HO CHI MINH CITY OPEN UNIVERSITY UNIVERSITÉ LIBRE DE BRUXELLES SOLVAY BRUSSELS SCHOOL OF ECONOMICS & MANAGEMENT MMCoM9 NGUYEN THI THANH PHUONG TRAN BOI DUNG FORXIGA- INTEGRATED MARKETING & COMMUNICATION ANALYSIS AND RECOMMENDATIONS TO INCREASE BRAND AWARENESS AND BRAND ASSOCIATION MASTER FINAL PROJECT MASTER IN MARKETING AND COMMUNICATION MANAGEMENT Ho Chi Minh City (2016) i STATEMENT OF AUTHENTICATION We, Tran Boi Dung and Nguyen Thi Thanh Phuong commit that we have done this project by ourselves based on the information collected from the public and ASTRAZENECA VIETNAM’s sources This paper is designed only for the academic purpose of the completion of our Master in Marketing and Communication It is not expected for any other uses ii ACKNOWLEDGEMENTS We would like to express our deep gratitude to Mr Nguyen Le Thai Hoa for his first guideline of the structure of this project Dr Van Thi Hong Loan deserves a special note of thanks for her comments, advices and approval on this paper We are indebted to Mr Nguyen Tien Chau and his staffs in AstraZeneca Vietnam for their continued encouragements and useful documents Finally, we must express our deep appreciation to all of my colleagues, friends, and our familys, who always give us their support throughout iii ACADEMIC TUTOR AND PRACTICAL TUTOR’S COMMENTS & APPROVAL SIGNATURE iv TABLE OF CONTENT STATEMENT OF AUTHENTICATION i ACKNOWLEDGMENT ii LIST OF CHART vii LIST OF TABLE .viii LIST OF FIGURE .ix LIST OF ABBREVIATION x GROSSARY .xi CHAPTER 1: INTRODUCTION 1.1 Over view about Vietnam pharmaceutical market & Oral Antidiabetic Medication market…………………………………………………………… 1.1.1 Vietnam pharmaceutical growth and size 1.1.2 Vietnam Oral Antidiabetic Medication market growth and share 1.1.3 Key player in Vietnam ODA market 1.1.4 Diabetes epidemiology 1.1.5 The unmet needs in diabetic management 1.2 Overview about Astra Zeneca and Forxiga 1.2.1 Overview about Astra Zeneca 1.2.2 Overview about Forxiga 1.2.2.1 Product 1.2.2.2 Price .12 1.2.2.3 Place .12 1.2.2.4 Promotion .13 1.3 Problem statement .15 1.4 Project Objective 16 1.5 Methodology .16 1.5.1 Secondary research…………………………………………………… 16 1.5.2 Primary research……………………………………………………… 17 CHAPTER 2: LITERATURE REVIEW 19 2.1 2.2 Brand and Brand Equity 19 2.1.1 Definition of Brand 19 2.1.2 Brand Equity 19 2.1.2.1 Definition of brand equity 19 2.1.2.2 Conceptualizations of Consumer based brand equity 20 Brand awareness 20 2.2.1 Definition of brand awareness .20 v 2.3 2.4 2.2.2 Measuring brand awareness 21 Brand association .22 2.3.1 Definition of brand association 22 2.3.2 Aaker’s categorization of brand association 22 2.3.3 Brand association’s role in creating equity 23 2.3.4 Measuring brand association 25 Integrated Marketing communication 25 2.4.1 Definition of integrated marketing communication .25 2.4.2 The marketing Communication mix 27 2.4.3 The marketing communication process 27 2.4.3.1 The communication process Kotler .28 2.4.3.2 Steps in developing effective marketing communication 29 CHAPTER 3: RESEARCH RESULTS AND CRITICAL ANALYSIS 30 3.1 Problem identification 30 3.1.1 FORXIGA sale performance analysis 30 3.1.2 FORXIGA sale analysis conclusion 34 3.2 Problem analysis 35 3.2.1 FORXIGA brand awareness analysis 35 3.2.2 FORXIGA brand association analysis 37 3.2.3 FORXIGA communication process analysis 38 3.2.4 FORXIGA marketing and communication analysis 40 3.3 Conclusion from market research result analysis and analyses FORXIGA Marketing Communication 42 3.4 Macro analysis 43 3.5 FORXIGA’s competitors analysis 44 3.6 The unique selling point of FORXIGA 45 3.6.1 Compare to other medication in SGLT2i classes 45 3.6.2 Compare to medication in different class 45 3.7 FORXIGA SWOT analysis 45 3.7.1 Strengths 46 3.7.2 Weaknesses 46 3.7.3 Opportunities 46 3.7.4 Threats 47 CHAPTER 4: CONCLUSIONS AND RECOMMENDATIONS 48 4.1 Conclusion 48 4.2 Recommendations for FORXIGA 49 4.3 Integrated Marketing communication plan for FORXIGA in 2016 50 4.3.1 FORXIGA Target audience 50 4.3.2 FORXIGA Marketing Communication