Digital health is percolating down to the local sabziwali, thanks to ubiquitous smartphones and a plethora of apps...

1. D E C E M B E R 2 0 1 8 | W W W . M E D I C I N M A N . N E T
DIGITAL TECHNOLOGY - HUMAN BEHAVIOR
INTERSECTION: LESSONS FROM OLA, UBER,
AIRBNB, OYO ET AL
Anup Soans
Large scale adoption of technology, while essential and beneficial, also shows up the seamier side, the underbelly
of society.
Nowhere is this more visible, ubiquitous and all pervading than on daily Social Media interactions. Trolls are the
dark side, what I call the "Under the Flyover People" (UFPs - Despairing Indians).
The unintended consequence of large scale technology adoption is: making the UFPs visible and often bring us,
the "Uniquely Privileged People" (UPPs - Aspiring Indians) into direct contact as we access and use services from
Ola, Uber, AirBnB, OYO et al.
UPPs consciously and furtively avoid interaction with UFPs, unless there is no option as in the case of drivers and
maids, where they behave either authoritatively or gratuitously - both ineffective approaches to understand or
appreciate the UFPs, who've never had anything close, to the privileges UPPs take for granted.
Under the Flyover, there is no law, no patrol jeeps, only occasional politicians' henchmen distributing posters,
manifesto, cash and liquor in election and festival season.
1 | MedicinMan December 2018

2. The yellow cabs (Kaali Peeli (KPs), in Mumbaikar lingo), is something both extremely useful and uncomfortable
for more than physical reasons. There is a sense of apprehension every time you approach them. KPs are
UFPs with a uniform. The uniform normalises KPs to a great extent. Their compulsory interaction with RTOs
and police, make KPs accept the inevitability of some sort of governance, a working moral compass with
margins for error.
Not so with the UFPs associated with digitally powered service providers like Ola and Uber. They have a sure-
shot GPS, a comfortable car in most cases, but no moral compass. Digital power obviates the need for
interaction with any sort of governance and UFPs become autonomous individuals who can switch off/hack the
digital governor and disappear from the radar and take you for a Mad Max like ride just to avoid paying toll
charges, which have already been extracted by Ola and Uber through their super efficient AI & ML powered
profit sniffing software. UFPs are trolls in the Phygital world of commerce.
Other myriad of services like AirBnB, OYO, "Make Your, Mine and Our Trip/Stay" services, Zomato, Swiggy are
no less distressing, when they shortchange you digitally.
The lesson is that, despite the investor-powered business-press hyped glorious advantages of these next
generation technology players, unless the human component is accounted for, which I daresay is the least of
concerns of this build-and-sell enterprises, end user will experience a new level of dissatisfaction, which is not
the same as that with Kaali Peeli operators but one of hyped expectations of UPPs let down by failure of Ola,
Uber, AirBnB, OYO et al to engineer change in human behavior of UFPs.
They could take a lot of lessons in the way Indian Army takes people from Less Privileged People, (LPPs -
Perspiring India) and transforms them into outstanding soldiers and citizens. But then, the Army is building an
institution of durable excellence, unlike Ola, Uber, AirBnB, OYO et al who have one eye on their operations and
the other watching ticker tapes of stock price movements.
Are the MPPs (Most Privileged People - Politicians, Businessmen, Media et al) listening?
This article was first published on LinkedIn
2 | MedicinMan December 2018

3. 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 12| December 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
3 | MedicinMan December 2018

4. WHAT MY SABZIWALI TAUGHT ME ABOUT THE
INTERNET, MOBILE HEALTH & SMARTPHONES
Pavan Kulkarni
It’s very common for a pharma professional having neighbors, friends and relatives to engage in conversation
over medicines. One such conversation – a pleasant surprise – which intrigued me to dig deep into internet
dynamics was one with the local roadside Sabziwali (vegetable vendor lady in her late 30s and little educated)
near home who stopped me one day, insisting, “Bhaiyya ek help kardo” while handing me her iPhone. At first, I
thought she was asking me if the iPhone was mine. Or maybe she thought my wife had left it behind while
buying vegetables. Then I realized it was neither. In fact, she had a question for me as she knew me as a
“dawai ki factory wala” (working in a medicine factory).
The 1mg app was open on iPhone with some glucosamine brands being searched.
She showed me a prescription from a local MBBS GP for her mother who is suffering from spondylitis. I often
see her mother at the vegetable counter in frail condition with evident kyphosis and I used to remember it as
surely a wedging or a compression fracture at the T12/ thoracolumbar region.
The prescription had some leading brands. One of a glucosamine for 3 months, a tramadol and paracetamol
for a week and a multivitamin for 3 weeks
She asked me, “Bhaiyya ye daactar ne sahi likha hai ya doosre daactar ko dikhana hai?”
(Has this doctor prescribed correctly or should we take a second opinion). The incident left surprised, though
I recommended her to trust her doctor. This is one of several incidents that we as pharma executives comes
across very often.
There are several insights here. She had a second-hand iPhone, knew to use Google, had the 1mg app on her
phone and was searching healthcare related content on the internet. This incident was when I decided to research
the digital trends. Jotting down a few of my thoughts and after combing through more than a dozen reports and
studies, I would like to put forward the facts and trends in this article. What we can/should do in pharmaceuticals is
up to you to decide.
4 | MedicinMan December 2018

