Whether Amazon succeeds in the healthcare market, or not, remains to be seen but the reason I believe healthcare is about to get ‘Amazonized’ is because of what Chris Holt, Amazon’s leader of Global Healthcare said recently: “When we think about the healthcare space, our overall philosophy of obsessing around the customer has served us really well. So, we start with the customer and we work backwards.” Such thinking comes as breath of fresh air – so antithetic it is to the current thinking in healthcare. Incumbents might smirk at it, but customer obsession is the primary reason why Amazon and other tech companies have built giant corporations at an unbelievable pace. The rules of the digital economy are different from what we are normally used to. That is why a shift in thinking and mindset is key to winning. New ways of doing business come with new rules...

1. MEDICINMANAugust 2018| www.medicinman.net Indian Pharma’s First Digital Magazine Since 2011
TM
L
ast month, Amazon was reportedly in talks
to invest Medplus, the second largest Indi-
an pharmacy chain after Apollo Pharmacy.
Whether Amazon succeeds in the healthcare
market, or not, remains to be seen but the rea-
son I believe healthcare is about to get ‘Ama-
zonized’is because of what Chris Holt, Amazon’s
leader of Global Healthcare said recently:
“When we think about the healthcare space,
our overall philosophy of obsessing around the
customer has served us really well. So, we start
with the customer and we work backwards.”
Such thinking comes as breath of fresh air – so
antithetic it is to the current thinking in health-
care. Incumbents might smirk at it, but custom-
er obsession is the primary reason why Amazon
and other tech companies have built giant cor-
porations at an unbelievable pace.
The rules of the digital economy are different
from what we are normally used to. That is why
a shift in thinking and mindset is key to winning.
New ways of doing business come with new
rules:
Rule 1: Move from selling to engaging. The
old business model was to sell products. The
new business model is to engage customers and
ensure that they consume your content and not
someone else’s. (Customers do have a choice).
1 | MedicinMan August 2018
Amazon's drive to put the consumer at the center of their
market strategy could very well topple well-established
incumbents in healthcare.
THE
'AMAZONIZATION' OF
HEALTHCARE
Salil Kallianpur
“... Amazon understands Indian
consumers better than most
other pharma players including
retailers due to their dependence
on data and business intelligence.
So, their move into the pharmacy
space might be better thought out
than we can possibly see now.

2.  Salil Kallianpur | The 'Amazonization' of Healthcare
Rule 2: Data is the new currency. The old curren-
cy was number of Rx, product sales etc. The new
currency is data – about your customers, their in-
terests, preferences – as much possible and con-
stantly updated.
Rule 3: Customer experience is the new lever of
competitive advantage. The old competitive ad-
vantage was size of field force, better drug efficacy
and safety, more SKUs etc. The new competitive
advantage is customer experience. If your custom-
er enjoys the experience that they have with your
brand, content, website, rep etc., you’ve won.
Amazon has always had a track record of creating
fundamental changes to any industry that they en-
ter:
“We are just trying to figure out what we learned in
other industries and how we have architected our
own infrastructure to figure out how we can bring
that to healthhcare and help healthcare migrate
to simpler solutions.” – Chris Holt
I also believe that Amazon understands Indian con-
sumers better than most other pharma players in-
cluding retailers due to their dependence on data
and business intelligence. So, their move into the
pharmacy space might be better thought out than
we can possibly see now:
“We aren't trying to fit into any traditional defini-
tion of how things work in healthcare. We're trying
to bring our own capabilities to the market. We've
seen a tremendous willingness among our cus-
tomer base to try out new things even though they
know that it might not be something that they're
used to.” – Chris Holt
Amazon has shown itself to have a ruthless, ‘win-
ner-takes-all’ approach and it is that monopolistic
approach to business that will worry the govern-
ment more than anything else. But, if patients,
caregivers and consumers are happy, the Ama-
zonization of Healthcare will be complete. MM
2 | MedicinMan August 2018
Salil Kallianpur is Principal
Consultant at Digital Trans-
formation Lab and Executive
Editor at MedicinMan

3. CONTENTS
Our mission is to collectively improve the pharma
sales and marketing ecosystem - leading to better
relationships with doctors and better outcomes for
patients.
MedicinMan Volume 8 Issue 8 | August 2018
Editor and Publisher
Anup Soans
Chief Mentor
K. Hariram
Executive Editor
Salil Kallianpur
Editorial Board
Prof. Vivek Hattangadi; Deep Bhandari; Hanno
Wolfram; Renie McClay
Letters to the Editor: anupsoans@medicinman.net
1. The 'Amazonization' of Healthcare ...............1
Amazon's drive to put the consumer at the center
of their market strategy could very well topple well-
established incumbents in healthcare.
Salil Kallianpur
2. Quality – A Key Issue at OPPI, IPA and IDMA
Joint Summit .......................................................5
Vivek Hattangadi reports on the issue that is keeping
industry CEOs awake at night, in an otherwise
globally respected industry.
Vivek Hattangadi
3. DigiStorm 2018 - To 'Do' Dgital or 'Be' Digital -
that is the Question ..........................................10
Digital is has changed how we travel, consume news,
connect with friends and family and buy groceries -
what is its true impact on healthcare?
K. Hariram
3 | MedicinMan August 2018
Connect with Anup on LinkedIn | Facebook | Twitter
Anup Soans is an L&D Facilitator,
Author, Pharma Consultant.
muckrack.com/anupsoans/articles
Meet the Editor

