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M/s. Alfa Corpuscle Ltd, Delhi , wanting to expand their product line in India approached
Our Institution Garden City College, Bangalore. They conducted an interview for MBA-
Marketing Students offering an internship programme on market research on Hernia Mesh.
Having got shortlisted for the internship programme, we had a training at their Delhi Office
briefing us about the Hernia Surgeries and their product range, The objective of the internship
Programme was to understand the current market of hernia mesh in Karnataka, and to get the
opinions of the General surgeons on the current available meshes in Karnataka Region, and to
know the market potential for the new product in the Karnataka Region.
To achieve this purpose, Karnataka region was divided into two geographic zone- Bangalore
Zone and Rest of Karnataka Zone. The target was to meet 150 Surgeons in a span of 15 days
in both the Zones. The Bangalore Zone was assigned to Jobin Babu Varghese and the other
being the rest of Karnataka assigned to Athar Amin.
We had planned to meet the General surgeon of both the Zone, based on reputed hospitals
and reputed surgeons. Some of the well know hospitals in Bangalore Zone like Columbia
Asia, MS Ramaiah, CMH Hospital, Baptist Hospital and Reputed Surgeons like Dr.
Anjanappa of General Surgeon Association. In Rest of Karnataka Zone, Famous Hospitals
Bapuji Hospital Davangere, SS Hospital Davangere, VIMS Bellary, Sidhartha Medical
College Tumkur, and reputed surgeons like Dr. Arun S K of Bellary were visisted and data
was collected based on the sample questionnaire(attached in Annexure). We were able to
cover about 100 hospitals and 121 surgeons. The said data is as summarised in the report in
detail below.
1
TABLE OF CONTENTS
2 MARKET RESEARCH 4
FACTS & FIGURES 5
MESH USAGE 10
IPOM MESH 11
SURGEONS ON MESH 12
PRIORTIES ON DECIDING 15
THE MESH
BUYING PATTERN 18
REASONS FOR NOT USING 19
THE MESH
COSTING 20
3 DISTRIBUTOR’S 23
INFORMATION
4 FACTS & FINDINGS 25
5 SUGGESTIONS & 26
RECOMMENDATIONS
6 ANNEXURE 27
2
OBJECTIVES OF THE MARKET SURVEY ON HERNIA MESH
To know the surgeons opinion of the Mesh that is currently available in the market.
To understand the market potential for a new product (mesh) in the Market.
3
MARKET RESEARCH ON HERNIA MESH
We conducted a market research on hernia mesh in Bangalore and other parts of Karnataka to
understand the views and opinions of the surgeons on the hernia mesh.
During the survey we found that at an average a surgeon performs 10 hernia surgeries in a
month.
The surgeons have started performing the laproscopic surgeries recently as it reduces the pain
for the patients and they feel more comfortable but the common man cannot afford the
laproscopic surgery as the cost of the surgery and the cost of the mesh is really high. Because
of this most of the surgeons prefer open surgery over laproscopic one as it costs much lesser.
Since the last five years the surgeons have started using the mesh more frequently in the
hernia surgeries.
The surgeons have the opinion that they require the best quality mesh at a very reasonable
price which meets the general specifications and standards.
Based on the cost of the surgeries we have categorized the surgeons into three groups such as
Overall we visited 121 surgeons in Karnataka out of which 19 % falls into tier I Surgeons
Category, 55 % falls into tier II Surgeons Category and 26% falls into tier III Surgeons
Category
4
FACT AND FIGURES ON HERNIA SURGERIES
Tier
Surgeries Percentages Type
Inguinal 80% I, II, III
Ventral 20% I, II, III
Hernia Surgeries
Inguinal
Ventral
5
I- Inguinal Hernia
Tier
Surgeries Percentages Type
Open 70% I, II, III
Laproscopi
c 30% I, II, III
Laproscopic
30%
Open Laproscopic
Open
70%
6
7
A) OPEN SURGERIES DETAILS IN INGUINAL
Open surgeries
La with Tier data
pr
Ti os Tier I
er co Tier II
I piTi Tier III
Ti 13 cer
er % 30 Laproscopic
III %II39
18 %
%
Laproscopic Surgeries
Tier I
T Ti
i eTi Tier II
o e rer Tier III
p r IIIII open
e I 18
n 6 7%
7 %%
0
%
8
II Ventral Hernia
Surgeries Percentages Tier Type
Open 70% I, II, III
Laproscopic 30% I, II, III
Laproscopic
30%
Open Laproscopic
Open
70%
9
10
A) OPEN SURGERIES DETAILS IN VENTRAL
70% are done through Open surgeries
Open surgeries
La with Tier data
pr
Ti os Tier I
er co Tier II
I piTi Tier III
Ti 13 cer
er % 30 Laproscopic
III %II39
18 %
%
Laproscopic Surgeries
Tier I
T Ti
i eTi Tier II
o e rer Tier III
p r IIIII open
e I 18
n 6 7%
7 %%
0
%
11
