An Exploratory Study on “The innovation, diffusion and adoption Processes” of the UK & Pakistan Pharmaceutical Industries, 2010

Submitted by:

Hasan Muhammad Raihan
On 27th September 2010:

Supervisor

Mr. David Shaw

Dissertation submitted in partial fulfillment for the degree of MSc. in Marketing, University of Wales, 2010.
Dissertation 1

Declaration and Acknowledgements

I, Hasan Muhammad Raihan declare that no part of this dissertation has been taken from existing published or unpublished materials without due acknowledgement and attribution, and that all secondary material contained therein has been fully and appropriately referenced. There are several people without their assistance this work may never have been completed and I would therefore like to acknowledge their help and support. First of all I would like to give thanks to Almighty Allah who gave me the strength and made me eligible to complete this research and then I would like to express my sincere gratitude to my dissertation supervisor Mr. David Shaw for his kind guidance, time and all his support in completion of this work. I would like to say thanks to the medical community, who helped me through their time, answers and responses in regard to my questionnaires to complete my research work.

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Abstract
Pharmaceutical industry is one of the most dynamic and vital dissection of the worldwide economy which is growing and progressive globally and expected to touch global sales of $ 825 billion by the end of 2010. The industry however is declining in its innovative performance and in converting the innovative product into brands, in spite of that the industry is the sixth most effective industry in generating innovation. This work investigates the process of innovation, diffusion and adoption of UK and Pakistan Pharmaceutical industry amongst physicians. Physicians are the only and key customer in pharmaceutical if talk about drug prescription. The failure and success of innovative drugs depends on their behavior to select the drug on the perceived newness of the drug. This study explores the physicians perspective of drug newness, their perceived characteristic of innovative drug, its diffusion and adoption amongst the physicians. A combination of qualitative and quantitative approaches of research is employed to explore the whole process amongst physicians from UK and Pakistan. The key results concern (1) the perceive innovativeness of the drug amongst the physicians and its characteristics, explanation and extensions of attributes of innovation in pharmaceutical context, (3) the diffusion processes and their influence on the adoption of innovative drug, and (4) the back ground of innovation adoption amongst the physicians. The study findings explore that the adoption of innovation is highly dependent on the perceived newness of the drug. Each physician may have his or her own interpretation that may be based on meeting one characteristic of the innovative drug or more than one characteristic.

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Contents Chapter One Introduction An Overview of global Pharmaceutical industry Customers in Pharmaceutical Industry Business Methodologies in the Industry Business Focus in Pharmaceutical industry The Concept of Disease Types of Drugs & Treatment Employed by Industry Research Title Research Objectives Research Questions Research Gap Dissertation outline 07 07 09 11 12 13 13 15 15 15 16 16 Chapter Two Literature Evaluation Importance of Innovation A Discussion & Definitions of Innovation Innovation in pharmaceutical Industry A Discussion & Definitions of Diffusion Diffusion of Innovation in Pharmaceutical Relative Advantage Compatibility Complexity Trialability 18 19 20 21 23 26 27 27 28 28 4 .

rate & Social Network Opinion Leaders Infrastructure A Discussion & Definitions of Adoption 28 28 28 29 29 29 29 29 Chapter Three Research Methodology Research Method Data Collection Data Analysis Research Limitation 33 33 35 38 40 Chapter Four Findings and Analysis Innovation Concept of Innovation among Physicians Perception of Innovation by Physicians Innovation Characteristic of Drug Relative Advantage Efficacy Tolerability Safety 41 41 42 44 44 45 45 46 46 5 .Observability Communication Channels Homophilous Group Pace of innovation Norm.

Complexity Compatibility Trialability Observability Process and Sources of Diffusion Main Sources of Information Additional Sources of Information Best Source of Information Qualitative findings of Drug diffusion Drivers & Barriers in adoption process Drivers of innovative drug adoption Qualitative findings 46 47 48 48 48 50 51 51 52 53 53 54 Barriers to innovative drug adoption 56 Chapter Five Conclusion Customer decision making process 58 64 Reflective Summary References 68 69 6 .

4 billion dollars (Prlog. many drug firms are focusing on ways to improve the efficiency and productivity of their R&D programs". friends but also in the countries‟ 7 . Currently. "Business as usual is no longer an option when it comes to developing new prescription drugs. 2010). yet the number of new drug approvals have declined steadily.CHAPTER 1 Introduction An Overview of the Global Pharmaceutical Industry Pharmaceutical industry is one of the most dynamic and vital division of the worldwide economy which is expecting to touch global sales of $ 825 billion by the end of 2010 with a growth rate of 4 to 7% (IMS. cited by Holland (2004). Since early 1990s. many of the people around the world may expect considerably longer and healthier lives in comparison to their ancestors and hence with their healthier lives they are contributing not only to their families. Indeed in the UK alone. As per Business wire 2006). 2009). On the other hand the rate of pharmaceutical innovation has been declining since 1980s. There has been argument if this merger and acquisition activity may have harmed innovation. As a result. One of the purposes of research and development in pharmaceutical industry has been to ensure that people have healthy and longer lives so that they have no dependency and they do not require a care. market size during the year 2009 was valued at 28. pharmaceutical industry has gone through a process of significant consolidation through mergers and acquisitions. Pharmaceutical and biopharmaceutical companies are spending more on Research & Development than ever before.

Pharmaceutical organizations are striving hard in developing drugs that are better than their existing drugs as well as better than competitive drugs. Organizations that divert their focus from innovation are likely to loose their ability to support their peoples as well as loose the competitiveness and sustainability. Technological advancement and development of innovative drugs are achieved on the basis of fundamental research carried out in universities and research institutes. Pharmaceutical innovation and the introduction of innovative drugs have positively played a key role in the process of assuring healthier and happier lives. The graph of innovative drugs development in the industry has also gone down during the last few years. efficacy that represents the ability of the drug to control or manage the disease. mounting new diagnostic technologies and drugs that 8 .economy by reducing health burden. innovation remains the core focus with the objective to resolve suffering of mankind and to be competitive within the industry. Over the period of time a very few drugs have got the acceptability among the physicians in the healthcare industry. Pharmaceutical innovation is based on improving. Apart from continuous evolvement in the pharmaceutical industry. evidence represent the supporting data of the drug on long term life of the patients and compliance deals with the stickiness of patients with the drug due to convenience in dosage and timing. The positive perception of physicians about the drug newness and its superiority over already available options is critical for the success of new drug introduction. as a whole or at individual attribute level. while virtually all end molecules and drugs are created and manufactured by the pharmaceutical industries. Huge developments have been made throughout the past decades in understanding illness. Price reduction so that most patients can afford the drug. tolerability which is reduction in side effects profile of the drug.

The decision making in pharmaceutical industry has been in the hands of physicians whereas patients have little knowledge or influence (Holland & Batiz. physicians and patients. In modern health care. planning and its implementation. over one half of the gains in health were due to access to better technology and application of new knowledge (WHO 1999). safety. Hence having the understanding about the decision making process and how they use information. Customers in the Pharmaceutical Industry Physicians both at hospitals and community setting are the key customers of pharmaceutical industry (Berbatis.resulted in better treatment and prevention of diseases. In Pharmaceutical industry. The complexity of the decision making in drug selection is well perceived amongst the patients and hence there happens no hindrances from consumers patients once a physician selects the drug for them. decision making is a complex process since both physicians and patients have to be satisfied and their expectations should be met. in the period 1952–1992. convenience and the affordability by its patients based on evidence and their experience. tolerability. pharmaceutical drugs hold the promise to heal the mankind to protect them from various serious and crippling diseases and its consequences. The behavior of physicians 9 . sales of drugs are dependent on the acceptability amongst physicians since they are the gate keeper for the final adoption of the drugs amongst their patients for the particular treatment so there is a need to have a satisfaction on levels. While patients judgments are based on their feelings and absence of side effects for the better quality of life. patients do discuss with their treating physicians about their experience. Blackbourn & Smith. Physicians judge the drug on the basis of its efficacy. However. are the focal point in pharmaceutical marketing management. 1981). 2004). feelings and constrains with the prescribed drugs. In Pharmaceutical industry. business modus operandi is complex. Indeed.

their own experience of treating patients and up to some extend government too that reflect their behavior. improving patients live by controlling or managing the disease. cost. patient types. Prescription of innovative drug is based on the perceived innovativeness and superiority amongst physicians. 10 . because only the first to market would benefit. convenience and evidence of the drug. long term consequences of disease and the future challenges from both patients‟ and physicians‟ perspectives. These external and internal actors are igniting the race to market innovative drugs. safety.is complex and is influence by multiple factors in the selection of drugs but with a one main objective. Over a period of time. Society. In other words not a good number of drugs had been ranked as golden standard in the treatment and has been able to alter the treatment protocol of the physicians. physicians‟ behavior could be observed on the basis of the diagnosis of the disease and selection of the treatment regime with a consideration of drug‟s benefits. In Pharmaceutical industry. 2004). physician‟s behavior in drug selection is fundamentally based on considering efficacy. taking competition ferociously at the level of therapeutic class and being not on time to market with an undifferentiated attribute in the product was a punch of failure (Holland & Batiz. tolerability. Resulting. concomitant disease. Physicians in pharmaceutical industry are surrounded by organizations‟ communication based on Ps of marketing. However. very few innovative drugs however could get acceptability amongst the physicians and are able to be converted into big brands to become a benchmark for other innovation to come or replaced the old available options.

