Case study

Launch Plan: Monocryl Plus

On a warm Monday afternoon in August 07, Amit Goswami the marketing
manger synthetic absorbable sutures in the Ethicon Business of J&J Medical
India was worried about a new product launch. Waiting outside the MDs
office he was reviewing his pitch to New Brunswick managers that was to be
cleared with the MD of J&J Medical India first.
Background:
J&J Medical is into many invasive and non invasive diagnostic and healthcare
solutions providing businesses. (See annexure 1)
New Brunswick (Global J&J headquarters) wanted a quick plan for launch of
Monocryl plus, a new innovation in the existing Monocryl suture. Sutures
primarily are closure products used to close incisions made by surgeons
and/or accidental wounds.
The Monocryl suture was launched some ten years back for skin closure and
had not been as successful in India as it was in other parts of the world.
Though ready with the plan, Amit was worried what would happen to the
brand extension of a product which had already received a lukewarm
response from Indian Surgeons.
This plan had been prepared with help of external consultants. For the
purpose of this case, kindly assume that you are that consultant.
The task:
To prepare a quick launch plan for the new Monocryl Plus suture.
Nuts and bolts:
Ethicon has been the global leader in the wound closure business and India
was no different. But as of the last 10 years sutures were fast becoming a
commoditized category. Many new compromised quality/low cost
producers had entered into the market. The compromised quality raw
material (threads and needles) was easy to produce and due to low internal
quality benchmarks/ low overheads the competition was able to sell the
finished goods at nearly half the price of Ethicon products.
There had also been an additional problem of Chinese Imports hitting Indian
hospitals.
The mainstay brand Vicryl (contributing to 40% of Suture top line) was under
threat.
Then three years back a new innovation Vicryl Plus with additional
antibacterial coating had been launched. In 3 years Ethicon team had
converted 18% of Vicryl users to plus. This was Ethicons reply to the low
cost threat to Vicryl. Move the surgeon higher on the benefit ladder rather
1

than competing on cost and hence keeping the value intact. Said Amit
Goswami. The whole sales team is really upbeat about the plus platform due
to the recent success of Vicryl plus.
Having taken the credit (and a good bonus) for Vicryl Plus success Amit was
thinking whether the same strategy would work for Monocryl. Market realities
for Vicryl and Monocryl were very different. Vicryl was a 80 crore product and
Monocryl had just reached 3 crores in 10 years. Also Vicryl was used for
many layers closure (Skin,fat,fascia) in nearly every specialty and Monocryl
was popular only with plastic surgeons for great cosmetic effect on skin
during aesthetic surgery.
With a smaller playing field even if we upgrade 100% of existing Monocryl
users, will a 3 cr topline justify a new product? We need new
applications/new markets/new surgical specialties for this product, said Amit
talking to himself.
Vicryl had been popular across private hospitals, government hospitals and
nursing homes. Amit had to make a choice of which segment to choose for
Monocryl plus.(See Annexure 4). From the specialty lens there were many
segments in the market. General Surgeons(20,000), Gynaecs(25000),
Plastic(1000), cardiac (500), Orthopaedic ( 6000). Whilst he could pitch this
product on all of them or one of them, the fact holding him back was that
Monocryl is only indicated for skin closure. Hmmm.. I wish this product
could be used for more than one layer of closure wished the thoughtful
marketing manager. Till then let me see if I can make it a multi specialty
product for skin closure.
Currently 60% of surgeons were using silk, nylon, Vicryl etc for skin closure.
Surgery being very skill driven, it was difficult to make a surgeon shift from
one material to other. Therefore professional education (teaching surgeons
how to use) had been the mainstay of J&J medicals worldwide strategy.
In terms of willingness to upgrade the latest Trigger and barrier research
on sutures named CV surgeons as the quickest to upgrade, followed by
Ortho, General surgeons and then Gynaecs.
Whilst thinking about the promo plan Amit remembered the constraint of not
being able to advertise in mainline media as these were ethical/prescription
products and not OTC.
Surgical conferences, newsletters, surgical journals, one on one meetings
were the options that traditionally people had been using.
During lunch Amit told the consultant on how impressed he was by
marketing people in other categories using digital media successfully and
how he wished medical device marketers could do the same.

Just before he was about to leave office he received the plus suture essential
prescribing information.(Annexure 3). Promptly Amit handed it over to the
consultant. Lets discuss this tomorrow morning.
Tomorrow you have to present your plan to Amit and then the MD. You may
use Internet to do some more data mining if you like. The expectation is to
present a refreshing strategic direction supplemented with implementation
plan on the new product launch.

