143 147 1.430 Total 215.093 149 5.447 2 2.723 1.307 Total Trips to seminars Total Between Groups Pens/notepads/calenda rs/ etc Between Groups Lunch for physician and staff Between Groups Tickets to special entertainment events Between Groups Dinner for the physician and their Within Groups 192.127 147 family Total 197.573 149 - 235 14.596 .000 10.147 .000 5.669 .004 .953 .388 1.731 .181 2.084 .128 ANOVA IN REGIONAL STATUS OF PRACTICE PLACE Sum of Squares Mean df Square F Sig. Effectiveness of information provided through different media in prescription 2.838 2 1.419 Within Groups 83.455 147 .568 Total 86.293 149 2.512 2 1.256 Within Groups 82.321 147 .560 Total 84.833 149 2.395 2 1.197 Within Groups 85.179 147 .579 Total 87.573 149 1.525 2 .763 Within Groups 105.248 147 .716 Total 106.773 149 .595 2 .298 Within Groups 74.498 147 .507 Total 75.093 149 1.763 2 .882 Within Groups 129.177 147 .879 Total 130.940 149 .585 2 .293 Within Groups 66.248 147 .451 Total 66.833 149 Between Groups Medical Representative Between Groups Medical Journals Between Groups Clinical papers Between Groups Television/ Electronic Media Between Groups Internet Between Groups Hoarding. Between Groups Specific Seminars held by companies - 236 2.499 .086 2.243 .110 2.066 .130 1.065 .347 .587 .557 1.003 .369 .649 .524 ANOVA IN REGIONAL STATUS OF PRACTICE PLACE Pharmaceutical advertisement in prescription of branded medicines Pharmaceutical advertisement to change prescription decision from Generic medicine to Branded medicines Patient suggestion (demand) influence prescription decision Between Groups Within Groups Total Between Groups Within Groups Total Between Groups Within Groups Total “Direct-toConsumer Advertisement” are important in promotion of medicines Ethical issues in Promotional activity adopted by companies. Advertising agency Importance in Consumer awareness about medicines Between Groups Within Groups Total Between Groups Within Groups Total Between Groups Within Groups Total Sum of Squares 1.004 2 Mean Square .502 64.070 147 .436 65.073 149 .362 2 .181 50.971 147 .347 51.333 149 1.058 2 .529 135.936 147 .925 136.993 149 .424 2 .212 121.770 147 .828 122.193 149 .945 2 .472 59.329 147 .404 60.273 149 .369 2 .185 94.964 147 .646 95.333 149 df F Sig. 1.151 .319 .522 .595 .572 .566 .256 .775 1.170 .313 .286 .752 Importance of promotional channels used by companies and their long lasting effect on the mind Between 1.507 2 .754 .502 .606 Groups Medical 220.493 147 1.500 Within Groups Representative 222.000 149 Total Between Groups Clinical Paper Within Groups Total 3.636 2 1.818 229.457 147 1.561 233.093 149 - 237 1.165 .315 ANOVA IN REGIONAL STATUS OF PRACTICE PLACE Between Groups Medical Journals Within Groups Total Between Groups Television advertisement Within Groups Total Between Groups Internet Within Groups Total Between Groups Hoarding Within Groups Total Between Groups Specific Seminars held by companies Within Groups Total Between Groups Celebrities Importance in brand promotion. Within Groups Total Specialized promotional channels and programmes in promotion of medicines. Between Groups Within Groups Total Between Groups promotional activities and growth of consumerism Within Groups Total Sum of Squares .539 2 Mean Square .270 258.534 147 1.759 259.073 149 6.125 2 3.063 262.948 147 1.789 269.073 149 .389 2 .194 82.171 147 .559 82.560 149 2.590 2 1.295 166.243 147 1.131 168.833 149 .324 2 .162 126.936 147 .864 127.260 149 2.080 2 1.040 84.293 147 .573 86.373 149 .047 2 .023 87.527 147 .595 87.573 149 .419 2 .209 81.741 147 .556 82.160 149 - 238 df F Sig. .153 .858 1.712 .184 .348 .707 1.145 .321 .188 .829 1.814 .167 .039 .962 .377 .687 ANOVA IN REGIONAL STATUS OF PRACTICE PLACE Sum of Squares Between promotional channel to consumers Square 2.381 2 1.191 Within Groups 110.079 147 .749 Total 112.460 149 1.454 2 .727 .806 Between Importance of Groups Regulatory Acts in Within Groups 118.520 147 Total 119.973 149 3.309 2 1.655 Within Groups 149.784 147 1.019 Total 153.093 149 .171 2 .086 Within Groups 219.829 147 1.495 Total 220.000 149 prescription Between Creativity in prescription decision Between Frequency of prescription decision a) 1.590 .207 .902 .408 1.624 .201 .057 .944 Groups pharmaceutical advertisement influence Sig. Groups pharmaceutical advertisement effect F Groups and companies convening information Mean df Importance of medium providing information about medicine available for patient in the market and regional status of practice place of doctor - In the above table having variables Medical Representative, Medical Journals, Clinical papers, Hoardings and Specific Seminars held by companies the value of significant is 0.003, 0.000, 0.000, 0.002 and 0.000 respectively which is significant (p<0.05) and tells us that null hypothesis is rejected. It means that Regional status of practice place has effect on these variables, where as Clinical papers and Internet having the value of significant is 0.694 and 0.739 which is insignificant (p>0.05) and tell us that null - 239 hypothesis is accepted, it means that Regional status of practice place has no effect on this variables. b) Reliability of information provided through different media about medicines and