interested. business situation for pharmaceutical organizations have been changing rigorously. interested. Physician‟s behavior is observed through face to face discussions and through pharmacies auditing about the prescription pattern of the physicians. Sales force has been a fundamental tool for the organizations to introduce a drug to physicians and delivering of the key messages of the drug with conducting the activities to change the beliefs and behaviors of physicians in favor of drug. Traditionally. Henske & Singh. The progress of sales forces is measured on the basis of the progress of doctors in the prescribing continuum (ladder of adoption). The model includes the detail follow up as well as conducting activities and its analysis. trying. 2003). broadened prescribing and full prescribing. trying. The model has been successful in moving the targeted physicians in the prescribing continuum (Awareness. a representative is assigned to visit certain number of physician within his or her assign territories and physicians are visited with a certain number of frequencies on a weekly. Key Account Management (KAM) in the pharmaceutical industry is concerning to create a strategic rapport with customers so that to achieve long term profit. sales growth and attain medium term goal by using the sales force. The current strategies are only delaying the inevitable and its is estimated that only one out of six innovative drugs shall be able to deliver returns above their cost of capital which is an unpleasant view for investors (Gilbert. which is generally comprises of five stages. the model that was successful in the past is not able to keep its pace and therefore making industry a hostage of its past triumphs. delivering of key messages to physicians had been supported by the industry.Business Methodologies of the Pharmaceutical Industry During the previous few years. Typically. monthly and yearly basis. broadened prescribing 11 . frequency of calling model for drug introductions. Awareness. In pharmaceutical business.

Business Focus in Pharmaceuticals Industry To manage this market. 12 . it shall not be unfair if the adoption of drug can be explained in two levels. pharmaceutical industry‟s communication strategy is focused on utilizing both push and pull methods so that to reach its target physicians and potential patients both physicians and patients. enormous amounts are spent on sales and marketing to ensure diffusion and adoption of drugs whether it is innovative or “me too” is the core amongst the strategies within the pharmaceutical organizations. In order to ensure the complete adoption. arranging dinner debate.and full prescribing). first level consists of the acceptability of drug by the physicians and second level consists of acceptability of drug by patients to comply the physician‟s prescription. Accordingly the push strategy is used to convince the prescribing physicians of the drug. Due to the nature of business. conducting round table discussion meetings in shaping up the perception in favour of drug by using both pull and push strategies depending on nature of disease and type of innovation. The model is also used to register the progress of the organization internally to change their approach in meeting the needs of the physicians especially when the physicians require additional support/services from the organizations. The company‟s Medical representatives are the key marketing tool in the bag having at the back the marketing department that formulate the campaign to be delivered to physicians as well as conducting the activities of developing prescribers and building opinion leaders. Marketing problems associated with the introduction of new products are often open to analysis and solution through the use of behavioural principles. where as pull strategy is used to ensure patients have the understanding about the disease and its management so that they must comply the prescription of drug and visit the physicians.

CHRONIC DISEASES TEND TO BE COMPLEX CONDITION IN HOW THEY ARE CAUSED. In ethical pharmaceutical drugs. Whereas the chronic diseases may persists for a longer duration of time and produce symptoms for longer time as well and may take several weeks or months in getting cure. MENTAL HEALTH PROBLEMS AND INJURIES. According to AIHW (2002). ARE OFTEN LONG LASTING AND PERSISTENT IN THEIR EFFECTS AND CAN PRODUCE A RANGE OF COMPLICATIONS. Because these drugs are meant to be taken for a longer period of time which is good for organizations since they always carry a sizeable pool of patients on their drugs (CBO 2006). Ethical drugs are those that can be sold only against the physicians‟ prescription. Types of Drug and Treatment Employed in the Industry Pharmaceutical products can also be divided into two group. Hence the drugs options for the doctors are based on these diseases types accordingly. namely the “Ethical products” and “OTC” (over the counter) products. Acute disease could be a disease with rapid onset and short duration of time and usually may last for few days but may have the intense signs and symptoms. but on the other hand OTC drugs can be purchased with out any prescription. There has been a shift now in pharmaceutical research and development and the efforts to create innovative drugs are focused for the chronic and degenerative diseases instead of acute diseases. there are two therapeutic classes available on the basis of disease types. one for acute diseases treatments and other for chronic diseases treatments and or management.The Concept of Disease Physicians in pharmaceutical industry come across with two types of diseases and that can be discussed as. Chronic diseases are likely to be difficult conditions in how they are rooted and are frequently ongoing and continual in their effects with complications (Thacker et al. the acute diseases and the chronic diseases. CHRONIC DISEASES ARE THOSE THAT OCCUR ACROSS THE WHOLE SPECTRUM OF ILLNESS. 1995). 13 .

000 compounds synthesized in laboratories can be regarded as highly successful drug (Schweitzer 1997). There is only about one out of 60. pharmaceutical industry is the sixth most effective industry in generating innovation (Business insight. 2010). a growing share of the industry‟s research and development outputs has consisted on incremental betterment on previously available medications instead of creating entirely new drugs. To ensure the 14 . Diffusion of innovation and its adoption remains the core focus in the strategy making process within the pharmaceutical organizations. competitive ensure its sustainability in the industry competitive. It is an integrated process through which organizations create value for physicians. Over the years. The new drugs launched during the period however could not gain reputations that could make them a best available choice over the available choices. The graph of new product development in Pharmaceutical industry has also gone down over the last few decades. The development of innovative drugs in Pharmaceutical industry is expensive. Over the period of time a very few drugs have got the acceptability in the market. All marketing activities are used to create and retain physicians by keeping them satisfied.As marketing environment is getting changed because of cost challenges. deliver drugs to physicians in exchange for some return. Thus organizations are demanded to improve the way they develop and introduce drugs to the market that should meet the changed needs of its physicians and remain profitable. The demand of innovative drugs grow as the number of alternatives flourish thus identification and successful launch of innovative drugs become critical for organizations‟ success and is probably the most important activity for many organizations. However. risky and time consuming as well. changing needs and expectations of physicians and frequent introduction of “me too” drugs. competitive pressures.

Explore and understand the Adoption process of an innovative drug amongst its customers (physicians). Explore how perceived innovation affects the market success of drug introduction. are to:     Gain a deeper understanding of how customers (physicians) perceive drug innovation.execution of drug diffusion and adoption. Diffusion and Adoption Processes of the UK and Pakistan Pharmaceutical Industries 2010 Research Objectives (In Context of UK & Pakistan). the company‟s Medical representative has been used as a fundamental instrument with the other synergistic tools. Understand the innovation diffusion process in the Pharmaceutical industry. Research Questions (In the Context of UK & Pakistan):     What is meant by the concept of innovation and how it is utilized in Pharmaceutical industries? What is diffusion and how does it happens in the pharmaceutical industries? What are the factors driving innovation and diffusion in the pharmaceutical industries? What are barriers and drivers of the adoption of innovative drugs among physicians? 15 . Title of Research An Exploratory Study on the Innovation.

However. 16 . studies available that should help researcher to complete the study mainly due to its special topic and complexity.Research Gap A number of studies have already been conducted that have focused on the different aspects of innovation within the pharmaceutical industry starting from patent related issues. analysts and through face to face meetings and focused participations. The proposed research would be unique. There is not much information in the form of books. since it shall be carried out in cross countries involving Pakistan and UK with no intention to compare the process but to explore collective findings since the nature of disease around the glob is same and hence the treatment options are also same. lack of implementation of patent laws. there are very few studies carried out that focus on the diffusion and adoption of innovative drugs in pharmaceutical industries among physicians. Diffusion and its Adoption and its linked components with relation to research question as mentioned above. Therefore the research is solely based on websites. huge cost involvement and possible failure of molecule during discover. articles written by pharmaceutical executives. however dissimilarities could be amongst the influencing factors on adoption of diffusion and hence could affect on treatment protocol. generic launches. Dissertation Outline The rest of the dissertation would be accessible in following approach Chapter 2 is dedicated for literature review of the topic and would cover and provide the citation in relation to Innovation.

It shall further explore and establish the concept each component of the topic. 17 . This chapter shall focus on the research philosophy. diffusion and source of information of the innovative drug and consequently the adoption of the drug. Chapter 4 shall present the anlysing and interpretation of the reviewed literature in chapter two and the findings of qualitative and quantitative research. Diffusion and Adoption in the pharmaceutical industry. This chapter shall also explore the type and structure of innovation. the research approach adopted with the detail about the research strategy. definition of Innovation. Chapter 5 shall be final chapter and hence present the researcher‟s conclusion in the light of research findings and interpretation. Chapter 3 shall explain the research methodology used for the research and rational behind them.This chapter will explore concept.