Annexure 1: Information about J&J businesses active in

India

JOHNSON &
JOHNSON &
JOHNSON
JOHNSON
MEDICAL
MEDICAL

ETHICON
Wound
Closure &
Tissue
Repair
Products
(Sutures &
Mesh)

CORDIS
Cardiology
&
Endovascula
r products
(Stents)

DEPUY
Orthopedic
Implants
(Knee & Hip
Replacemen
t)

ASP
Advanced
Sterilization
& Infection
Prevention
Products

LIFESCAN
Diabetes
Management
Solutions
(Glucometer)

ETHICON
ENDO
SURGERY
Minimal
access
surgical
products

Cordis
Since its establishment in 1959, Cordis Corporation has been a pioneer in
circulatory disease management. Dedicated to helping physicians and other
healthcare professionals enhance the lives of patients suffering from cardio
vascular disease, Cordis is driven to transform the future of vascular care
through its commitment to R&D.
In India, Cordis has four specializations: Cardiology, Endovascular,
Neurovascular and Electrophysiology.
DePuy
3

Over one in ten people above the age of 55 suffer from Arthritis. DePuy aims
to empower sufferers by increasing awareness about arthritis and its
management on the one hand and training surgeons to increase the
specialist pool on the other. DePuy Orthopaedics Inc., a subsidiary of Johnson
& Johnson, is a company that designs, manufactures and distributes
orthopedic devices and supplies including hip, knee, extremity, trauma,
orthobiologics, and operating room products.
A market leader in the joint replacement sector, DePuy has always stayed
ahead of the curve with its speed to market the latest technology products.
With this, DePuy aims to serve patient needs and restore the joy of motion.
Ethicon
Innovation is a key factor that drives business at Ethicon, one of the worlds
most respected brands in surgical and health care. Today Ethicon has a range
of over a thousand products in the area of wound closure, womens health
and urology and cardiovascular solutions. On an average Ethicon products
touch the lives of 11 million patients in a year making it one of the largest
surgical product brands across product categories.
Ethicon Endo-Surgery
Minimally invasive surgery is the way of the future. Ethicon Endo-Surgery
markets advanced medical devices for minimally invasive and open surgical
procedures. Focusing on procedure-enabling devices for the interventional
diagnosis and treatment of conditions in general and bariatric surgery, as
well as gastrointestinal, gynaecology and surgical oncology.
JJHS
Popularly called the "Hospital Division of J&J", Johnson & Johnson Hospital
Supplies helps healthcare providers touch, save and improve countless
patient lives across the country, by saving blood and preventing infections.
Its range of infection prevention products, are used for environmental
disinfection inside hospitals, for disinfection and sterilization of surgical and
endoscopic instruments, and skin disinfection of surgeons and patients.
Passionate to improve the safety of patient, environment and healthcare
workers, the company is dedicated to protecting patients, healthcare workers
and the environment with products that focus as much on safety as they do
on efficacy and cost-effectiveness.
Lifescan
Dedicated to improving the quality of life for people with diabetes by
developing, manufacturing and marketing a wide range of glucose
monitoring systems and software for use by people with diabetes and by
health care providers, Lifescan, Inc. The ONETOUCH Brand of consumer
4

and institutional products includes portable electronic meters and disposable

reagent test strips to provide accurate, less painful glucose readings and the
software tools to transform this information into actionable health care
decisions.
Ethicon Institutes of Surgical Education
Ethicon Institutes of Surgical Education (EISE), at Delhi, Mumbai (Bombay) &
Chennai (Madras), symbolizes the commitment of Johnson & Johnson
Medical, India towards the field of Professional Education. Dry and Animate
Labs for hands-on experience form an integral feature of courses at EISEs.
These state-of-the-art Institutes house modern operating theaters equipped
with latest patient monitoring and life support equipment to simulate real life
situations. The conference rooms are ergonomically designed with the latest
audio-visual aids including equipment for distance learning. EISEs are
recognized by the Royal College of Surgeons, Edinburgh, U. K., as centers of
excellence for conducting their Basic Surgical Skills Courses in India.
Business Knowledge Centre
An Asia Pacific initiative, the Business Knowledge Centre is a state of the art,
scalable, captive model. Established in 2006, at a tech park in Pune, India; it
is based on the time-proven concept of Regional Planning. It aspires to
support, with a long-term view, various initiatives, in areas of Operational
Excellence, Global Process Outsourcing and Knowledge Development.
BKC adds value, by bringing operational excellence and in depth industrial
and functional knowledge to JJM affiliates' critical business processes. It
provides high-quality execution of these processes, monitors them against
multiple performance metrics, and seeks to improve them on an ongoing
basis. BKC achieves its objectives, by providing service based on the five
verticals of: Business Analytics, Distribution Analytics, Financial Analytics
Regional Information Technology and Information Technology Strategic
Sourcing