4. Pharma in the Digital Economy.
DigiStorm 2018
Bangalore Edition
11th
September, Lalith Ashok
About DigiStorm
DigiStorm is the flagship digital pharma event
from MedicinMan.
Every year, DigiStorm brings together thought
leaders from Indian pharma to decipher the
impact of digital on the patient journey, phar-
ma marketing, corporate L&D and the health-
care landscape at large.
With speakers and participants from India’s
biggest and most innovative pharma compa-
nies and service providers, DigiStorm sets the
digital agenda for the year ahead.
Karnataka Drugs and Pharmaceuticals Manufacturers' Association
REGISTER AT:
medicinman.net/digistorm
Prabir Jha,
President &
Global Chief
People Officer,
Cipla
Salil
Kallianpur,
Principal
Consultant –
Digital Trans-
formation Lab
and Executive
Editor at
MedicinMan
K. Hariram is
Chief Mentor
at Medicin-
Man and an
executive
coach. He is
the former MD
at Galderma
India
Deep
Bhandari,
Editorial Board
Member,
MedicinMan
Sunil Attavar,
Chairman and
Managing
Director, Group
Pharmaceuticals
Anup Soans,
Editor, Medicin-
Man
Sankar Dass,
Chief Executive
Officer, Curatio
Healthcare
Amit Bhakri,
Business Unit
Head, Specialty
Care, AstraZen-
eca
Suresh
Subramanian,
Head South Asia,
Biocon Branded
Formulations,
Biocon
Raja MVSMA,
Vice President,
Marketing &
Portfolio, Dr.
Reddy’s Labora-
tories
Varadarajan S,
Vice President,
Corporate Learn-
ing & Develop-
ment, Micro Labs
Dr. Karthik
Anantharaman,
Business Unit
Head (Meta-
bolics/Branded
Formulations/
Biosimilars),
Biocon
Pankaj N
Gursahani, PhD,
Director, Sales
Training, Astra-
Zeneca India
Amlesh
Ranjan, Deputy
Director, Super
Specialty, Sanofi
Jiten Karani,
Senior Director,
Sales Force Effec-
tiveness, Biocon
IN PARTNERSHIPWITH
For more information and
to register, visit:
medicinman.net/digistorm

5. 5 | MedicinMan August 2018
T
he other day I asked a medical practitioner, a
friend of mine for the last 41 years, as to which
brand of amoxicillin+clavulanic acid would he
use if someone from his family needed it.“Augmentin”,
pat came the reply. ”Why not…,”I named a few brands.
“Because Augmentin is Augmentin. And I know that it
comes from a top-class company with top class quali-
ty. I do not wish to take a chance with any other brand.”
“Each time we pop a pill, feed syrup to little ones, vac-
cinate our babies or inject a medicine into our critical-
ly-ill loved ones, the obvious hope is that it will work.
But, we are totally oblivious to the untold story of the
medicine,”says an Organization of Pharmaceutical Pro-
ducers of India (OPPI) release.
Millions of people all over the world are alive and in
good health today because they have ‘trusted’ the pill
to do its job. “Trust” that is a result of the doctor-pa-
tient relationship and in the pill that is expected to do
its work.
For the first time in the history of the pharma indus-
try in India, all the three major pharma manufacturers
bodies viz. the OPPI, the IPA (Indian Pharmaceutical
Alliance) and the IDMA (Indian Drug Manufacturers
Association) met on a common platform in June 2018
to set an agenda that would:

QUALITY – A KEY ISSUE
AT OPPI, IPA AND IDMA
JOINT SUMMIT
Vivek Hattangadi
Vivek Hattangadi reports on the issue that is
keeping industry CEOs awake at night, in an
otherwise globally respected industry