CHAPTER 2 Literature Review Literature review demonstrates the thinking. An increasing amount of literature have discussed about the certain type of innovative models with perceived innovativeness of the drug which are explained as the characteristics of innovation. firstly the surrogate physicians that decide to prescribe drugs to patients and patients are the second level adopters since they need to stick with the prescribed drug. Innovation. 18 . & Renko. Doctors‟ keenness in adopting a new drug is subjective to their judgments of distinctiveness of the drug from the viewpoint of their patients. M (2007) conducted research to investigate the critical characters of innovation that influence the acceptability of new drug of pharmaceutical. They termed physicians as “surrogate adopter” since they select pharmaceutical drug for their patients. According to them. They further discussed that patients have the influence on (physicians) surrogate adopters in the evaluation of the satisfactoriness of an innovation in spite of the professional powers of the physicians. the adoption at second level is critically important since without having drug being adopted by the patients innovation would not be adopted. A number of authors and studies have connected innovation with its diffusion and adoption when talk about the physicians and patients perspectives. explanation and relation of Innovation. Jaakkola. In their study. they discussed two level adoptions in pharmaceutical product. Diffusion and Adoption of innovation. E. its diffusion and adoption are the main focus of interest in this study.

the new product launch method can facilitate the innovation. positioning so that to ensure growth. it gives management visibility into the product development channels. It mechanizes everyday jobs. and increasing consumers expectations are motivating organizations to get better the way they are developing and introducing products to the marketplace. INNOVATION IS ONE OF THE KEY VARIABLES INFLUENCING PRODUCTIVITY GROWTH. And. quality. price confronts. BY ITS OWN NATURE THE PRODUCTION OF INNOVATION CREATES KNOWLEDGE SPILL-OVER THAT ALLOW OTHER FIRMS TO BENEFIT FROM THE INITIAL INNOVATION IN TERMS OF INCREASING TOTAL FACTOR PRODUCTIVITY. competitive advantages. its acceptance and implementation considerably persuades potential for success (PTC. According to West midland observatory report (2009). INNOVATIVE FIRMS GROW FASTER AND ARE MORE LIKELY TO SURVIVE DURING A RECESSION. IN TURN THIS CAN CREATE THE CONDITION FOR A VIRTOUS CIRCLE OF ECONOMIC GROWTH FROM WHICH THE WHOLE OF SOCIETY CAN BENEFIT. increase or maintain market shares and adds values in the organizations and the portfolios it deals. Whether the new product idea is cultivated internally or in response to customer need and market requirement. Aggressive demands. 19 .Importance of Innovation Innovation play an important and critical role in organization since it is connected with the improvement in efficiency. productivity. THE BENFITS OF INNOVATION ARE NOT ONLY LIMITED TO THE ORIGINAL INNOVATOR THOGH. Since new product introduction is so linked with supplementary product development processes. depictions performance bottleneck. and forces steady implementation and unbroken upgrading. 2006).

OR OBJECT THAT IS PERCEIVED AS NEW BY INDIVIDUAL OR SOME OTHER ENTITIY OF ADOPTION. Rogers (1995) explains. 1962). VALUED NEW PRODUCT. relative advantage of the product. OR SERVICES. OR SYNTHESIS OF KNOWLEDGE IN ORIGINAL. RELEVANT. newness. however Robertson (1967) classified innovation between. Innovation can be evaluated on four characteristics. PRACTICE. There could be many definition and classification of in innovation or new product. a continuous innovation that involve in alteration of a product rather than the creation of entirely new product. 1998). market growth rate. COMBINATION. INNOVATION IS AN IDEA. ergonomics.” The “value” can be described in a wide manner to comprise more value added for the organization and also benefits to customers. design. INNOVATION…IS GENERALLY UNDERSTOOD AS THE SUCCESSFUL INTRODUCTION OF NEW THING OR MEHOD… INNOVATION IS THE EMBODIMENT. Two significant division of innovation may be Product innovation that deals in introducing the new 20 . competition. PROCESS. or other portion of the activities of an organization which results in increasing the “value. it could be the application of novel ideas to the product.A Discussion & Definitions of Innovation Luecke and Katz (2003) explain. compatibility. relative price. customer loyalty. There is correlation amongst technology. a dynamically continuous innovation that involved in creation of a new product on the alteration of an existing one and a discontinuous innovation that involved in establishing a new product and new related behavioural pattern. market size. Observability and complexity (Rogers. uniqueness. customer familiarity with the product class and frequency of purchases (Veryzer. Innovation can have several definitions. its Trialability. processes.

AND ANNUAL R&D SPENDING HAS GROWN FASTER STILL NEVERTHELESS. To market innovative pharmaceutical drug is a lengthy. According to Congressional Budget Office (2006). 21 . ECONOMIC AND SOCIAL ISSUES. cited by Bishop (n. INNOVATIVE PEOPLE AND INNOVATIV PEOPLE AND INNOVATIVE MEDICINES. time consuming and complex process that requires significant amount of money and time to establish and got accepted by physicians and require maximized market admittance at the premium price to make return out of investment in the form of drug prescriptions. HEALTH INNOVATION COVERS A WIDE RANGE OF SCIENTIFIC. IT TAKES ABOUT 10-15 YEARS AND MILLIONS OF DOLLARS TO DEVELOP A NEW MEDICINE. INNOVATIVE MANUFACTURING PROCESSES. INNOVATION. ON AVERAGE. or a major qualitative modification within the current product. THE PHARMACEUTICAL INDUSTRY IS ALL ABOUT INNOVATION. INNOVATIVE SCIENCE. INNOVATIVE SCIENCE. MEDICAL.product. positioning innovation and paradigm innovation.d. Till et all (2005). process innovation. have supplemented the innovation types in the organization and describe innovation in four different ways namely. INCLUDING EXPENDITURE ON FAILED PROJECTS AND THE VALUE OF FORGONE ALTERNATIVE INVESTMENTS. Innovation in Pharmaceutical Industry According to Graham (2010) UNLEASHING INNOVATION IS AT THE CORE OF THE PHARMACEUTICAL INDUSTRY’S BUSINESS MODEL. Process innovation deals in the application of a new process in producing the products. A large body of proof strongly associates innovation to economic growth.). AVERAGE PRICES OF NEW DRUG HAVE BEEN RISING MUCH FASTER THAN THE RATE OF INFLATION. INTRODUCTION OF INNOVATIVE DRUGS HAVE SLOWED. product innovation. INNOVATIVE MANUFACTURING PROCESSES. THE AVERAGE COST OF DEVELOPING AN INNOVATIVE NEW DRUG AT MORE THAN $800 MILLION.

cited by Attridge (2006). cited by Attridge (2006). Pharmaceutical organizations simultaneously got engaged in race to compete on the bases of different patterns that resulted in saturation and it became difficult to differentiate the drug and hence using the term radical and incremental got 22 . which offer value in treating particular disease variation of segments of specific segment of patients.According to freeman (1982). innovation in pharmaceutical industry can be classified as revolutionary. Where as creating a drug with different mode of action which is based on the identified disease mechanism is radical innovation which is followed by the incremental innovation that are based on benchmarking radical or revolutionary innovation by bringing improvement in different attribute. Advancement in the concept such as detection of new microbes and a new anti infective to cover that microbe is a revolutionary innovation. According to Landau (1999). radical or incremental (table 1).

difficult too. One after launch of similar kind of drugs that carry the similar benefits, mode of action and side effects profile have created a competition amongst different generic but in the same class. However the third and fourth or fifth launched drugs carry more balanced benefits for the patients and physicians over the first launch. Therefore the first molecule launch in a new class could fall in the radical innovation and the following molecules could be the incremental innovation. According to CBO (2006), ON AVERAGE, ONLY ABUOT ONE THIRD OF NEW DRUG APPLICATION SUBMITTED TO THE (FDA) FOOD AND DRUG ADMINISTRATION ARE FOR NEW MOLECULAR ENTITIES (NMEs),MOST OF THE REST ARE EITHERFOR REFORMULATION OR INCREMENTAL MODIFICATIONS OF EXISTING DRUGS OR FOR NEW ON LABEL USES.

According to Well (1998), cited by Attridge (2006), This incremental innovation tends to be perceived as the best drug hence get more acknowledgments and acceptance by the physicians as compare to the first introduction.

A Discussion & Definition of Diffusion
According to Arthur et al (1983) cited by Bronwyn (2003), THE STUDY OF INNOVATION, THE WORD DIFFUSION IS COMMONLY USED TO DESCRIBE THE PROCESS BY WHICH INDIVIDUALS AND FIRMS IN A SOCIETY/ECONOMY ADOPT A NEW TECHNOLOGY, OR REPLACE AN OLDER TECHNOLOGY WITH A NEWER. BUT DIFFUSION IS NOT ONLY THE MEANS BY WHICH INNOVATIONS BECOME USEFUL BY BEING SPREAD THROUGHOUT A POPULATION, IT IS ALSO AN INTRINSIC PART OF THE INNOVATION PART OF THE INNOVATION PROCESS, AS LEARNING, IMITATION, AND FEEDBACK EFFECTS WHICH ARISE FROM ITS UNFOLDING ENHANCE THE ORIGINAL INNOVATION.

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The adoption of a new drug or idea does not happen all at once in marketing system. Ryan & Murray (1977) explain two ways of illustrating the process; the generalized cumulative diffusion pattern and the generalized noncumulative diffusion pattern which both end up with the 100% adoption. A substantial number of studies provide evidences that the timing of acceptance can be represented by a normal distribution (Rogers, 1962). Robertson (1970) suggested that the process of innovation diffusion can be conceptualized as; the adoption of the new product overtime by consumers within a social system that is encouraged by the marketing. The nature of product has affects on the type of consumers that are adopting, the rate of adoption over the time and so on.

Diffusion is a process by which things get dispersed (Robertson 1970). In marketing the process of product, service or idea acceptability amongst the consumer is known as diffusion. Since the acceptability of new product varies amongst the consumers thus they can be classified because some consumers accept the product immediately upon the launch of product where as some are last to buy.