regional status of practice place of doctor:- In the above table having variables Medical Representative, Television/ Electronic Media and hoardings the value of significant is 0.000, 0.000, and 0.000 respectively which is significant (p<0.05) and tells us that null hypothesis is rejected. It means that Regional status of practice place has effect on these variables where as Medical Journals, Clinical papers, Internet and Specific Seminars held by companies the significant value is 0.090, 0.073, 0.644 and 0.264 respectively which is insignificant (p>0.05) and alternative hypothesis rejected and null hypothesis accepted. It means that Regional status of practice place has no effect on these variables. c) Medical Representative as key element in providing information and regional status of practice place of doctor: - In the above table the value of significant is 0.001 which is significant (p<0.05) and tells us that null hypothesis is rejected. It means that Regional status of practice place has effect on this variable. d) Importance of promotional items /other facilities distributed /provided by companies and regional status of practice place of doctor - In the above table having variables free samples, Trips to seminars and Pens/notepads/calendars/etc, the value of significant is 0.000, 0.000, and 0.004 respectively which is significant (p<0.05) and tells us that null hypothesis is rejected. It means that Regional status of practice place has effect on these variables where as Lunch for physician and staff, Tickets to special entertainment events and Dinner for the physician and their family, the significant value is 0.388,0.181 and 0.128 (p>0.05) which is insignificant and - 240 alternative hypothesis accepted and null hypothesis rejected. It means that Regional status of practice place has no effect on these variables. e) Effectiveness of information provided through different media in prescription and regional status of practice place of doctor: - In the above table having variables Medical Representative, Medical Journals, Clinical papers, Television/ Electronic Media, Internet, Hoardings and Specific Seminars held by companies the value of significant is 0.086, 0.110, 0.130, 0.347, 0.557, 0.369 and 0.524 respectively which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on these variables. f) Pharmaceutical advertisement in prescription of branded medicines and regional status of practice place of doctor:- In the above table the value of significant is 0.319 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variables g) Pharmaceutical advertisement to change prescription decision from Generic medicine to Branded medicines and regional status of practice place of doctor: - In the above table the value of significant is 0.595 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. h) Patient suggestion (demand) influence prescription decision and regional status of practice place of doctor: - In the above table the value of significant is 0.566 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. i) “Direct-to- Consumer Advertisement” are important in promotion of medicines and regional status of practice place of doctor: - In the above table the - 241 value of significant is 0.775 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. j) Ethical issues in Promotional activity adopted by companies and regional status of practice place of doctor: - In the above table the value of significant is 0.313 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. k) Advertising agency Importance in Consumer awareness about medicines and regional status of practice place of doctor: - In the above table the value of significant is 0.752 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. l) Importance of promotional channels used by companies and their long lasting effect on the mind and regional status of practice place of doctor - In the above table having variables Medical Representative, Clinical papers, Medical journals, Television/ Electronic Media, Internet, Hoardings and Specific Seminars held by companies the value of significant is 0.606, 0.315, 0.808, 0.184, 0.707, 0.321and 0.829 respectively which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on these variables m) Celebrities Importance in brand promotion and regional status of practice place of doctor:- In the above table the value of significant is 0.167 (p>0.05) which is insignificant and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variables n) Specialized promotional channels and programmes in promotion of medicines and regional status of practice place of doctor: - In the above table the - 242 value of significant is 0.962 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. o) Promotional activities and growth of consumerism and regional status of practice place of doctor:- In the above table the value of significant is 0. 687 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. p) Promotional channel and companies convening information to consumers and regional status of practice place of doctor: - In the above table the value of significant is 0. 