Objective 51 vi 4.3.3 4.3.4 4.3.5 4.3.6 4.3.7 FORXIGA Communication messages 51 FORXIGA Marketing communication mix 52 4.3.4.1 Personal selling 52 4.3.4.2 Seminar, Scientific meeting 52 4.3.4.3 Advertising 55 4.3.4.4 Worth of month Marketing 56 4.3.4.5 Public relationship 57 Budget allocate 58 Timeline 59 Measurement and feedback 59 REFERENCE 60 APPENDIX 61 APPENDIX 69 APPENDIX 70 APPENDIX 71 APPENDIX 74 vii LIST OF CHART Chart 1.1: Market value of Brand-name drug vs Generic drug in antidiabetic market .4 Chart 1.2: Leading corporations in Vietnam pharmaceutical market Chart 1.3: Leading corporations in Vietnam pharmaceutical market – Ethical sector .7 Chart 1.4: FORXIGA sale performance months after launching 15 Chart 3.1: The sale performance of FORXIGA month after launching Compare with Januvia 30 Chart 3.2: FORXIGA channel sale overview 32 Chart 3.4: FORXIGA Private hospital sale over view month after .33 Chart 3.5: FORXIGA Government hospital sale over view months .34 Chart 3.6: The brand awareness of FORXIGA and other DPP4i brands 35 Chart 3.7: The familiar of Doctor to type diabetes drugs 36 Chart 3.8: The important of treatment objectives in type diabetes management 37 Chart 3.9: The perceptions of Doctor toward FORXIGA advantage and disadvantage 38 Chart 3.10: The key messages that FOXIGA MR use to delivery to doctors 39 Chart 4.1: FORXIGA marketing communication budget allocate 58 Chart 6.1: Market value and market share of Vietnam OAD market 2011-2015 .74 Chart 6.2: Vietnam OAD market overview in value 75 Chart 6.3: Vietnam OAD market overview in unit 75 viii LIST OF TABLE Table 1.1: Total Market sales (2014 – 2019) Table 3.1: Summary of FORXIGA marketing activities since 2014 – 2015 40 Table 4.1: Key messages for FORXIGA based on target patients 52 ix LIST OF FIGURE Figure 1.1: Product image 10 Figure 1.2: Forxiga key visual image and logo 13 Figure 2.1 Types of Brand Association (Aaker 1991) 23 Figure 2.2: Brand Associations as value creators for a company (Aaker 1991) .24 Figure 2.3: 4C’s versus 4P’s of marketing (source: Integrated Marketing Communication by Schultz, Tannenbaum, and Lauterborn) 26 Figure 2.4: The communication process (source: Kotler 2003, P.565) .29 Figure 4.1: FORXIGA marketing communication timeline .59 Figure 6.1: Anti hyperglycemic therapy in type diabetes: General recommendation 70 64 Kiểm soát số HbA1c Control HbAc1 Index Kiểm soát số FPG (đường huyết đói) Control FPG index (Fasting Plasma Glucose) Kiểm soát số PPG (đường huyết sau ăn) Control PPG Index (postprandial Plasma Glucose) Giảm cân Weight loss Giảm nguy tim mạch – kiểm soát huyết áp, mỡ máu, bệnh lý động mạch vành Reduce cardiovascular risk - control blood pressure, cholesterol, Coronary artery disease Giảm nguy hạ đường huyết reduce the risk of hypoglycaemia Không ảnh hưởng chức thận Do not effect to kidney function Bảo tồn chức tế bào bê ta Preserve beta cell function Q7: Khi lựa chọn thuốc cho bệnh nhân đái thái đường bác sĩ thường quan tâm tới tiêu chí gì? Q7: When choosing medications for diabetes patients what are the elements that you concern about? …………………………………………………………………………………………… …………………………………………………………………………………………… ………………………………………….………………………………… Q8: Đối với thuốc bác sĩ thường quan tâm tới thơng tin gì? Q8: For a new medication, what kind of information that you care about? …………………………………………………………………………………………………… …………………………………………………………………………………………………… ………………………….………………………………… Q9 Theo bác sĩ biết đến vai trò chất đồng vận chuyển Natri Glucose (SGLT-2) việc điều hòa đường huyết từ nguồn nào? Q9: Where did you learn about the role sodium glucose cotransporter (SGLT-2) plays in glucose balance? 