5. Triggering the history of shifts
Smartphones today are truly incredible devices capable of tasks beyond the primary function of communication.
With the advent of smartphones, the noise and the hype has grown with almost 800 new apps being launched
daily. Communication – then a primary and sole feature – is now only one of a plethora of features available.
Among the several paradigms which have had an impact on society, the Digital Age & Smartphones are having
the maximum impact in reshaping it.
“An apple is a sweet, edible fruit produced by an apple tree. Apple trees are cultivated worldwide, and are
the most widely grown species in the genus Malus”. That’s the result to the Google search “Apple the fruit”.
However, were you to simply type ‘apple’ you would receive results relevant to the tech giant, Apple. Gone are the
days when ‘apple’ was a fruit or a ‘tablet’ meant medicine. Be it an apple, orange or blackberry, apricot etc. - which
are well known - commodity names are now DIGI names.
After the Industrial Revolution during the 1750s, the New Millennium is the next big shift to have happened in
human history. This is facilitated by Digitization and Smartphones. The Information Age characterized by a
rapid transition from traditional industry. Back then the Industrial Age saw the initiation of mass production,
production lines and reaching out to the masses with different offering. The New Millennium has reached out to
billions through small devices, otherwise just a fictional instrument in the Star Trek series.
The smaller boxes making us idiots?
Since the television, to the smartphone today, technology has seen the public grow increasingly dependent on
it. Once an uncomfortably large handset with a long aerial to today’s devices with 4 cameras built in and
multitasking abilities, the usefulness of mobile phones and our dependency thereof has grown exponentially. So
much is the impact that we take more than 30% of important decisions on day to day basis using or enabled by
our phones. Be it finding a route, or shopping, comparing prices, reviews etc.
The Deloitte Digital reports that smartphones crossed
the 2 billion mark in 2014 and are expected to reach
4.6 billion by 2019. (almost 50% + of world
population). Some of you may be aware of the size of
activity on the internet every 60 Seconds in 2018
(approximate figures). This is but a screenshot of that
activity, though actual figures of what happens on the
internet every 60 seconds is in itself, different big
data. One should also note, that these figures are
growing more than 50% annually. Smartphone
technology is the fastest changing and improving
arena. A flagship model today is an antique tomorrow.
What is in it for Indian Pharma Marketers?
Now pause for a moment and ask yourself - What percentage of the aforementioned data is taken up by
healthcare related queries, searches, discussions, medical uploads, discoveries, statistics of chronic and acute
areas and other medical related activities in the world? Pessimistically, if healthcare related activities estimate
to only 5%, the Indian pharma industry is far behind and it will take some radical changes to reorganize the
digitization model. I am not talking about iPad detailing which is debatable. I also remember the quotes of
Martin Luther King., “We have guided missiles but misguided men handling them” & another “I have a dream”.
Both need to be pondered upon by marketers in Indian pharma sector on how to have a digital dream to pick up
exponentially and yet use it in a guided manner.
5 | MedicinMan December 2018