207 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. q) Importance of Regulatory Acts in prescription and regional status of practice place of doctor: - In the above table the value of significant is 0.408 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. r) Creativity in pharmaceutical advertisement effect prescription decision and regional status of practice place of doctor: - In the above table the value of significant is 0.201 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. s) Frequency of pharmaceutical advertisement influence prescription decision and regional status of practice place of doctor: - In the above table the value of significant is 0.944 which is insignificant (p>0.05) and tells us that null hypothesis is accepted. It means that Regional status of practice place has no effect on this variable. - 243 CHAPTER- 5 DISCUSSIONS AND CONCLUSION The conducted research has been executed to answer the research questions presented in section 3.14. 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 OTC drugs 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. Similarly there is no significant association between marital status of respondent and medium of advertisement that get the attention of respondent as the Chi-Square value is insignificant. But there is 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. - 244 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 ChiSquare 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. 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. This study also show that there is no significant association between family type, marital status of respondent with suggestion by which consumer purchase common use medicines as the Chi-Square value is - 245 insignificant. Similarly this study also indicates there is significant association between educational qualifications, occupation with various suggestive medium by which consumer can purchase common use medicines. 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. Nies,E.A. (1982) 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. - 246 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. From the data analysis about advertising attributes that impact in selection of medicine, findings shows that pharmaceutical advertisement which have strongest theme influenced the buying behavior of respondents and this decision is highly stable as shows from the mean value (2.12) and standard deviation (1.077) of the respondent. Visual presentation of advertisement creates more attention and makes their impacts in selection of medicine as the mean value and standard deviation of this attributes is 2.35 and 1.230 respectively. For prescription medicine consumer is not directly purchase the medicine but doctor on the behalf of consumer/patient prescribed the medicines for purchase. That’s why in this doctor response regarding pharmaceutical advertisement is also valuable for us to know how the pharmaceutical advertisement changes the prescription behavior of doctor. According to doctor as respondent on importance of medium providing information about medicine available for patient in the market shows that television medium of advertisement are important medium for providing information to the consumer as the mean value is 1.81. - 247 Similarly there are various medium which provide information about medicine but doctor do not rely on the information provided through all different medium. The reliability of information provided through medical journal are important as the mean value is 1.49 followed by clinical paper whose mean value is 1.53.This study also find that according to doctors effectiveness of information provided through clinical paper (mean value 1.95) and medical journal (mean value 1.97) are more effective. 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. Caudil,T.S.et al (1996) 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 function where as Ravindra Goyal and Pranav Pareek (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 - 248 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. Various promotional channels used by companies make their long lasting effect of the mind of doctors , but it is not possible that all promotional channel make their impact on doctor mind and it is found that MRs are important promotional channel used by companies that makes their long lasting effect on doctor mind having mean value 2.40 followed by specific seminars held by companies having mean value 2.54.Influence of prescription decision w.r.t branded medicine, generic medicine and patient demand also shows that pharmaceutical advertisement are important factor in prescription of branded medicine (mean value 2.89) and pharmaceutical advertisement influence the doctor to change the prescription decision from generic to branded medicine (mean value 2.93). Manchanda, P. and Honka, E (2005) also concluded that there is also strong evidence that detailing affects physician (prescription) behavior in a positive and significant manner. Impact and extent of impact of Pharmaceutical advertisement depends on the various variables, and due to different variables impact also differs.Qualification of doctors has impact on the variable like hoardings and specific seminars conducted by companies for Reliability of information provided through different media about