Rogers's (1983) explained the diffusion model which is based on the classical "bell-shaped" normal distribution curve, the curve in the bell symbolizes the consumers‟ frequency for accepting the product over different intervals of time. He classified consumers as innovators, early adopters, early majority, large majority and laggard. His classification is based on demographic, socioeconomic and personality characteristics. This approach suggest once the target market for innovative product is set, companies must specifically plan to approach innovators and early adopters that should follow the adoption of innovation by early and late majority due to word of mouth (Hawkins, Best and Coney 1989). Rogers (1995) has further explained diffusion as “the

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process by which an innovation is communicated through certain channels over time among the members of a social system”.

A rising body of study discloses the importance of positive recognized innovation characters as strong forecasters of the rate of adoption (Black et al, 2001). An innovation is an idea, practice, or object that is perceived as new by individual or some other unit of adoption (Rogers, 1995). There is correlation amongst technology, newness, uniqueness, ergonomics, design, market size, market growth rate, competition, relative price, customer loyalty, customer familiarity with the product class and frequency of purchase (Veryzer, 1998). Rogers (1962), describe four distinctive attributes of innovation to be evaluated, relative advantage of the product, compatibility, its Trialability, Observability and complexity.

Diffusion deals in the process of spreading of something (Robertson, 1970). It is a concern amongst the marketers by which way adoption of the new product or service spreads in the marketplace. Diffusion is the process by which an innovation is communicated through certain channels over time among the members of social system (Rogers, 1995). Mittman & Cain (2002) explained ten stages of the diffusion of innovation as, relative advantages, Trialability, Observability, communication channels, homophilous group, Pace of innovation, Social network, Opinion leaders, compatibility and infrastructure. Once physicians decide to use a new device or a piece of technology, the physician must often see the impact of product on the patient (Mittman & Cain, 2002).

Ryan & Murray (1977) explored that marketing controlled sources had less influence than extent of their usage might suggest. The influence of professional meetings, medical journals and peers in comparison to their actual usage is noteworthy.

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Coleman et al. The researchers also found that doctors who are cosmopolite were likely to adopt the new drug. 2002). Ryan & Murray (1977) explain two ways of illustrating the process. but that the rate of tetracycline adoption was faster than the rate of other innovations adoption. Different with previous diffusion research that relied on respondents‟ recall of how they adopted new technology. Diffusion of Innovation in the Pharmaceutical Industry According to Rogers (1996). Elihu Katz.The adoption of a new product or idea does not happen all at once in marketing system. Pfizer initiated to investigate the impact of advertisement on the adoption of drug. (1966) asked their respondents to list their interpersonal connections in order to investigate the effect of interpersonal network links with the new drug adoption. 1962). The result shows that the percentage of adoption of the new drug followed an S-shaped curve. In addition to this. Coleman. A substantial number of studies provide evidence that the timing of acceptance can be represented by a normal distribution (Rogers. this study gathered data both from physicians' responses and pharmacies' prescription. They conducted a survey to gather accurate and reliable data. Because of the success of drug. The company asked three professors at Columbia University to find out how physicians adopted the new innovation and how mass communication influenced this adoption process. diffusion theory became more widely accepted after James S. technology or a new devices on patients is prime consideration of clinicians once decides to use (Mittman & Cain. An impact of drug. and Herbert Menzel conducted a study on the diffusion of tetracycline which is a drug developed by Pfizer laboratory during 1966. One of the most important findings was that 26 . the generalized cumulative diffusion pattern and the generalized noncumulative diffusion pattern and both end up with the 100% adoption.

According to Rogers (1996) The Columbia University study is „one of the most influential diffusion studies in showing that the diffusion of an innovation is essentially a social process that occurs through interpersonal networks‟. SECONDLY. Adoption of innovation is dependent on the characteristics of innovation. California Health Foundation (2002) in its health report has discussed in detail of the ten different dynamics of innovation diffusion. THE ABILITY OF A POTENTIAL ADOPTER TO JUDGE WHETHER THE BENEFITS OF USING THE INNOVATION WILL OUTWEIGHT THE RISKS OF USING IT. The five characteristics of Rogers (1995) that are relative advantage. Compatibility. as per them: Relative advantage is the ability of a potential adopter to judge if the benefits of the innovation outweigh the risks of using it. additionally in comparison to the existing option whether the innovation provide more benefits. This meant that interpersonal communication channels with peers had a strong influence on the adoption process. Trialability. THE MORE RAPIDLY IT WILL DIFFUSE. Compatibility deals with the degree to which an innovative product is perceived to be simple as compare to available option so that the behavior of 27 . THE MORE BENEFIS PEOPLE ANTICIPATE FROM ADOPTING THE INNOVATION RELATIVE TO WHAT THEY NOW DO. according to them Relative Advantage: THE DECISION TO ADOPT A TECHNOLOGY IS INFLUENCED BY FIRSTLY. and Observability have been explained by Fadi et al (2010). Complexity. WHETHER THE INNOVATION IMPROVES UPON THE EXISTING TECHNOLOGY.doctors who had more interpersonal networks adopted the new medical drug more quickly than those that did not.

Trialability is the characteristic of an innovation that provides opportunity to an adopter to evaluate if the innovation is experiment-able on a limited scale to validate the promises of the innovation. traditions and expectations are established. California Health Foundation (2002) has explained five other dynamics of innovation diffusion. Complexity is the capability to seek out an innovation without total commitment and with minimal investment. It deals with the partial agreement from a customer to try the product in few of the cases so that to build a confidence to move on. The more the innovation is complex in nature the more it is difficult to be adopted. if the customers watch others using the product and the outcome of usage is acknowledged for the safety and benefits of the product.adopter does not need to be modified. The compatibility of innovation has a direct relationship in case if the practices. Homophilous group play a vibrant role in innovation diffusion since innovation diffusion is smooth and speedy in similar group of customers. Observability deals with the observation of customers from other customers. 28 . values. the more likely it will be adopted by new customers. they are: Communication Channels are critical for innovation to be diffuse since it is a social process and depend on innovation to be communicated from the customers they know it to the customers they don‟t know it. In addition to five characteristics of innovation.

The relevant diagnostic facilities and techniques has a direct impact on the adoption of innovative drug since to asses the product profile and monitor through clinical and laboratorial analysis. Infrastructure is important for an innovation to be diffused and adopted. More is the satisfaction with the available option more it create barrier for innovative products by the adopters. The satisfaction rather the level of satisfaction with the available choices also matters in adopting the innovation. role in diffusion is very important since their words and behaviors influence the peers due to greater exposure of opinion leaders to new ideas than others. Pace of innovation and its degree is also important in the adoption of innovation since innovations are readily accepted by customers than others depend on the nature of innovation. The norms. 2002). and social networks of medicine are very important to the diffusion of new technology. the adoption of the new product overtime by consumers within a social system that is encouraged by the marketing. the rate of adoption over the time and so on. Opinion leaders. A Discussion & Definitions of Adoption Adopting an innovation needs time by the adopters since there is inherent uncertainty involve with the new options (CHF. 29 . 2002).Robertson (1970) suggested that the process of innovation diffusion can be conceptualized as. It is important to evaluate the actions required by the adopters as well as the choices available to them so that to decide whether or not to put and innovation into practice (CHF. The nature of product has affects on the type of consumers that are adopting. roles.

2001). There for it requires pharmaceutical organization to target 30 . In the scenario of drugs selection. followed by developing interest amongst the consumer to use the product which leads to Evaluation of the product and agreeing to try the product upon his or her evaluation and finally adopt or reject the product. Vandenbosch and Hullnad (2001) and is cited by Jaakkola and Renko (2007) that there is only one group responsible for adopting the innovation and that is a “consumer” and this consumer has the decision power to adopt the innovation. There has been an inherent hypothesis. as shown in (Fig 2). the drug has to be adopted by the patient also. nor is he the consumer of the prescribe drug‟. Allen (2009) has explained five stages of adoption as awareness. Solomon (1986) describe this kind of decision making that involve third party decision makers as a surrogate consumer that has the influence on the end users. In pharmaceutical drug adoption. According to Turnbull and Parsons (1993) and cited by Jaakkola and Renko (2007). two levels of adoption take place. implementation and confirmation (see appendix 1 for more detail).Kotler (1991) explains adoption process in five phases and according to author the innovative product are adopted through Awareness amongst the consumer. persuasion. firstly the drug has to be adopted by the physician and secondly once a drug is prescribed by physicians. Rogers (1995) describe five step processes to explore innovation decision process and they are knowledge. as argued by Plouffe. „A physician is not a customer in the sense of actually buying the product. integration and adoption. increase understanding. consumer or customer are neither single adopter or decider but they both have to agree to adopt the product. positive attitude. decision. Physician in the drug selection has the ultimate responsibility and patients‟ role is to comply with the prescription of the physician (Gonul et al.

It is due to the nature of industry. social circle and friends in adopting an innovative drugs. 2002). friends or social circle on the end user (patients) due to the involvement of treating physicians (Aggarwal and Cha 1997). 2000). Additionally. there is less or no influence of peers. cited by Jaakkola and Renko (2007). opinion leaders have a strong influence on GPs for adopting the innovative products because of their experience and expertise at the treatment level and disease understanding. There is a strong influence of opinion leaders on the consumption pattern of drug at the second level of adopters. According to Jones.both treating physicians and patients with channelized marketing activities accordingly (Wilkes et al. Greenfield and Bradley (2001). opinion leaders are useful external source that can speedup the adoption of innovative drug at both level of adoption (Groves et al. However first level adopters are strongly influenced by peers. 31 .