65 Bài báo chuyên ngành (Journal article) Bác sĩ đồng nghiệp (fellow doctor) Báo chí (news paper) Bài trình bày hội thảo (presentation conference) Internet Khác (ghi rõ,…) Other Không nhớ Do not know Q10 Theo bác sĩ, bác sĩ đánh giá điểm mạnh sản phẩm Forxiga gì? Q10 What would you consider to be the strengths of Forxiga? ……………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… …………………………………………………………………………………… Q11 Theo bác sĩ, bác sĩ đánh giá điểm yếu sản phẩm Forxiga gì? Q11 What would you consider to be the weaknesses of Forxiga? ……………………………………………………………………………………………… ……………………………………………………………………………………………………………… ……………………………………………………………………………… Q12 Dựa kinh nghiệm ý kiến riêng bác sĩ, vui lòng cho biết mức độ đồng ý hay không đồng ý bác sĩ hoạt động trình dược viên nhãn hiệu thuốc điều trị đái tháo đường thuộc nhóm ức SGLT2 nhóm ức chế DDP4i nào? Q12: Please give us your opinion about the activities of Medical representatives of SGLT2i and DDP4i by rating a scale 1-7 (1 means totally disagree and means totally agree with it) 66 Trình dược viên thuốc thường xuyên gặp gỡ These medical representatives regularly meet me Trình dược viên thuốc có khả ln khiến tơi muốn kê toa sản phẩm These medical representatives are capable of always makes me want to prescription products Trình dược viên thuốc thường xun trình dược/giới thiệu thuốc với tơi ipad (máy tính bảng) These Medical representatives often introduce to me with ipad ( tablet ) Trình dược viên thuốc biết làm để khiến tham gia vào việc thảo luận sản phẩm lần gặp gỡ This medical representatives know how to make me participate in the discussion of product each meeting Trình dược viên thuốc có sáng tạo trình bày sản phẩm This medical representatives are innovative when introducing the products Trình dược viên thuốc có kiến thức tốt sản phẩm, giải đáp thắc mắc sản phẩm This medical representatives have good knowledge of the product , can answer my questions about the product Q13: Trình dược viên nhóm Forxiga thường trao đổi nội dung với Bác Sĩ Đánh giá theo thang điềm 1-5 (1 trao đổi trao đổi nhiều nhất) Q13: Please rate for the regulariy of benefit of Forxiga that the Medical representatives often talk with Doctor by using the 1-5 scale (1 means “most rarely”, means “most often”) 67 Trao đổi most rarely Hiệu kiểm soát đường huyết Effective glycemic control Hiệu kiểm soát cân nặng Effective weight control Hiệu kiểm soát huyết áp Effectiv blood pressure control Cơ chế không phụ thuộc insulin Insulin independent mechanism Nội dung khác others… Trao đổi nhiều most often 68 APPENDIX BẢNG CÂU HỎI CHO TRÌNH DƯỢC VIÊN The questionnaire for medical representatives Q1 : Hãy liệt kê điểm mạnh Forxiga Please list the strong points of FORXIGA ……………………………………………………………………………………………… ……………………………………………………………………………………………………………… ……………………………………………………………………………… Q2 : Hãy liệt kê điểm yếu Forxiga Please list the weak points of FORXIGA ……………………………………………………………………………………………… ……………………………………………………………………………………………………………… ……………………………………………………………………………… Q3 : Để thuyết phục BS thử dùng Forxiga bạn thường dùng thơng điệp ? What key messages you use to persuade doctors using Forxiga ? ……………………………………………………………………………………………… ……………………………………………………………………………………………………………… ……………………………………………………………………………… Q4: Để thuyết phục BS thử dùng Forxiga, đâu khó khăn mà bạn thường gặp phải ? What key ocstacle that you have to deal with while you persuade doctors using Forxiga ? ……………………………………………………………………………………………… ……………………………………………………………………………………………………………… ……………………………………………………………………………… 69 APPENDIX ADA/EASD GUIDELINE ABOUT DIABETES MANAGEMENT UPDATE 2015 In most patients, begin with lifestyle changes; metformin monotherapy is added at, or soon after diagnosis, unless there are contraindications If the HbA1c target is not achieved after months, consider one of the six treatment options combined with metformin: a sulfonylurea, TZD, DPP-4 inhibitor, SGLT2 inhibitor, GLP-1 receptor agonist, or basal insulin Drug choice is based on patient preferences as well as various patient, disease, and drug characteristics, with the goal being to reduce glucose concentrations while minimizing side effects, especially hypoglycemia In patients intolerant of, or with contraindications for, metformin, consider initial drug from otherclasses depicted under “Dual therapy” and proceed accordingly In this circumstance, while published trials are generally lacking, it is reasonable to consider three-drug