Annexure 2: Suture market

Volume share 61%
Total suture market = 3.42 MM doz
MM

Value 74%
Total suture value = Rs. 2184

Annexure 3
About Sutures:
Essential Prescribing Information
Vicryl

Vicryl Plus

Synthetic
Absorba
ble

Synthetic
Absorba
ble

Material

Polyglactin 910

Antibacterial
coated
Polyglact
in 910

Usage
Occasi
ons

All tissue layers

Braided suture

Type

of
suture

Key
Produ
ct
featur
e

Predictable
absorpti
on
behavior

Key Benefit

Offers easy
handling
by
surgeon

Monocryl

Synthetic
Absorba
ble

All surgical
specialti
es

Synthetic
Absorbab
le

Poliglecaprone
25

Antibacterial
coated
Poligleca
prone 25

All tissue layers

Ideal for skin

tissue,
Bowels

Ideal for skin

tissue,
Bowels

Braided suture

Monofilament
suture

Monofilament
suture

Most smooth
suture of
all

Most smooth
suture of
all

Predictable
absorpti
on
behavior
Antibacterial
coat
prevents
bacterial
colonizat
ion
Offers easy
handling
by
surgeon

Offers very good

cosmetic
results
on skin

Less risk of
Surgical
site
infection

Current
high
users

Monocryl
Plus

General
surgeons
&
Cardiac
surgeons

Antibacterial
coat
prevents
bacterial
colonizat
ion
Offers very good
cosmetic
results
on skin
Less risk of
Surgical
site
infection

Plastic surgeons,
OBGYN
surgeons
, General
surgeons

Contraindic
ated
for

Cardiac tissues,
Neuro
tissues

Cardiac tissues,
Neuro
tissues

Deeper layers
(fascia),
Cardiac
tissues,
Neuro
tissues

Deeper layers
(fascia),
Cardiac
tissues,
Neuro
tissues

Information for Use

MONOCRYLPlusAntibacterial
(Poliglecaprone25)
Suture
VIOLET
MONOFILAMENT
SYNTHETIC ABSORBABLE SUTURE, USP, EXCEPT FOR DIAMETER
INDICATIONS
MONOCRYL Plus Antibacterial sutures are indicated for use in general soft
tissue approximation and/or ligation, but not for use in cardiovascular or
neurological tissues, microsurgery or ophthalmic surgery.
ACTIONS
MONOCRYL Plus Antibacterial suture is a monofilament that elicits a minimal
acute inflammatory reaction in tissues and in growth of fibrous connective
tissue.
Using zone of inhibition studies, Irgacare MP (triclosan) in MONOCRYL Plus
Antibacterial Suture has been shown to inhibit colonization of the suture by
Staphylococcus aureus, Staphylococcus epidermidis, Methicillin Resistant S.
aureus, Methicillin Resistant S. epidermidis, Escherichia coli, and Klebsiella
pneumoniae which are microorganisms known to contribute to surgical site
infections. Animal studies have demonstrated that MONOCRYL* Plus inhibits
bacterial colonization of suture after direct in vivo challenge with bacteria.
CONTRAINDICATIONS
This suture, being absorbable, should not be used where extended
approximation of tissue under stress is required.
MONOCRYL Plus Antibacterial suture should not be used in patients with
known allergic reactions to Irgacare MP(triclosan).
8