medicines. Qualification of doctors also has impact on the free samples as promotional items and it has also impact on the medical journals as promotional channels. Regional status of practice place has impact on the variable like Medical Representative, Medical Journals, Clinical papers, Internet and Specific seminars organized by companies as importance of medium providing information about - 249 medicine available for patient in the market and in context to reliability of information provided through different medium about medicines Regional status of practice place has an impact on Medical Representative, Television/Electronic Media and Hoardings and it also has impact on Medical Representative as key element in providing information. Similarly Regional status of practice place has an impact on free samples, Trip to seminars and Pens/notepads/calendars etc. as importance of promotional items Conclusion: - Quite a number of important conclusions can be drawn from the findings 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 feedback about necessary changes made for doctors for prescription of medicines. Brand positioning place a consumer brand in doctor mind - 250 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 India 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. Managerial Implications for doctors: In terms of managerial implication, the findings 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. Future Research: The final objective of the researcher is that what all findings have been achieved may become part of future researches. Further direction for future research is:- 251 Future research can be extended to pharmacists that how these pharmacists make their impact on consumer to sell the medicine because pharmacist is also an important medium of advertisement for pharmaceutical products. Additional research could explore how consumers make use of the pharmaceutical staff when they are in a pharmacy, and how the pharmaceutical staff is aware of their own influence on the customers and how they use their knowledge to guide the decision making process. More focus on the promotional sector can be done through further research that studies through which media pharmaceutical advertisements are best to reach the consumer segment that is recognized to buy products that are familiar to them through advertisement. Direct to consumer advertising is banned in most countries, and the research evidence tends to support the negative impact that is feared by those who support a legislative ban. 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(2005), “Direct-to-consumer advertising and drug therapy compliance”, Journal of Marketing Research, 42(August), 323–332. - 266 ANNEXURE-A Impact of Advertisement on Customer Purchase Behavior in Pharmaceuticals Research Scholar: Ram Dheeraj Supervisor: Dr.S.K.Kaushal PLEASE MARK YOUR RESPONSES BY PUTTING A TICK MARK (¥) AT APPROPRIATE PLACE 1:- Personal profilea) Name:- ______________________________________________________ b) Age:- (i) 18-28 years (ii) 29-39 years (iv) 51-61 years ( iii) 40-50 years (v) >61 years c) Marital Status-:- (i) Married d) Family size:- e) Family income :- (ii) Un Married (i) Nuclear (iii) Widow (ii) Joint (i) <1.5 lacs (ii) 1.5 lacs-.3.0 lacs (iii) 3.01 lacs- 5.0 lacs (iv) 5.01 lacs- 7.0 lacs (v) > 7.0 lacs f) Educational Qualification: (i)Undergraduate (ii) Graduate g) Occupation:(i) Student ( ii) Business (iv) Professional (iv) Separated (v) Housewife ( iii) Post Graduate (iii) Government Service (vi) Any Other (Please Specify)______ 2- Do you know about Advertisement? (i) Yes ( ii) No 3- Which medium of Advertisement get your Attention (i) Print ( ii) Radio (iii) Television (iv) Word to Mouth 4- How does advertisement affect you? (i) Recall ( ii) Positive impression ŝ ( iii) Interest ( iv) Decision Process 5- For common use medicines (OTC) which medium of advertisement is more affective? ( i) Television ( ii) News Paper ( iii) Radio ( iv) Internet (v) Other (Magazines/Bill boards/brouchers/kiosks/fillers/Event 6- By which suggestion you will purchase common use medicines (i) Doctor ( ii) Retailer ( iii) Television (iv) News paper ( v) Friends & Relatives 7- How long does the input of an advertisement last on you (i) Few hours (ii) one day ( iii) one week ( iv) one month (v) more than month 8- To what extent of advertising of various pharmaceutical products create the need for the Product in your mind( i) To a great extent ( ii) To some extent ( iii) To a considerable extent ( iv) Not at all 9- When there is a new advertisement of pharmaceutical product like Vitamin , tablets, Cough syrup and Contraceptive etc. Do you pay (i) more attention ( ii) some attention ( iii) little attention ( iv) ignore it 10- While seeing the various advertisements of medicines, which aspect of product attribute do you observe in advertisement-? (i) strength (ii) dosage form (iii) route of administration ( iv) Dosing schedule 11- Who influenced you most in selecting medicine for common diseases-? (i) Advertising (ii) Friends & relatives (iii) Retailer ( iv) Doctor 12- To what extent advertising influenced you in purchasing a particular type of Pharmaceutical product/ medicines(i) To a great