combinations that not include metformin Consider initiating therapy with a dual combination when HbA1c is ≥ 9% to more expeditiously achieve target Insulin has the advantage of being effective where other agents may not be and should be considered a part of any combination regimen when hyperglycemia is severe, especially if the patient is symptomatic or if any catabolic features (weight loss, any ketosis) are evident Consider initiating combination injectable therapy with insulin when blood glucose is ≥ 300–350 mg/dL (≥16.7–19.4 mmol/L) and/or HbA1c≥10–12% (≥86–108 mmol/mol) Potentially, as the patient’s glucose toxicity resolves, the regimen can be subsequently simplified 70 Figure 6.1: Anti hyperglycemic therapy in type diabetes: General recommendation Source: Inzucchi SE, Bergenstal RM, Buse JB, et al American Diabetes Association (ADA); European Association for the Study of Diabetes (EASD) Management of hyperglycemia in type diabetes: a patient- centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Diabetes Care 2012;35:1364-1379 71 APPENDIX MACRO ENVIRONMENT ANALYSIS a Socio-Cultural factor: Vietnam population size reach 102 million in 2015 with the growth rate is 1% The life expectancy between 75 and 80 years According to the Department of Population and Family Planning, Vietnam currently has one of the fasting aging populations in the world Results from the country’s latest population census show that more than 8.6 million people were aged 60 years or older in 2014, representing nearly 10 percent of the population This may lead to a greater prevalence of chronic diseases in the years ahead The health consciousness of people increase through education channel and media channel especially about diabetes therefore it creates a higher demanded for brand name medication Vietnam cultural is b Legal factor Public health insurance reimburse 80% to 100% of total medical care costs Public health insurance generally reimburses the cost of drugs on the national major drug list for reimbursable treatments Only 65-70% of the population had health insurance in 2012 resulting in high out of pockets costs for the uninsured The government is committed to achieving universal health coverage and has set a target enrollment rate of more than 80% of the population by 2020 The insurance capital is limited Therefore hospital use to set up an ceiling level for each prescription from 700,000 to 1,500,000 VND High out of pocket spending is the opportunity for FORXIGA when it have just launch to Vietnam market 72 Infrequent updating of reimbursable drugs list:Vietnam has two primary lists of drugs that are reimbursable The latest National List of Essential Medicines (NLEM) was issued in December 2013, but historically had been updated infrequently with the previous list dating back to 2005 The list expanded from 355 to 466 western medicines In 2008, the government released the major drug list, which expanded the total number of reimbursable drugs in the country to about 750 western medicines and 237 traditional herbal medicines The infrequent updating of the reimbursable list of drugs, compounded by the potentially long process of obtaining drug approval and marketing authorization, may severely limit foreign manufacturers’ ability to distribute its products in the country The next time to update reimbrustment list is in 2018 Protracted approval process for imported drugs.The process of obtaining drug approval and marketing authorization can be protracted After all required documents are submitted by the manufacturer, the Drug Administration of Vietnam (DAV) will evaluate the application before approving for marketing authorization, which typically takes six to eight months In most cases, the DAV will require supplementary documents from the applicant, which could extend the approval process by three to five more months from the date of the supplementary documents submission If the drug is approved, the DAV will issue a marketing authorization (MA) registration number for that drug It is typical for