WARNINGS
Users should be familiar with surgical procedures and techniques involving
absorbable sutures before employing MONOCRYL Plus Antibacterial suture for
wound closure, as risk of wound dehiscence may vary with the site of
application and the suture material used. Physicians should consider the in
vivo performance (under ACTIONS section) when selecting a suture for use in
patients. The use of this suture may be inappropriate in elderly,
malnourished, or debilitated patients, or inpatients suffering from conditions
that may delay wound healing.
Do not resterilize. Discard opened packages and unused sutures.
As with any foreign body, prolonged contact of any suture with salt solutions,
such as those found in the urinary or biliary tracts, may result in calculus
formation. As anabsorbable suture, MONOCRYL Plus Antibacterial suture may
act transiently as a foreign body. Acceptable surgical practice should be
followed for the management of contaminated or infected wounds.
As this is an absorbable suture material, the use of supplemental
nonabsorbable sutures should be considered by the surgeon in the closure of
the sites which may undergo expansion, stretching or distention, or which
may require additional support.
PRECAUTIONS
Skin sutures which must remain in place longer than 7 days may cause
localized irritation and should be snipped off or removed as indicated.
Subcuticular sutures should be placed as deeply as possible to minimize the
erythema and induration normally associated with absorption.
Under some circumstances, notably orthopedic procedures, immobilization of
joints by external support may be employed at the discretion of the surgeon.
Consideration should be taken in the use of absorbable sutures in tissue with
poor blood supply as suture extrusion and delayed absorption may occur.
In handling this or any other suture material, care should be taken to avoid
damage from handling. Avoid crushing or crimping damage due to
application of surgical instruments such as forceps or needle holders.
MONOCRYL Plus Antibacterial suture knots must be properly placed to be
secure. Adequate knot security requires the accepted surgical technique of
flat and square ties with additional throws as warranted by surgical
circumstance and the experience of the surgeon. The use of additional
throws may be particularly appropriate when knotting monofilaments.
Avoid prolonged exposure to elevated temperature. To avoid damaging
needle points and swage areas, grasp the needle in an area one-third (1/3) to
one-half (1/2) of the distance from the swaged end to the point. Reshaping
needles may cause them to lose strength and be less resistant to bending
and breaking. Users should exercise caution when handling surgical needles
to avoid inadvertent needle sticks. Discard used needles in "sharps"
containers.
ADVERSE REACTIONS
9

Adverse effects associated with the use of synthetic absorbable sutures

include wound dehiscence, failure to provide adequate wound support in
closure of the sites where expansion, stretching, or distension occur, failure
to provide adequate wound support in elderly, malnourished or debilitated
patients or in patients suffering from conditions which may delay wound
healing, infection, minimal acute inflammatory tissue reaction, localized
irritation when skin sutures are left in place for greater than 7 days, suture
extrusion and delayed absorption in tissue with poor blood supply, calculi
formation in urinary and biliary tracts when prolonged contact with salt
solutions such as urine and bile occurs, and transitory local irritation at the
wound site, as well as allergic reaction to Irgacare MP (triclosan).Broken
needles may result in extended or additional surgeries or residual foreign
bodies. Inadvertent needle sticks with contaminated surgical needles may
result in the transmission of bloodborne pathogens.
See Package Insert for Full Prescribing Information.
*Trademark

Annexure 4: Traditional market segments

Nursing Homes

Private Hospitals

50,000 nos
Entrepreneurial

Untapped, Profit
Driven
Fragmented

850 nos
Trust/Private
ownership
High sales
coverage
Group based
10

Government
Hospitals

4750 nos
Government
owned
Good sales
coverage
Slow-burn tenders,

Buy at MRP

KSF: Mass
communication
abilities,
product
availability

buying very high

buyer power
Low profit
realizations
KSF: Relationship
with KOLs,
Customers,
Buyers

KSF: Key Success Factor

KOL: Key Opinion Leader

11

change after 1-2

years
Very low
realization
KSF: Tender
management

Annexure 5: Pricing Matrix

Average Price of 1 Vicryl Suture = Rs.280

Price
Index

Vicryl

Vicryl
Plus

Vicryl
Rapide

Monocryl

PDSII

100

120

90

110

115

12

Rules for Submission

Your launch plan can be submitted in a word document (not exceeding

10 pages)
Please submit a 5-6 slide Powerpoint presentation capturing the
essential points of your Launch plan along with your Word document
Though there is no maximum limit to the number of words or slides
special credits will go to the strategists for clear, concise
communication

Evaluation Criteria
For Round 1 Selections:
Criteria of evaluation
Ability to arrive at core business issue, marketing
issue & final objective
Ability to provide succinct solutions
Analytical ability in problem solving
Demonstration of clarity of thinking
Process followed in arriving at final solution

For Final Presentation:

Criteria of evaluation
Verbal & Written Presentation skills
Demonstration of clarity of thinking

Any decisions pertaining to the judging of the competitors by the panel

of judges from Johnson & Johnson will be held final. It cant be
contested on any account.

13