6.  Vivek Hattangadi | Quality – A Key Issue at OPPI, IPA and IDMA Joint Summit
ØØ Agree on the importance of setting and adopt-
ing best-in-class global quality standards for
the pharmaceutical industry;
ØØ Bring all stakeholders together – regulators,
industry and governments, both state and
central – to create the enabling conditions for
achieving this goal, and
ØØ Define the quality roadmap for India
It is imperative to build a culture of quality in the
country. The summit called for adopting global
quality standards. “Bring all stakeholders like reg-
ulators, industry and government to work jointly
towards the growth of the sector”, was the rallying
cry.
In an interview, Dr. Sanjit Singh Lamba, Chair - OPPI
Technical & Supply Chain Committee & Managing
Director, Eisai Pharmaceuticals India, spoke about
the initiative taken by FDA (Food and Drug Ad-
ministration) to inject Quality by Design (QbD) to
build quality into the product right from the start
of manufacturing.
This contrasts with the traditional Quality by Test-
ing (QbT) approach that tests product quality by
checking it against the approved regulatory spec-
ifications at the end of the manufacturing stream.
QbD principles promote innovation and continu-
ous improvement of the product.
When asked about the benefits of implementing
QbD principles at the formulation development
stage, Dr. Lamba said that there are many benefits
of QbD at formulation development stage. A few of
them are listed below:
ØØ The product is developed considering custom-
er’s (patients) need.
ØØ A robust process is developed as it focuses on
a control strategy rather than testing
ØØ Overall development is systematic, and multi-
variate experiments are conducted to under-
stand the process and product which estab-
lishes a design space.
6 | MedicinMan August 2018
“
For the first time in the history of
the pharma industry in India, all the
three major pharma manufacturers
bodies viz. the OPPI, the IPA (Indian
Pharmaceutical Alliance) and the
IDMA(IndianDrugManufacturers
Association) met on a common
platform in June 2018

7.  Vivek Hattangadi | Quality – A Key Issue at OPPI, IPA and IDMA Joint Summit
ØØ The process can be adjusted within the design
space rather than remaining a fixed process.
ØØ Product life cycle is managed as a preventive
action rather than through reactive problem
solving.
He added that QbD principles can save costs in
terms of both time and money as against QbT.
Mr. Annaswami Vaidheesh, President, OPPI and
Managing Director GSK Ltd. said, "Quality of medi-
cines are pivotal in delivering patient care and the
entire pharmaceutical industry has come together
to stress the importance of quality in delivering re-
sponsible and safe patient care. Quality should be
embedded in every stage of the medicine-making
process and across the delivery chain – from the
R&D laboratory to the pharmacy where the patient
buys the drugs”.
The Indian pharma industry has contributed im-
mensely to driving healthcare objectives and the
economic growth of India. The industry has grown
by 8.5% over the last 10 years and contributes to
3.1% of our nation’s GDP and close to 10% of India’s
exports. One million Indians are employed in this
sector, the release said.
Indian pharma has contributed not just to the
health outcomes of Indians but to patients glob-
ally. 60% of vaccines globally are produced in In-
dia and India supplies 30% of the requirements of
United Nations Children’s Fund (UNICEF). 60-80%
of vaccines procured by the UN come from India.
7 | MedicinMan August 2018
“
Dr. Sanjit Singh Lamba, Chair -
OPPI Technical & Supply Chain
Committee & Managing Director,
Eisai Pharmaceuticals India, spoke
about the initiative taken by FDA
(Food and Drug Administration) to
inject Quality by Design (QbD) to
build quality into the product right
from the start of manufacturing.
This contrasts with the traditional
Quality by Testing (QbT) approach
that tests product quality by
checking it against the approved
regulatory specifications at the end
of the manufacturing stream.

8.  Vivek Hattangadi | Quality – A Key Issue at OPPI, IPA and IDMA Joint Summit
No wonder then that India is called the ‘Pharmacy
of the World’.
India will continue to drive the availability of high
quality drugs at low cost. Quoting an example, the
cost of therapy per month of the long acting insu-
lin, LANTUS is US$42 in India, US$139 in China and
US$186 in the US. Advair Inhaler costs US$10 in In-
dia; in the US it is US$154.
The summit also highlighted the many instances of
poor quality products manufactured in India that
have recently surfaced. Drug quality is one of the
major challenges faced by the industry. This has
been reported extensively.
At the summit, adherence to a Quality Assurance
Programwasemphasizedtomakecertainthateach
medicine reaching a patient is safe, effective and
of a standard quality – all adhering to WHO-cGMP.
The ‘c’ in cGMP stands for ‘current,’ requiring com-
panies to use technologies and systems that are
up-to-date, to comply with regulations, and assure
the quality of every batch every day.
By implementing WHO-cGMP and PIC/S, India
can aim for meeting stringent Global Standards. It
highlighted the differences between GMP (Sched-
ule M) and WHO-cGMP and why the latter needs to
be adopted.
The summit highlighted the difference between
pharmaceutical equivalence and bioequivalence.
Two pills may look alike but they may not be the
same. The determinants of pharmaceutical quality
were discussed in detail.
Identity, purity, potency, uniformity and stability
are defined in pharmacopoeias and stated in the
certificate of analysis (COA) of each lot of the prod-
uct.
Low quality of medicines can result in prolonging
illness and even death. Besides it is a waste of limit-
ed financial resources, loss of credibility and worse
– distress to patients and family.
8 | MedicinMan August 2018
“
By implementing WHO-cGMP and
PIC/S, India can aim for meeting
stringent Global Standards. It
highlighted the differences between
GMP (Schedule M) and WHO-
cGMP and why the latter needs to
be adopted.