So adoption at the second level plays a vital role in the success of innovative drug because a lacking in the compliance by second level adopters has a serious consequence on adopters and on the society because of disease burden. 2007). Renko. The adoption of innovative drug at physician level however is based on considering the barrier in patients compliance but based on the benefits of drug and hazard of the uncontrolled disease and point of view of their patients (Jaakkola.The adoption of innovative drug at first level is critically important but it is also important the drug is purchased by second level of adopters and consume as per the advice of the treating physician. 32 .

The research design is the fundamental plan for a piece of observational research. and includes the key thoughts like strategy. Additionally. Research design is to be followed from the questions and match them with the data. For the research. Structured online survey. The use of multiple methodologies permitted researcher in triangulation of the data to improve the validity of the findings. quantitative method of research hold the dominance where as qualitative method used helped research filling up the gap from the quantitative research as well as to have deep understanding and explanation of certain perception and beliefs that 33 . Research Method Exploratory method of research was adopted to carry out the conceive study because exploratory research provides an opportunity to utilized both qualitative and quantitative methods including a document review. qualitative and quantitative approaches were used with the preparation of questionnaires. The research method that was used is the “mixed-model” which combines quantitative and qualitative data collection techniques and analysis procedures. secondly. 2000). and enabled greater inferences from the results. face to face meetings and telephonic interviews were conducted to collect the data. Design to be seated amongst. sample. tools and measures to be used for collecting and analyzing the gathered data (Punch. the tools and measures are used in getting them answered. firstly.Chapter 3 Research Methodology The function of research design is to attach the questions to data. presentation how the research questions are to be connected to the data.

Additionally qualitative method helped researcher to obtain feedback from respondents to improve the questionnaire. Thirdly. how diffusion is define and discussed by authors. Ryan & Murray (1977) used quantitative methodology to investigate the diffusion of ethical drug amongst the physician. what drive diffusion and what are constrains in the diffusion process. Firstly to investigate that how innovation is defined and discussed by the authors. This research was conducted by applying qualitative and quantitative research method and evaluated the collective responses of UK and Pakistan and relationship between the primary and secondary findings. how diffusion happened amongst the physicians of pharmaceutical industry. Several studies have developed and used quantitative and qualitative instruments to measure adopters‟ perceptions on product diffusion. how adoption is define and discussed by authors and how innovative drugs are adopted by physicians of pharmaceutical industry. The use of literature review. how it is perceived by physicians in pharmaceutical industry and exploring innovation practices in the pharmaceutical industry. The use of three sources however researcher believes has increase the research credibility for the conclusions and findings. The study presented here has investigated the process of innovation.were identified from the quantitative research and the answers that were not possible from quantitative research or needed exploration. quantitative and qualitative method of research helped researcher to establish the understanding gain in close to the more accurate way by validating data collected through cross verification from two or more sources. Jaakkola & Renko (2007) used qualitative 34 . diffusion and adoption of innovative ethical pharmaceutical drug of two different countries. Secondly. The purpose of the study was three fold.

The objective of separate but similar questionnaire was to gather the responses separately so that to the dissimilarities if found. Since the research was based on exploring the innovation. graduation year etc. The selection of physicians was not done on the basis of their specialty. The qualitative research from focus individual from random specialty was based on an un-structured series of questions. diffusion and adoption processes of UK and Pakistan pharmaceutical industry so telephonic 35 . although it was not an objective of the study. quantitative that was covered the structured questionnaire surveys from randomly selected customers from both countries. The questionnaire for the qualitative research was developed and finalized considering the knowledge required from the responses out of quantitative findings as well as the questions that need explanation on the topic which researcher believe would be difficult in gaining from quantitative research and validating the responses of both qualitative and quantitative research so both the methods had complemented each others all the way. additionally software helped respondents to participate effectively and conveniently. An online survey software was subscribe for the purpose to conduct the quantitative research which helped researcher to conduct the survey in simplest framework and shortest time. two similar questionnaires were designed and used for each country and send separately to the identified list of physicians.methodology of research to investigate the product related characteristic that physicians evaluate while adopting the new pharmaceutical product Data Collection Data collection methods in this study had been divided into two groups. On the other hand the use of software helped researcher in analyzing the finding conveniently and time efficient manner. For the quantitative research. age. type of practice. gender.

This discussion helped in uncovering how the individual thinks and visualizes the scenario of the topic and what is their understanding. In qualitative research the discussion between the researcher and the respondent was largely determined by the respondent‟s own thoughts and feelings. Qualitative research helped researcher in gaining an understanding of how or why things are as they are.mode of qualitative research and Skype technology was used for Pakistan since researcher was based in the UK. The data gathered from quantitative research was by the use of online structured series of questions. The interviews were longer and in depth so the responses were also in detail and were requiring clarification at some point so that researcher‟s interpretation was true and based on actual responses. Additionally it was also informed to the respondents of both quantitative and qualitative research about the academic purpose of study so that they are open in you point of view and their responses are not biased. A series of questions in a draft version was sent through email to the respondents of both countries so that they have a time and preparedness to discuss on the topic and maximum information could be gathered out of the interviews. the appointments and timings for the telephonic interview and Skype were not a problems and they were conveniently conducted and recorded on the telephone and voice recorder. Each question was connected with the next question so that response of each question was double checked and validated which helped researcher in gaining accurate information and at some point with the example in the answers. descriptive questions with 36 . It is due to the experience of researcher worked within the pharmaceutical industry of Pakistan. Questionnaire for the quantitative research was design by using multiple choice questions.

The responses from both the countries were evaluated and analyzed collectively and separately also so that to find the dissimilarities if any and explain. 50 each from UK and Pakistan keeping in mind a time of 25 days. Additionally. Both qualitative and quantitative researches were having the questionnaire that was focus on non product base or disease based so that insight gain from the research is not product related or any disease related. gender. but it was mandatory for a respondent to have active involvement in treating patients either in hospital or at private clinic. The qualitative data was collected by using semi structured questionnaire selecting respondents separately from Pakistan and UK having 5 respondents from each country. year of experience etc. At some stage in particular to 37 . Altogether 100 respondents were targeted to get response. Altogether 82 responses were received from both countries and were compiled accordingly. So the research provided researcher a general perception of medical community regardless of any product specific and or disease related. age.closed ended and open ended questioning technique. Since the questionnaire was sent as a link through email so following up for the responses became easier that help researcher in getting the maximum responses with a minimum efforts and follow ups. Doctors were selected randomly without any consideration of specialty. A consensus was taken from the targeted respondents for quantitative research before sending them the questionnaire link so that they could understand the urgency and importance of the research. From Pakistan 46 responses were received where as 36 responses were received from the United Kingdom. it was also ensured that one respondent can attempt the link to reply only once so that there are no repetition which could otherwise have an impact on the findings.

the transcripts were coded. the respondents feedback was consequently based on believes and perceptions which were based on their experience in real life scenario with innovative drugs. It was critical for researcher at the point to have in depth perspective of respondents since they may not be aware of the definition of innovation. The data from each country was compiled all together as well as separately so that to compare and contrast the similarities and dissimilarities. its types and characteristics as explained by the authors. Obviously. an added questioning technique was also used in which researcher probe responded in further explaining their responses. the answer of the respondent in his own word with example if applied. Researcher‟s experience in the study had played an important role since an in-depth knowledge of drugs and diseases helped researcher conducted the research in a focus and precise way without any deviation from the topic. Each country‟s data was transcribed and send back to the respondents of qualitative research so that there is no ambiguity once the data is compiled and analyzed. doctors were requested to give examples to support the answer so that insight gain is not subjective but have a logical meanings. At some stages. Data Analysis Data analysis started by writing down the tape recorded interviews. Firstly. The transcribed was based on the format of question and under the question. Knowing the drugs on researcher end had a significant importance for researcher because to avoid the response about the “me too” and OTC drugs. This had a significance to know if there are some differences in the point of view of any 38 . This helped researcher to be sure that the interviewee physicians have a clear understanding on their replies.qualitative research.

The analysis process led to the identification of a set of general themes that were subsequently compared to existing concept and theories. Since the research was conducted separately for both UK and Pakistan.level so that it is explore in the study and open the opportunity for the next level research on “why”. The participants according to groups of physicians were contrasted in order to find out if certain point of view and arguments were more prevalent in from quantitative research had different from those of qualitative research respondents. But this comparison was done on the basis of any specialty since it was not the purpose of study 39 . Each response was compared from both countries so that to present any findings those are dissimilar.