the issuance of a MA number to take one to two years c Economic Factor: Dynamic economic: Gross domestic product of Vietnam in 2014 is 188 billion USD, 3.78 time higher than GPD of 2004.Vietnam Gross national income (GNI) per captia data accessed on April 18, 2014 from World Bank’s World Development Indicator is 1550 USD, it times higher than the GNI in 2004 Vietnam is classify into low-middle-income countries 73 As well as the development of economic, the health care spending is increasing dramatically In 2012, Vietnam healthcare spending per capita is 102 USD, in 2015 the healthcare spending increase to 134 USD d Political Factor: The government encourages the Vietnamese people use Vietnamese medicines to boost national pharmaceutical sector Several decrees as well as circulars have been released to medical centers, hospitals especially Social Health Insurance Companies to make priority to use domestic medicines Also, doctors are encouraged to prescribe “Made in Vietnam” medicines FORXIGA is more or less, effected by all these policies APPENDIX OAD MARKET ANALYSIS and COMPETITOR ANALYSIS 74 Currently, In Vietnam Oral Antidiabetic medication market there are three main categories, which is prescribed the most are SU, Metformin, DPP4i and others The total Market size is 61 mil USD Chart 6.1: Market value and market share of Vietnam OAD market 2011-2015 Source: Panel Audit Quarter 4- 2015 SU group is the leader in the market with 59% market share but the growth rate is low (11%) in compare with total market (15%) Metformin is the oldest medication in this group but still keep the good growth 9% DPP4i is the new player that have just joined Vietnam market since 2010 After year DPP4i have gained 11.2%% market share in OAD market which impressive growth rate 104% However, look at the market share of each group since 2011 to 2015, the trend line of SU and Metformin is slightly going down while the trend line of DPP4i increases significantly 75 Chart 6.2: Vietnam OAD market overview in value Chart 6.3: Vietnam OAD market overview in unit In term of unit, DPP4i keep impressive growth 106%, the second is Metformin (11%) 76 a b Competitor analysis: compounds Mode of Action Advantage Disadvantage Key message in Key activities Price Low communication Sulfonylurea Increase insulin (Glimepiride secretion Gliclazide) - Extensive experience - Hypoglycemia - Value of 50 years’ - Pharmacy: discount -10% - Reduce 1-1.5% HbA1c - Gain weight experience - after month - Low durability - Control HbA1c fast and detail about product to target effectively doctor events - Economic choice for - Brochure, leaflet - In the reimbursement list patient - Hospital present - Reduce microvascular Medical representative - Scientific meeting - Sponsorship Inhibit - No hypoglycemia (Sitagliptin, DPP4 - Well tolerated ticarial Vildagliptin, activity, - Long durability other immune- Linagliptin Increase - In Saxagliptin) Postgran reimbursement list dermatological dial ( effects active Linagliptin) DPP4i - incretin (GLP-1, GIP) concentr ation - the Angioedema/Ur and mediated except - - - - Acute pancreatitis - Control HbA1c - Pharmacy: discount -10% gradually - and Medical representative gently detail about product to target No doctor hypoglycemia - Brochure, leaflet Control - Hospital present PPG physically - Scientific meeting Neutral in side - Sponsorship effect High 77 SGLT2i - Block - Low (Dapagliflozin glucose Empagliflozin*, reabsorp - Lose weight Canagliflozin*) tion - Reduce by - hypoglycemia some Genitourinary - Insulin - Pharmacy: discount 10% st infection independence For order only - Polyuria mechanism - - Volume Triple detail about product to target - benefit: Medical representative the cardiovascular risk depletion/ Reduce HbA1c, doctor kidney, factors hypotension reduce weight - Brochure, leaflet blood - Hospital present increasin g glycosur - Long durability and pressure - Scientific meeting - Sponsorship ia In short, when compare the profile of FORXIGA with SU or DPP4i FORXIGA have many strong point High 78