MESH USAGE IN HERINA SURGERIES
A) In Inguinal Hernia
Usage of MESH
W With Mesh
it
h
o W Without Mesh
ut it
M h
es M
h es
1 h
5 8
% 5
%
B) In Ventral Hernia
12
IPOM MESH
Only 10% of the surgeons use the Composite Meshes in Laparoscopic surgeries
100%
90%
80%
70%
60%
Column2
50% Not using the Mesh
IPOM MESH
40%
30%
20%
10%
10
5 2
0%
Tier 1 Tier 2 Tier 3
Reason for not using the composite mesh is that the price of the mesh is very high therefore
the common man is not able to afford so much for the composite mesh for a Laparoscopic
surgery. The surgeons have suggested that the price of composite mesh has to be brought
down so that the common man can afford it but without compromising with the quality of the
mesh
13
SURGEONS OPINIONS ON THE PRESENT MESH
ELASTICITY (9)
MEMORY (9)
COST (8)
Of the current mesh that they are using .The Surgeons don’t have an issue with
the cost of the Mesh as most of the patients are coming from a high class
family background or they are coming through an insurance company. For
these patients the quality of the product and the service of the hospital is more
important than the cost. The surgeons are bothered about the properties and the
features of the mesh rather than the price of the mesh.
14
B) Tier II Surgeons Take on the Present Mesh
ELASTICITY (9)
MEMORY (9)
COST (6)
Of the current mesh that they are using, the Surgeons concentrate more on the
features, the cost and the technical specifications of the Mesh. They want the
Best Mesh at the Best Price.
The Patients are concerned about the cost of the mesh and the surgery as well as
the Quality of the Service. The Cost is the main factor for the patients while
deciding on the Mesh and the hospital for a surgery.
15
C) Tier III Surgeons Take on the Present Mesh
ELASTICITY (9)
MEMORY (9)
COST (5)
Of the current mesh that they are using. These Surgeons concentrate more on
the cost and the technical specifications of the Mesh. They want the Mesh at the
most reasonable Price. Their Patients are bothered about the cost of the mesh
and the surgery. The Cost is the main factor for the patients while deciding on
the Mesh for a surgery. Their patients will not be bothered about anything else
other than the cost. These surgeons sometimes does surgeries at a very low cost
as the patient is not able to afford it and sometime at free of cost too in
government hospitals. Special consideration should be given to these hospitals
when the Mesh is sold to them
16
PRIORITES OF DECIDING THE MESH
PRIORTIES PERCENTAGES
Technical 50%
Cost 15%
Brand Name 30%
Availability 5%
Cost
15%
17
B) Tier II Surgeons Priorities while deciding on the Mesh
PRIORTIES PERCENTAGES
Technical 40%
Cost 50%
Brand Name 5%
Availability 5%
Technical Specifications
Technical
Specifications Cost
40% Brand Name
Availability
Cost
50%
These surgeons concentrate on the cost of the mesh and then the technical specifications as
their patients are from middle class families.
For these patients the surgery has to be done with a good quality mesh & without any
defects. The brand name and the availability of the Mesh are not given much importance.
They want good quality product and service.
18
C) Tier III Surgeons Priorities while deciding on the Mesh
PRIORTIES PERCENTAGES
Technical 30%
Cost 60%
Brand Name 5%
Availability 5%
Technical
Specification Technical Specification
30% Cost
Brand Name
Availability
Cost
60%
These surgeons concentrate on the cost of the mesh and then the technical
specifications as their patients are from middle class or Lower class families.
For these patients the surgery has to be done with a good quality mesh without any
defects. The brand name and the availability of the Mesh is not given much
importance. They want good quality product and service. They t want the surgery to be
done. In some cases the surgeon waives off the cost of the surgery of cost as the
patient is not able to afford it by themselves.
These surgeons should be given special considerations on the cost of the mesh.
19
PURCHASE PATTERN OF MESH
In 80% of the hospitals, Pharmacy deals with the purchase of the Mesh,
the Medical officer decides on the purchase of the Mesh(examples: Multi
specialist Hospitals)
20% of the hospitals ,the Surgeons take the final decision on the Mesh
(examples: Nursing homes, Clinics, etc)
In 70% of the hospitals, Pharmacy deals with the purchase of the Mesh,
but the surgeons decide on the brand and type of the mesh
30% of the hospitals, the Surgeons take the final decision on the Mesh
and deals with the purchase of the Mesh..