40 . Additionally the scale of study is not as big as it is recommended by the authors which should represent at least 7-10 % of the population. Respondents having dissimilar knowledge. specialty. The responses of quantitative hold potential success factors that contribute a positive role in the reliability of the study. qualification. the findings of the research could be different. the answers of the respondents may be biased due to the reasons mentioned above. The researcher has acted just an observer avoiding any possibility of influencing or biased the respondents‟ answers due to his previous knowledge and experience working within the same industry. Additionally. Further more. Even though the researcher is experienced and have knowledge of the industry. he did not try to influence respondents to obtained specific results or a specific behaviour from any of them. researcher has designed the format of questions in a way that each response by the targeted physicians would be linked to the next questions and so.Limitation of Research Several issues in connection to this study were kept in the consideration. experiences. Since the method used in this study is the mix of both quantitative and qualitative so any ambiguity would be address and minimize with the findings of each method. however the participants were selected randomly but their responses might be based on their year of practice. In order to reduce the unreliability of the study. There may be chances if the same research is conducted on the one specialty of physicians or one classified category of physicians. their attachment with government institutions were not considered during the study. practices. education. type of patients they see and the potential of patients since the introduction of new drug to a low profile physicians are done at low pace from business point of view.

5% of physicians responded that they are satisfied with the innovative drug introduced in the market where as 12. However 25% of the responded believe the innovation in pharmaceutical are entirely new drugs.8% physicians believe that innovative and new products are different.5% physicians showed their dissatisfaction on the innovative drugs introduced in the market and hence believing the innovations in the drugs should be in the form or new molecule introduction instead of brining insignificant incremental improvement over the available therapeutic options. but the respondents that were believe innovative and new products are same had mentioned the name of innovative drugs. There has been an overall satisfaction amongst 62. the satisfaction level amongst the physicians was 50% with innovative drugs because majority 62.Chapter 4 Findings & Analysis Innovation Innovation was revealed as the most important and understood concept amongst the respondents of both from quantitative and qualitative research. so the interpretation of their response was same. However it is observed that at some level there is small degree of confusion prevails in differentiating a new drug and innovative drug.5% of them believes the innovative drugs are not entirely new and are based on the improvement over the existing available option. Additionally. 41 . However majority of 77.

Where as 11.Moreover findings of research also revealed that Majority (60%) of the physicians are not satisfy with the innovation in pharmaceutical drug. However this single improvement should not be at the cost of patients‟ compliance and safety.1% of the respondents believe if any significant improvement even in a single attribute of drug is innovation since that gives the drug an advantage over the existing option and open the opportunities for drug to be evaluated and prescribed. Innovation is highly linked with the improvement over the available existing therapeutic options. Research explores. better safety margin. improve tolerability profile with a convenience in dosage. where as (30%) of the respondents were satisfy with the innovative drugs introduction within the industry.8% believe innovation in pharmaceutical drugs should be a package of improvement in every aspect of drug‟s attribute that include better efficacy. Research findings of both quantitative and qualitative research validating each other and exploring following attributes carry importance while physicians evaluate the innovative drugs:      Efficacy Safety Tolerability Compliance Evidence of the product Physicians rated the tolerability profile of the drug as the highest considered attribute explaining reason that if a drug does not have the better tolerability profile means their patients can not stay on the prescribed drug and hence it is 42 . Concept of Innovation among Physicians Majority of the physicians 77.

They explained.not possible to gain the benefits of available evidences. the efficacy is implicit attribute of the drug and drug which does not provide the efficacy at-least similar to the existing drug is not an innovative drug. If the innovative drugs offer the desired improvement in the attributes than the price of the drug does not matter. 43 .1). Additionally. prices and convenience of dosage (graph 4. research explores that majority (60%) of the physicians were not satisfy with the innovation in pharmaceutical drug because they find the drug introduced are similar in offering the benefits and claims of the drugs are not either inline or can not be measure due to insignificance difference. However. (30%) of the physicians were satisfy with the innovative drugs introduction and they find these introduction as another option for them to choose for their patients since they comment that not every patient get response from single drug.

Perception of Innovation by Physicians 70% of the respondents believe that innovation in pharmaceutical industry is all about bringing improvement over the existing options available. Innovation Characteristic of Drug Research findings explores that all five characteristics of innovation that were proposed by Rogers are found to be in practice during the diffusion and adoption process at physicians level. compatibility and complexity of innovative drug as presented by Rogers 1965 since incremental innovation are not significantly different from each others. safety. few or all attributes of the drug as shown (in graph 1) and hence the 44 . however 40% physicians from both UK and Pakistan were not satisfied with the innovative drug introduced. Trialability. Findings from literature review and qualitative and quantitative explore that the innovation in pharmaceutical drugs are generally incremental in nature and there is a radical innovation demanded by the physicians. Qualitative research explores that it is difficult for physicians to evaluate the drug on the basis of five characteristics reliability. physicians have pre-define set of priorities of the drug attributes (graph1) based on disease profile and patients types and those priorities are consist of single. However. tolerability. Additionally. they explained if the innovative drug is entirely new than they found it ideal to evaluate the drug in comparison to other already available options on the basis of its efficacy. Observability. compliance etc. physicians find the incremental innovation as another option to consider without adding value in their treatment protocol. relative advantage.

efficacy is monitored and compared with available option within short span of time which results in immediate perception building of the drug in comparison to other or in isolation. efficacy is one of the important attribute of the drug which is connected with other attributes of the drug including tolerability. compliance and evidence to be evaluated as a relative advantages of the drug. Efficacy is prime attribute of the drug and considered mandatory amongst the physician during drug selection regardless of the disease type. Whereas in chronic disease treatment and management. safety. However. As per the research. in acute disease. they evaluate the drug on the relative advantages basis which include the assessment of drug both on short and long term basis against the claim attribute of the drug and against the available medications. However.innovative drugs are evaluated to see the benefits accordingly by using the characteristics of innovative product as explained by (Rogers 1965). Usually for chronic disease drug relative advantages are evaluated on more than short term benefits of the drug. in acute disease relative advantage comparison is based on short term of the drug because patients need to take acute disease treatment for short time. Three type of relative advantage emerged from the research that was consistent with the reviewed literature. Relative Advantage Interviewee discussed. Physicians evaluate drug on the basis of its effectiveness and the financial burden on the patients on both long term and short term basis. efficacy is fundamental attribute of drug with no 45 . Physicians assess the drug not only with the widely prescribed drug but also with the recent introduction of drugs both in same class and other therapeutic options of other classes.

This attribute has particular importance for drug of chronic diseases. Some drugs need special adjustment in dosage while prescribed with other medication. if the innovative drug has similar usage pattern as of already available option for patients and physicians make the drug easier to be adopted. dosage adjustment as per the need of the patients. Evidence of innovative drug/Safety is another feature that physicians used to monitor or observed. acute diseases and chronic diseases. They judge the complexity of the drug both from their own perspective as well as from patients‟ perspective. Compliance/tolerability of the innovative drug is another consideration while evaluating the relative advantages because more the patients are compliant with the drug more the benefits and claims of the drugs can be validated and gain in both. According to physicians. This complexity is important 46 . It is important for a drug to be easy in dose titration. Complexity Physicians evaluate the drug on the basis of its complexity. If the drug has strong evidences it got preference and perceived better even the other attributes of the drug evidence deals with the regression or controlling of disease and prevention or positive effect of drug on vital organs of the body. Compliance according to physicians deal in the number of pills to be taken. It was also explored that some drugs required some kind of special skill to screen out the patients for the innovative drug. This is again and important attribute since drugs are compared on this attribute immediately even sometime followed by only one dose intake. Innovative drugs that hold strong evidences are usually got acceptance amongst the physicians due to safety of the drug.compromise and drug evaluation is based on a collection of attribute and their relative advantages within the same class and with other classes also. number of times to be taken and timing of dose to be taken and the side effects related with the drugs.

for both physicians and patients. Compatibility Compatibility of the innovative drug with the prevailing environment and the behavioural pattern of physicians‟ buying process is another characteristic of the drug adoption. he or she might miss the dosage which means missing the benefits and more complication in chronic disease. because if the drug is complex for patients to take. In case of an innovative drug which is indicated in a particular disease and that disease from physician point of view does not exist or there is lacking in the diagnostic techniques for the physician. This characteristic is also important for patients since there is a need to have created awareness amongst the patients also to ensure their compliance due 47 .

Trialability matters in innovative product since it helps physicians in validating the evidence /claims of the drug and drug effects on the patients‟ and their feedback about the drug and their own observation on the key drug attributes. Trialability The interviewed physicians‟ comments explores that Trialability of drug is one of the important characteristic that establish the newness of the drug and increase their confidence level in perceiving the drug in comparison as well as in isolation. 48 .to perceive importance of disease management as well as its consequences over long term. extent and rate of the diffusion process. physicians clinical assessment based on sign and symptoms of the disease and the laboratorial findings of the drugs. consequence the market positioning decisions of the marketer and the product attributes they choose to emphasize are critically connected to the diffusion process. innovative drugs benefits must be observable. Process and Sources of Diffusion The perception of Physicians‟ on the drug influences. Observability As per the comments form interviewee physicians. It is also explored that organizations provide free samples to physicians‟ at the time of drug introduction so that physicians can evaluate the drug in their patients. according to them the Observability of innovative drug is three dimensional and they are patients own feelings with the drug.

dear doctor letter from the specific organizations and some time from patients visits. innovative drug is introduced to them by the medical representative of the organization but they believe the information received from medical representative is not sufficient enough to take decision to prescribe the drug. 49 .The findings form qualitative research explores diffusion of innovative drugs is based on the quality. As per the comments from interviewee physicians innovative drug information is reached to them from several sources that include. Diffusion of innovative drug need a comparative information along with the drug related information. quality and about the comprehensiveness of the information. company medical sales representative. frequency. advertisement in the medical journal. But they believe medical representative of an organization is the best source in having the information both on product related and also on the basis of product comparison. scientific meetings and symposia. However in generally. internet.