6. Bridging the 70-30 Imbalance - IPM
A PwC & CII mHEALTH analytics report showed that while India is the home for 21% of global disease burden, the
Indian healthcare reach has a long way to go. A large section of India remains deprived of even the basic
healthcare facilities. Let’s talk facts:
For every 1000 people in India, we have 0.7 doctors, 1.3 nurses & 1.1 hospital bed only. No doubt this is enough
to validate the belief that identification & diagnosis of diseases in India is itself a big problem. More surprising is
that 30% of Indians do not have access to healthcare facilities & 70% of healthcare infrastructure is limited to top
10 cities in India. While many are deprived, there are two facets being observed in Indian digital and healthcare
trends. One is, increased reach of internet and mobiles and second is interest and eagerness for Mobile
Health Solutions.
Increased reach of internet and mobiles
Where once without technology people were able, they are now differently abled. Technological disruption is also
known to be the existential threat of 21st century. Artificial intelligence (AI) is proving humans wrong in several
fronts. Internet may be threatening to enlarge the rift between the classes rather than bringing them together. Yet,
we are all diving deep into it. By the end of 2017 (and during 2018) some Indian statistics reveal a drastic shift of
masses moving to some digital analogues in some or the other way. Google trends in India show:
Around 700-800 million Indians out of 1.3 billion populations are television viewers
400 million internet users and
300 million active smartphone users
Most important to note are the projections for India. Currently around 1 crore (10 million) people shift to some
smartphone or the other every month
What do Indians do on the net?
They do a variety of things which Google captures as bulk data. The percentage lessens if we categorize the micro
payment platform and its users which is one of prime contributors to the rise in online retail business in the work
and India. Rural usage of smart phone has also increased. It’s very interesting to see how Indians are HUNGRY –
or should say DIGI-HUNGRY? Yes, India is now World’s first, video first internet economy. Which means video
content is accepted well.
“What the use? / Itna bas hogaya / Isse zyada use nahi hai” etc etc…We have all heard it from our elders at
home when we asked them to switch to a smartphone. The biggest hurdle in the dissonance of internet &
smartphones in India may not be the complexity of using smart phones but I feel it’s their belief balance i.e.,
the cost of data vis-a-viz the primary usage.Earlier when the masses got communication ease at bare
minimum price, they were not ready to jump to the next level of internet and data driven content due to its high
cost. People were reluctant (few rigid laggards even now) when data was at the rate of Rs 200 - Rs 500 per GB
and thus it was limited to high income/tech savvy segments. However, with huge competition and advent of JIO,
the scenario has changed with bandwidth available at INR 10/GB. This has helped further the digital age.
Interest and eagerness for Mobile health solutions.
Before going looking into mobile health, one should note that in 2010 there were < 10 million active smart phone
users in India which jumped to 100 million active users when smartphones prices fell to the < Rs10,000 range.
This grew again to 350 million when smartphones in the range of Rs 6000 were available. This was 2017. Google
expects that India will reach 600 million soon with 10 million new users added every month. People are also
watching less television as the same is now available on their smartphones.
Relatively, every other industry has strategized and reorganized their business models accommodating e-
commerce. The following are few reasons which I feel have matched up & Indian Pharma seems to be still in
infancy stage in these sections.
6 | MedicinMan December 2018

7. Patients (and doctors) search internet for healthcare related content. This content is generally trusted as
most people are not able to distinguish between what is authentic and what is fake. One important insight is
“video content is the choice” & pharmaceutical branding surge faster into it in terms of awareness in genuine
form. Few companies are doing it.
Can Indian pharma companies generate / build goodwill or revamp the company’s image using the rapid
reach of internet and not only influence doctors and patients but shareholders too?
Can we attract talent or position our company as a ‘Dream Company’?
Can we showcase products, manufacturing facilities or technologies to public to instill confidence?
Can we leverage the international reach, projections, or our API growth with the internet?
Rise in content for individuals
Rise in rural
Rise in learning / education / earning
Reduced data cost
Digital gaming
Increased smart phone coupled with reduced cost
Micro-payment platforms
Conclusions and what can IPM do. Well, you have to decide. I am going to leave you with some questions
Pavan Kulkarni is the General Manager: Corporate Strategy
at J B Chemicals and Pharmaceuticals Ltd.
7 | MedicinMan December 2018

8. PHARMINTECH 2019: BIG INCREASE IN INTERNATIONAL PARTICIPATION EXPECTED
Milan, November 2018 – The nutritional and biotech sectors, medical devices, personal care products
and, more broadly, the entire pharmaceutical industry are the focus of the upcoming edition of
Pharmintech, the international fair organised every three years by BolognaFiere Group and dedicated to
technologies for the life science sector, taking place in Bologna from 10 to 12 April 2019.
The main aim of the upcoming edition is internationalisation: numerous promotional campaigns have been
devised and are now in progress to engage operators from various countries, targeting them with
strategies to attract foreign visitors. This will hopefully bring professionals from faraway markets like South-
East Asia and South America to the fair, increasing the number of international visitors and operators
beyond the usual visitors from Europe, Africa, the Middle East and the Mediterranean, who are the main
target audience. In terms of buyers, the Pharmintech organisers expect to see an overall increase of at
least 35% compared with the previous edition in 2016.
Scheduled to coincide with Cosmofarma, which runs from 12 to 14 April 2019, Pharmintech will help
provide a full and varied fair offer. The Bologna Health week, from 10 to 14 April, will be a meeting point for
the whole life science industry, giving all international visitors a unique opportunity to meet with managers,
professional operators and technicians from the sector’s entire supply chain. Taking centre stage is the
very best of processing and packaging technologies, which are still Pharmintech’s core business, enriched
by offers from the integrated supply chain with content and solutions for contract manufacturing, industrial
automation, distribution, supply chain management, clean rooms and digital solutions.
PHARMINTECH
Organised by BolognaFiere, Pharmintech is the landmark event for the life science sector. The fifth edition
of the fair, held in 2016, had over 300 exhibiting companies taking part, representing the entire supply
chain.
For more information, visit: www.pharmintech.it