extent ( ii) To a some extent (iii) To a little extent ( iv) not at all 13- I always rely on advertisement while making a purchase decision ( i) Strongly agree ( ii) agree to some extent (iv) Strongly disagree ŝŝ ( iii) disagree to some extent 14- On a scale of 1-5 Kindly rate the following medicine advertisement attributes in Order Of your preference where 1 stands for highest rank for agree or favoring to Particular View and 5 stands for completely disagree or disfavoring to Particular View. Please put a tick mark (¥) (1= Strongly Agree, 2= Agree , 3= Neutral, 4=Disagree & 5= Strongly Disagree) Attributes Theme of Advertisement Visual presentation Strength of Medicines Dosage form(tablet,capsule,liquid etc) 1 Role of celebrities ŝŝŝ 2 3 4 5 ANNEXURE-B Impact of Advertisement on Customer Purchase Behavior in Pharmaceuticals Research Scholar: Ram Dheeraj Supervisor: Dr.S.K.Kaushal PLEASE MARK YOUR RESPONSES BY PUTTING A TICK MARK (¥) AT APPROPRIATE PLACE 1- Personal Profile 1a.) Respondent Name: 1b.) Gender: Male Female (1) 1c.) Qualification: (2) Graduate (M.B.B.S) Post Graduate (MD/MS) (1) 1d.) Position Hold by Respondent: (2) (3) Medical Officer Junior Resident/MS/MD (1) Teacher/Professor (3) (4) >2 years (1) 1f.) Regional Status of Practice Place: >5 years 4 hours (1) >10 years (2) Rural (1) (3) Semi Urban (2) 6 hours (2) ŝǀ (2) Senior Resident/Super specialist 1e.) No. of years of Practice: 1g.) Practice Hours: Specialist. 8 hours (3) >15 years (4) Urban (3) round the clock (4) 1h.) O.P.D Frequency (<15) (Daily Average): (15 to 25) (1) (26 to 40) (40 to 54) (2) (3) (>54) (4) (5) From Question no. 2 and onwards are based on the scale of 1 to 5 in which; 1 Stands for highest rank for agree or favoring to particular view and 5 stands for completely disagree or disfavoring to particular view. (1= Strongly Agree, 2= Agree , 3= Neutral, 4=Disagree & 5= Strongly Disagree) 2 Importance of medium providing information about medicine available for patient in the market. 2a. Medical Representative 1 2 3 4 5 2b. Medical Journals 1 2 3 4 5 2c. Clinical papers 1 2 3 4 5 2d. Television/ Electronic Media 1 2 3 4 5 2e. Internet 1 2 3 4 5 2f. Hoardings 1 2 3 4 5 2g. Specific Seminars held by companies 1 2 3 4 5 3 Reliability of information provided through different media about medicines. 3a. Medical Representative 1 2 3 4 5 3b. Medical Journals 1 2 3 4 5 3c. Clinical papers 1 2 3 4 5 3d. Television/ Electronic Media 1 2 3 4 5 3e. Internet 1 2 3 4 5 3f. Hoardings 1 2 3 4 5 3g. Specific Seminars held by companies 1 2 3 4 5 4 Is Medical Representative (MR) visiting in your yes ( 1 ) No ( 2 ) practice hours: 4a. If yes, on average how many companies MR visiting per day <5 ǀ 5 -10 11- 15 15- 20 >20 4b. Is Medical Representative are important key 1 2 3 4 5 element in providing information about medicines. 5 State the importance of promotional items /other facilities distributed /provided by companies 5a. Free samples 1 2 3 4 5 5b. Trips to seminars 1 2 3 4 5 5c. Pens/notepads/calendars/etc 1 2 3 4 5 5d. Lunch for physician and staff 1 2 3 4 5 5e. Tickets to special entertainment events 1 2 3 4 5 5f. Dinner for the physician and their family 1 2 3 4 5 6 Is Prohibiting Bodies (Bodies Discouraging) 1 2 3 4 5 influencing promotional activities 7 State the effectiveness of information provided through different media in your prescription. 7a. Medical Representative 1 2 3 4 5 7b. Medical Journals 1 2 3 4 5 7c. Clinical papers 1 2 3 4 5 7d. Television/ Electronic Media 1 2 3 4 5 7e. Internet 1 2 3 4 5 7f. Hoarding. 1 2 3 4 5 7g. Specific Seminars held by companies 1 2 3 4 5 8 Pharmaceutical advertisements are important 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 factor in prescription of branded medicines. 9 Pharmaceutical advertisement influences me to change my prescription decision from generic medicine to Branded medicines. 10 Patient suggestion (demand) influence my prescription decision 11 Importance of “Direct-to- Consumer Advertisement” in promotion of medicines ǀŝ 12 Importance of Ethical issues in Promotional 1 2 3 4 5 1 2 3 4 5 activity adopted by companies. 13 Importance of advertising agency in Consumer awareness about medicines 14 State the important of promotional channels used by companies and their long lasting effect on the mind. 14a. Medical Representative 1 2 3 4 5 14b. Clinical Paper 1 2 3 4 5 14c. Medical Journals 1 2 3 4 5 14d. Television advertisement 1 2 3 4 5 14e. Internet 1 2 3 4 5 14f. Hoarding 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 Specialized promotional channels and programmes 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 14g. Specific Seminars held by companies 15 Importance of celebrities used by companies in brand promotion. 16 are important in the promotion of medicines 17 Importance of promotional activities adopted by companies in the growth of consumerism 18 Importance of promotional channel used by companies convening information to consumers 19 Importance of Regulatory Acts in your prescription 1 2 3 4 5 20 Creativity in pharmaceutical Advertisement effects 1 2 3 4 5 1 2 3 4 5 my prescription decision. 21 Frequency of Pharmaceutical advertisement are important factor to influence my prescription decision. ǀŝŝ