2). internet and medical association. symposia/scientific meetings and medical association or community are the first sources of information for innovative product. Main Source of Information Both. However 50% respondents believe medical representative are the first source of information that is followed by scientific meeting/symposium.Qualitative and quantitative research explored the physicians seek more than two sources to gain information. it is explored that the medical representative. whereas 25% of the physicians believe that scientific meetings and symposia are the first source of innovative drug information (graph 4. quantitative and qualitative research explore that more than one sources of information are used by the physician to have quality knowledge about the introduced drug and related supportive evidence. There response to predefine list for the source of information. However 50% of physicians believe the main source of drug information comes from the organization‟s medical representative. 50 . internet.

Similar percentage of physicians believes that scientific meetings and symposia are the best sources for additional information (Graph 4.5% physicians believe the best additional source of information is internet due to comprehensiveness and quality of information. There were 37.5% physicians that believe that Medical Journal is the best source of information that provides them comprehensive information of the drug and the studies/ evidence related 51 .Additional Sources of Drug Information Used by Physicians Research explores that for physicians Internet is best alternative source for information followed by symposia/scientific are medical representative of the organization. 37. However 25% physicians again look medical representative of the organization for the additional information they seek.3). Best Source of Information Research explores that the best source of information varies amongst the group based on quality of information.

Additionally. personal sources of information are more important than impersonal sources that indicate the importance to the organization of the medical representative. The importance of medical journals as a best source of information has implications for media expenditure at the drug introduction phase to ensure the maximum reach and coverage in widely read journals.to this.4). and access to the interpersonal network during the course of seminar/symposia and scientific meetings. However this is important to realize that medical journals are classified as autonomous source of information that is not biased. Where as 25% physicians believe medical representative of the organization is the best source of information and similar 25% physicians believe symposia and scientific meetings are the best sources or information (Graph 4. Physicians‟ usage of information sources in this instance highlights the importance of the medical representative of the organization. 52 .

Qualitative findings of drug diffusion Qualitative research explores that interviewee physicians get exposed with the drug well before the formal introduction of the drug but that information is not usually comprehensive and neither comparative. Additionally. Drivers and Barriers in the Adoption Process Drivers of innovative drug adoption Interviewees comments explored that adoption of drug depend on successful evaluation on the basis of innovative characteristics of the drug. 50% of the respondents give preference to the profile of drug where as 25% respondents link it with the organizations‟ 53 . the most important factor that drives adoption process is the profile of the drug which is followed by the expertise of organization in that particular category. several factors influence the adoption process including innovative drug itself. physicians‟ own dissatisfaction. patients‟ dissatisfaction with the previous treatment. Physicians believe. However the get detail information of the drug through the medical representative of the organization that is purely related to drug attributes and its benefits supported with evidence of the drug. For additional information they believe scientific forum and medical journals are the best sources. profile of drug. Amongst the respondents from quantitative research. Furthermore amongst the factors. However apart from innovative characteristics of the drug. They found internet is the initial source of information for them since they get the drugs‟ updates regarding supportive clinical trials etc. they believe medical representative of the organization has vital importance since they get their precise queries answered through them. organizations‟ relationship with the physicians and organizations‟ expertise in the therapeutic class. if the drug is introduced from an organization that already have expertise in the therapeutic category is tend to facilitate the adoption of drug.

they select few patients to be put on the innovative drug once the drug is introduced to them with the sole objective of validating drug on innovative characteristics where as 37. 50% of the respondents‟ believe in evaluating the profile of the drug on the basis of efficacy. tolerability and compliance.5% physicians discuss the drug amongst the peers before moving on.5). Since believe there is a direct relation for them to decide if they would potentially accept the drug. they were found to evaluate the drug on the basis of the profile of the drug. 62. relative advantage over available option and also the platform or the organization that is launching the drug. Quantitative findings: Once physicians‟ are exposed with the innovative drug. safety. From the respondents.expertise in the therapy area (graph 4. Whereas 25% thinks that for them it is important to see which organization is launching the drug because some 54 .5% physician believe. innovative drug itself.

When they were asked to rate the different factors that are important from them to consider from the predefine list.organization have got expertise in certain therapeutic categories and their previous introduction of innovative drugs have given physician confidence in treatment protocol and gaining patients‟ respect.25 points. The highest importance from the rating scale of 7 was given to the profile of drug with 6 points. the least important factor was the relationship with the organization (graph 4.6) 55 . followed by better option on comparative analysis over available options with 5.

It is one of the reasons that the frequencies of new patients 56 . According to the comments of interviewee. It is equally important to asses the patients also for the drug since certain disease. aging. However this relative advantage does not actively apply on the drug for acute disease treatment since patient pay for the drug for very shorter period of time in comparison to chronic diseases.Research explores. Barriers to innovative drug adoption: Research explores that there is strong connection and association between the innovative drug and its adoption. specially from the patients perspective because it is physicians responsibility to select the drug on the basis of its advantage and potential benefits to the patients that also include the financial burden on him. The adoption of drug in chronic disease is slower and delayed because of the nature of disease. adoption process of innovative drug is a conscious process and is influenced by drugs own characteristics as well as external efforts and influences. malnutrition etc effect overall performance of drug and similarly the drug may not be suitable for the patients due to its certain effects on certain parts of the system that might worse and un necessary involve the system over a long run. namely acute disease and chronic disease. disorders like genetic mutations. or other drugs. The strongly believe in evaluating the drug to see the relative advantages of the product. Interviewee physicians believe if drug is providing them the opportunity to evaluate the drug for the comparison with the previously available options make the adoption process quickly. Physicians are fundamentally involved in treating two types on patients. drug adoptability in the chronic diseases management is highly based on Pharmacodynamics of the drug (the effect of the drug to the body) and pharmacokinetics of the drug (the effect of body on the drug) because a drug's Pharmacodynamics can be affected by physiologic changes due to disorders.

However chronic disease patients usually require dosage adjustment in their therapy that may include the decrease and increase in the dosage or adding some drug with the current treatment. 57 . There are at-least three advantages that a physicians assess of innovative drug. in case of drug switching. The only scenario where a physician feels to change the therapy is the medication failure or the quality of life of patient is getting impaired due to increase in side effect or tolerability of the drug. physicians adopt the ethical way of lower down the dosage and add other drug or lower down the dosage till the zero dosage point and allow patients for a wash out period so that the from the body is eliminated. In most of the cases a drug can not be withdrawn or switched from the treatment and initiate new drug.with chronic disease are low to be prescribed innovative drug since they are generally settled on their existing medications. Additionally. whether the drug is fulfilling its promise as per literature. chronic disease patients are generally those patients that are usually taking multiple drugs depending on the nature of disease and its complications from the future point of view. The drug which is missing with the proof to offer relative advantages over the existing drug does not get adopted amongst the physicians. relative advantage of the efficacy of the drug and relative advantage of drug on financial burden on the patients both on long term and short term. hence it is important for the innovative drug to be compatible with the adjuvant drugs used in particular diseases so that an innovative drug can be easily prescribed in combination to other adjuvant drugs.

the findings of study validate the general findings of Jaakkola and Renko (2007). And hence there was a need to study innovation. explored and discussed in literature. and its diffusion on single drug focused or on innovative format of the drug within pharmaceutical industry. Thirdly. The findings of this research add to the concepts on innovation. however there are dissimilar findings this research that makes the findings to be further 58 . Secondly. The research explores a strong link amongst innovation. diffusion and adoption. findings of the research maintain the agreement with the proposed and discussed topic and definitions by the authors and authorities in general and in particular to pharmaceutical industry. diffusion and its adoption collectively and draw an overall inference out of whole process.Chapter 5 Conclusion The research explores the perspective of physicians about the concept of innovation and how they perceive innovative drug. This research supports the previous studies done on the subject. The research reported in this document explores the innovative drugs‟ characteristics that physicians assess themselves when evaluating to adopt in the pharmaceutical industry. Firstly. this research has focused innovation. its diffusion and adoption. perceived innovativeness its diffusion and adoption. diffusion and its adoption collectively in relation to pharmaceutical industry since previous authors have focused themselves separately on innovation. this research brings in refinements and extension to the conventional concept of and traits considered.

It is further explored that patients they do discuss with them the benefits and drawback of drugs due to increase awareness and information they get from patients awareness societies and patients forum. Trialability. The research findings are similar and inline with the concept discussed by Rogers (1965) on the characteristics of innovation and also inline with the findings of Jaakkola and Renko (2007) that the adoption of innovative drug is influence because of the drug ability to be assessed on its relative advantage. However in addition the characteristics. Enthusiasm of Physicians‟ to adopt an innovative drug is solely based on their own judgments that are based on the characteristics of the drug. this research further explore and additional characteristics of innovative products as explored by Jaakkola and Renko (2007) and they are drugs Observability. Trialability to validate the relative advantages of the drug. Author feels that the variations in the findings may be due to different educational background. its complexity. patients have an influence on treating physician for the selection or adoption of innovative drug. Social network.explored and discussed. homophilous group. communication channels. Research validate the involvement of ten level of Mittman & Cain (2002) in innovative drug adoption as relative advantages. communication gap between physicians and patients‟. Where as the authors in this research explores that patients have no influence on the selection of innovative product in the health care industry however the selection of dug is done on consideration to the profile of patients so that the adoption of drug at the end user level is not compromised. and access of drug information to the patients and their companion on end user level. compatibility and its perceived risk (safety of the drug) for the patients. Observability. disease and patients profile. According to Jaakkola and Renko (2007). Pace of innovation. Opinion 59 . Thus this research explores that patients that are an users used do not reject the innovative drug due to its benefits and drawbacks and hence the decision to adopt the drugs are hold be the physicians.