20
REASONS FOR NON-USAGE OF MESH
Financial Condition of the Patients: the surgeons prefer not to use the
mesh in an Hernia Repair Surgery as the patients are not able to afford
the cost of the surgery.
Strong Muscle tone: Sometimes in some Patients the muscle tone would
be very strong. In these cases the surgeons do not use the Mesh as it is not
required in the Patients
21
SURGEON OPINION ON IDEAL COST OF MESH
100%
90%
80%
70%
60% C
50% B
40% A
30%
20%
10%
0%
3 4 6
100%
90%
80%
70%
60%
C
50% B
40% A
30%
20%
10%
0%
3 4 6
23
850 to 1150 (20%) (B)
>1150 (0%) (C)
100%
90%
80%
70%
60%
C
50% B
A
40% 80 80 80
30%
20%
10%
0%
3 4 6
DISTRIBUTOR’S INFORMATION
During the project we also surveyed the distributiors who supply different brands of hernia
meshes to the hospitals. The objective of the distributor’s survey is to find out the distributing
channel that the distributors follow to supply the meshes to hospitals. And, also to find out
the cost of mesh at which they supply it to the hospitals and to the customers( i.e the MRP).
The details of the survey are given below.
COST DETAILS:
30cmsX30cm Rs.
3 Vipro Mesh s 15362 Rs. 11817 12%
Rs.
5 Proceed Mesh 3"X6" 19689 Rs. 15145 12%
Rs.
6"X6" 31658 Rs. 24352 12%
Cost to
Sl. No Mesh Type Size MRP Cost to Hospitals Distributors
Rs.
1 Trulene Mesh 3"X6" 1350 25% 33%
Rs.
4"X6" 1966 25% 33%
Rs.
6"X6" 2258 25% 33%
Brand: Dolphin
25
Distributors
Rs.
1 Dolphin Mesh 4"X6" 1600 20% 40%
From the survey we came to know that Ethicon is the major player in the Karnataka market.
The reasons for this being its quality and its availability. Ethicon (J & J) has got good
network of distributors who supply the meshes to hospitals effectively and efficiently.
DISTRIBUTION CHANNELS:
The distribution channels that the distributors (Ethicon, Sutures India etc.,) follow are
- The medical representitives get the orders from the hospitals and the distributors gives
the delivery of the meshes ordered.
- Sometimes hospitals buy the meshes on yearly or monthly basis from distributors.
- Sometimes hospitals give the order for meshes when there is need.
26
6. 90% of the surgeons use Mesh in the Surgeries
7. 99% of the surgeons are of the opinion that the ideal weight of the mesh, pore size is
as it is available in the market
11. 10% of the Surgeons use the other Brands Like Sutures India, Dolphin, Bard, etc..
12. Tier I surgeons prefer the quality and technical specification of the mesh over the Cost
13. Tier II surgeons prefer both cost and technical specification along with the quality of
the mesh
14. Tier III surgeons area concerned with the Cost of the mesh
2. No Compromise on Quality
27
4. Should be easily available
28
ANNEXURE
Doctor: Hospital:
Phone:
Email:
Total: ____________________________
Laparoscopic________
Brand __________
Laparoscopic________
Brand _______________
29
When you do a Laparoscopic Ventral hernia surgery and put an IPOM do you use a composite mesh?
Yes(Brand:-_____________________) / No
Q2: Are you satisfied with the Mesh that you are using currently? Yes/ No
Reasons___________________________________________________________________________
______________________________________________________________
Q3: On a scale of 1 to 10 how will you rate these parameters in the Mesh that you are currently using? (10
being the best 1 being least)
Q5:When you decide to buy a mesh how would the following four play a role: (Rank them in order of
priority) (Most important being 1and 4 being least important)
a) Cost________________
b) Brand Name__________
30
c) Availability___________
d)Technical specification________
Name_______________________________________________________________
Phone no____________________________________________________________
________________________________________________________________________.
Q8: Who is the decision maker to buy the mesh in your hospital?
_______________________________________________________________________
__________________________________________________________________________________
______________________________________________________________
Q10. How bothersome is mesh infection in your hospital setting and do you feel adding antibiotics to mesh
will help in reducing infection?
__________________________________________________________________________________
__________________________________________________________________________________
____________________________________________________
31
Q 11.What should be the price to the Hospital for an Ultra Light Weight Mesh
( Monofilament Polypropylene, Macro porous Mesh) with good Elasticity and Memory in size of
750 to 1000
>1000
850 to 1150
>1150
1400 to 1800
>1800
Q12.What is the total cost of surgery for a one sided inguinal hernia repair with mesh in your
hospital:
Laparoscopy:_______________
Open:_____________________
32
Please give some suggestions to help us make a product more suited to your
needs:
____________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
_________________________________________________
Signature :
Date:
Remarks:
33