9.  Vivek Hattangadi | Quality – A Key Issue at OPPI, IPA and IDMA Joint Summit
The summit also discussed the underlying issues
that drive a gap in quality from the manufacturer’s
perspective. There were the gaps in ensuring ad-
herence to standards or SOPs. Standards are not in
line with best-in-class. Schedule M provides robust
guidelines but needs to be upgraded to global
standards. The need is to adopt WHO GMP & devel-
op a roadmap for PIC/S.
There is a dire need for pharmaceutical manufac-
turers to achieve excellence in quality on a sustain-
able basis.
In conclusion, six potential themes emerged
1. Adopt to WHO-cGMP.
2. Develop a roadmap to join PIC/S
3. Strengthen drug filing requirements in India.
4. Extend regulatory and quality checks till the
last mile
5. Cooperate with other regulators
6. Provide requisite financial support to ensure
baseline standards
MM
9 | MedicinMan August 2018
“
Low quality of medicines can
result in prolonging illness and
even death. Besides it is a waste of
limited financial resources, loss of
credibility and worse – distress to
patients and family.
Vivek Hattangadi is a
Consultant in Pharma
Brand Management and
Sales Training at The En-
ablers. He is also visiting
faculty at CIPM Calcutta
(Vidyasagar University)
for their MBA course in
Pharmaceutical Management.
vivekhattangadi@theenablers.org

10. 10 | MedicinMan August 2018
D
o a Google search on "digital transformation"
and you'll get 11.5 million results, topped by
ads from various technology giants. People
generally don’t explain what they mean by "digital
transformation," and quite often it sounds like one of
those buzzwords (or buzz phrases), like "paradigm
shift" and "new normal," that don't mean much of any-
thing at all.
Of course, Digital transformation is a current buzz-
word, but the roots go far back. Today, the retail indus-
try, hospitality and taxi services are three examples of
what digital transformation really is and the amazon,
the Airbnb and the Uber are a part of us on our smart-
phones that we hold very dearly in our hands day in
and day out.
Where is India pharma in this journey of digital trans-
formation? The Ken, in an article titled“Indian Pharma
doesn’t have a choice but to market digitally”was cat-
egorical that Indian pharma has no option but to em-
brace digitalisation of its marketing activities.
While Indian pharma has certainly been moving in
this direction, there seems to be a lot of hesitation in
wholeheartedly embracing it. Mostly, for Indian phar-
ma digital is synonymous to “iPad detailing” which
means transferring the visual aid onto glass (tablet) or
each brand manager creating an app for the physician
to download. At the receiving end is the pharma sales
person who finds it very difficult to convince the phy-
sician to download the app, much to his annoyance.

K. Hariram
DigiStorm 2018 - to 'do'
digital or 'be' digital -
that is the question.
Digital is has changed how we travel, consume
news, connect with friends and family and buy
groceries-whatisitstrueimpactonhealthcare?

11.  K. Hariram | DigiStorm 2018 - To 'Do' Dgital or 'Be' Digital - that is the Question
Couple of relevant questions pop up in my mind.
Is this what digital means? Is the digital route just
a different medium? Should it just be looked at
through the marketing lens or should it grow be-
yond? Should digital function be a separate one
from marketing or should all marketers be savvy to
embrace digitalization as part of their core market-
ing function?
DigiStorm 2018, to be held on 11th September in
Bangalore in partnership with KPDMA, provides an
opportunity to deliberate and find some of the an-
swers to the above questions and a way forward to
adopting digital in pharma marketing.
One of the questions that will be asked in this fo-
rum is: “Is Indian Pharma embracing more digital
technology?”The relevant question in my mind is,
“do we want to be‘doing digital’rather than‘being
digital’?”– which means using digital technologies
to make incremental improvements to the status
quo, but not yet weaving digital into their organi-
sational and marketing DNA.
To have greater understanding, better perspective
and deeper insights, do register yourself and join
us on 11th
September 2018 at The Lalit, Bengaluru
for the DigiStorm 2018 event. Visit us for more de-
tails at www.medicinman.net/digistorm. MM
11 | MedicinMan August 2018
K. Hariram is the
former MD (retd.) at
Galderma India.
He is Chief Mentor at
MedicinMan and a
regular contributor.
khariram25@yahoo.com