It is important for an innovative drug that physicians have clear understanding about the screening/diagnosis of the patients for that particular type of disease against that the innovative drug needs to be prescribed. that exposed appropriate motivator or influences that shape up their perception and behaviors.leaders. these findings are surprisingly similar since even a lot of development has been in pharmaceutical industry due to information technology and the ways to reach the physicians. evidence with the drug. efficacy. its safety. The quantitative portion of study explores that innovation of drug is perceived amongst physician as “an improvement” of at least one attribute of drug that might be perceive “at-least better than available option” or a collection of improvement in variety of attribute including. compatibility and infrastructure. diffusion and its adoption in their own phrases and understanding. However these ten stages vary from physicians profile since some times based on specialty and category described by (Rogers 1965) bell shaped non cumulative diffusion pattern. tolerability at patients level. The qualitative and quantitative method of research helped researcher in gaining the general perspective and in depth point of view of the interviewees and respondents on the three areas innovation. Author‟s findings about the drugs diffusion are same as Ryan & Murray (1977). The adoption of drugs get delayed or rejected at a particular specialty if the diagnostic tools or skill is missing. The importance of medical representative during the drug diffusion is more significant since research explore that physicians found that innovation in pharmaceutical is not significant and innovative drugs are 60 . But research explore that medical representative is the implicit source of drug information and is not indispensible.

Research explores. This finding are in line with Robertson (1967) classification of innovation since pharmaceutical innovation is mainly focus on “continuous innovation” that involve in alteration of a product rather than the creation of entirely “new product” as well as “dynamically continuous innovation” that involved in creation of a new product on the alteration of an existing one and a “discontinuous innovation” that involved in establishing a new product and new related behavioural pattern. Findings of the research also confirm and validate the literature that the innovation done in pharmaceutical drugs are generally incremental in nature and a very few drugs are revolutionary in nature. Research findings are also in line with the findings of Ryan & Murray (1977). Compatibility. since physicians beliefs that drug been introduced are generally better than available or similar to the available. Trialability. although the level of importance of medical journal differs from Ryan & Murray (1977) since this research explore Medical Journal is the best source of information for the drug information. Physician‟s behavior is closely linked and based on those characteristics. that makes the role of medical representative more important since this is the only way when physicians interact and have a dialogue in relation to drug and develop their mindset. 1995) as Observability. explain by Rogers (1962. but not the first source of information.coming with a small improvement over the available medication. Complexity. 61 . Relative advantage. Cost burden and Social advantage. that Medical journal have significant importance in drug diffusion process. Any missing characteristics have a direct impact on the drug adoption in the form of rejection or delay in drug to be adopted. physicians have the clear understanding of the characteristic of innovation which are reasons for the drug adoption.

diffusion and adoption of innovative drug in pharmaceutical has a direct relationship with the customer buying process (Fig 5.1) The decision making process and model of customer behavior draw together various influences. customer buying behaviour means their decision to prescribe drug in a few or majority of consumer (patients). it is critical for an organization to have a clearly and deep understanding on the series of decision making chain.Research explores. In order to be successful in introducing any innovative product. In pharmaceutical industry. 62 . The decision is complex and mainly logical (rationale) with no or low involvement of emotions.

more the drug is align with the decision making process more it is able to be adopted. Some innovation in pharmaceutical industry need a push strategy to make the product success and that need a persistent education program for the consumer (patients) so that they have the awareness about the disease and the importance of its management. he or she is taking or no or partial response of the drug in providing the relief. the more it is easier for a physician to adopt the drug. In Pharmaceutical industry. Generally the visit of patients with chronic disease are fundamentally a follow up visit with his or her satisfaction or dissatisfaction due to the reason of side effect of the drug. so that they visit the doctors on the basis of symptoms of the disease. The lack of diagnostic facilities may become a barrier for an innovative drug to be adopted Once the diagnosis is done and consumer (patients) found an establish disease which the innovative drug is indicated. the customer (doctors) have 63 . Diagnosis of the disease is another important phase in buying process of the doctor for the new product since it is important for a doctor to have the clinical and laboratorial facilities available in screening the patients to have an establish disease and making him an ideal candidate for the drug. The type of disease play important role for the adoption of drug since physician treats patients with acute or chronic type. If the patients visits are based on with his or her satisfaction of drug than the chances of innovative drugs get closed. It is also concluded that more is the patient aware of the disease and its consequence.It is concluded that innovative drug diffusion also has a relationship with the doctor decision making process. doctor decision making start right from the point where a patient visits the physician with signs or symptoms.

and cost benefit analysis. Customer Decision making process for innovation: Customer decision making process to adopt an innovative drug is not a simple process since the need for both customers and consumers have be there and identified so that innovative drug satisfy both adopters in general but specifically of the 1st adopters that are physicians. The behavior of physicians involve the psychological processes that customers go through in recognizing needs. safety (based on available evidence). finding ways to solve the 64 .phase in which he or she compare the drug with the previously available option and compare the new product on the basis of innovative product features and benefits which is generally based on the efficacy.

For example.identified needs. Affect. it is important for organization to classify the physician on the basis of consumer life cycle that is innovators. In order to ensure the success for the innovative drug. In Pharmaceutical industry drugs are not discovered on the basis of social. in turn leading to the satisfaction of ultimate value. making decision initially to select the innovative drug in selected patients for certain indication to try. beliefs. improving the quality of life of the patients. cognition. a physician may not be particularly interested in the mode of action of the drug. early adopters. number of tablets and dosage schedule but might reasons as follow:      Highly reliable drug. Path 65 . references and communication. and late majority and laagered. Drugs are research and manufactured to provide cure against the disease. social influence. available choices. cultural and other values. Customers in pharmaceutical industry often adopt the innovative drug not only because of its attributes but rather a combination of the ultimate benefits that these attributes provide. resource and evidence Drug has a potential to fulfill promise with consistency Quality of life of the patients Patient‟s stay on therapy (stickiness) Self Esteem and respect gain The success innovative drugs depend of the ability of this product to diffuse and adopted by the physicians. A number of sources influence the decision making process (see the fig 2) a part from those that are found through quantitative survey that include perception sensation.

different habit and different type of patients as well so have a different believe behind. how he does why he does but also what are the external forces shaping up customer behavior. they pushed to be change and some times this change required at the level of diagnosis where drug selection is not directly involved. identifying the external stimuli would be key for organization for innovation diffusion and adoption. specialty has its own understanding of the innovativeness of the drug and its own importance of sources of information. Knowing the belief. what he does. When an innovative drug is introduced.physiology of the disease is same around the word and disease need a universal cure and management. It is important for the organization to identify the innovators and early adopters from their market and separate them from late majority and laagered since they need time and influence from innovators and early adopter. Each physician is a different market. confidence with a variety of drugs. The diffusion process of the drug may also play in the adoption process since different doctors may have their own perception and believes about the authenticity of source they use. physicians for the innovative drug adoption need a change in perception and believe which may be painful for them since they carry with them a great deal of experience. it is not simply knowing. when we talk about market understanding. Innovative product success depends on great deal of market understanding. Marketing efforts needs to be channelized on identified innovators and early adopters An overall conclusion from the findings is that the adoption of innovative drug is linked with the perceived innovative characteristics of the drugs and its diffusion. 66 . Each physician class. satisfaction.

Different physicians consider different characteristic or a set of characteristic of innovative drug before they decide to adopt the drug and the decision to reject the innovation. It is also explored that each characteristic have some fundamental components that each physician consider. Since the study reported here is based on exploratory method.Research explores the background of potential influences to the physicians along with the characteristics relevant to them but also how and why the perceived characteristic matters. However the adoption of innovative drug is based on logical consideration of type of innovation and matching that innovation with the type of patient. 67 . diffusion and adoption. A limitation for this study is focusing on general physician population without any specific specialty and involved only physicians. the findings required further empirical validation. This decision may be based on considering the single characteristic of innovation or a collection of different characteristic. Further research focusing on one individual specialty or class and involving patients needed to investigate on concerns that influence innovation.

This research has provided me with up to date and accurate knowledge of both UK and Pakistan pharmaceutical industries customers and their perception in detail. diffusion and its adoption amongst the pharmaceutical customers. I am now more knowledgeable and competent to resume the industry. Being a Marketing student and relevant experience within the industry. future students could use this research to help analyse this market in more depth and from a different perspective. To the University This research has provided the university with an in depth analysis of Innovation. 68 .Reflective Summary Benefits to Myself Prior to completing this research my knowledge of Innovation. The research has explored how the pharmaceutical organization can adopt the customized diffusion channel to ensure its success and ideal adoption in short and precise timing. Furthermore the knowledge base that has been built can now act as a keystone for me to build further knowledge and its implementation within the industry. Furthermore. diffusion and its adoption was basic and superficial in nature. I was aware of the importance and seriousness of the topic.

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