Connected Markets, Rob Dhoble

It used to be that pharma companies had one marketing strategy for the United States and other developed nations, a second strategy for emerging countries, and a third, mostly focused around access, for the developing world.

Rob Dhoble

But the problem with that plan, says Rob Dhoble, president of Diversified Agency Services, which houses the Omnicom Group's healthcare agencies, is that it ignores how global markets are becoming more connected. While the industry has been busy playing defense to issues such as reimportation and parallel pricing, companies have largely fallen behind in maximizing the opportunities that come from working in a smaller world, where healthcare markets are dynamic and influence one another.

Dhoble's job is to help Omnicom agencies connect their clients to customers in global markets. However, he sees a fundamental change coming—where companies must learn what it means to truly think globally.

In the past, companies have had difficulty executing global brands. Do you see that changing?

I do, because the landscape is changing. I believe we will see more of a "one-world market" because it'll be harder to do clinical trials that ignore key countries, either because of genetic differences or just local policy. It'll also be harder to have different tiers of pricing. And as the market becomes more connected in those respects, the cost of promotion actually trickles down because companies will develop more holistic campaigns with the world in mind.

The campaigns will still require customization to make them more relevant, but companies will eventually have a different architecture for marketing—that extends to the way they are actually organized. And I think what you'll see is a more coordinated, worldwide platform not just for marketing and sales, but for R&D and for regulatory because of the harmonization opportunities that are slowly coming, primarily between Japan, Europe, and the United States.

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How can companies carve out an identity for themselves in a global market?

It's hard to be at the top of any drug company today because it can be a full-time job just working the defensive agenda, justifying yourself. But companies need to know what they stand for.

I do think, one by one, companies are figuring this out. And it's not just the sum of their drugs—but rather what they stand for in terms of the larger stakeholder population. You're seeing pharma companies starting to stand up and say, "We represent the pediatric population. We represent patients' rights in the survival for cancer. We represent female health. We're looking out for you, ma'am."

Companies can certainly express this ideal through corporate advertising. But I think corporate advertising for the sake of just doing it stopped a long time ago. Instead, companies need to use it to clarify and to really engrave in people's minds the position that they want to take—and it can't just be that they want to increase the price of their drugs.

These are straightforward messages. But at the same time, it almost feels that what companies are doing and how they are organized is becoming more complicated.

Part of that is that we're seeing more partnerships as more single groups try to solve more social problems.

Just think of our clients, who are not purely generic or brand any more. You have very large plays, like what Novartis has created [with Sandoz]. And the largest generics company, Teva, has had a brand commitment with Copaxone (glatiramer) for many years that, in some ways, is a completely different business than their core manufacturing business. There are more than a handful of foreign generics manufacturers that are using that as a model and developing novel chemical entities. Some are the same type of hybrid as Teva, while others are doing it through partnerships with Western pharma companies.

What's the most interesting partnership you've seen?

The partnership between GlaxoSmithKline and Ranbaxy is fascinating because it gives GSK access to research scientists and others on the R&D side that, at any cost, might be hard to get given where GlaxoSmithKline is in North America and in the United Kingdom. But even more than that, for GSK, this partnership could accelerate the time it takes to get a drug to market and could ultimately lower the cost of R&D. Even if a drug is a GSK brand in the United States, it can benefit from that back engine of lower cost—and give more people access—yet still maintain high quality.

Some of Ranbaxy's competitors in the region are doing hybrids of that relationship through official joint ventures. They are retaining the rights to certain drugs in certain markets and allowing the licensor, the joint venture partner, to have the rights to the drug in other, more developed markets.

That sounds similar to the way Japanese companies grew and began to market in the United States. Is there anything this new wave of companies can learn from their experience?

There are some Eastern and Indian pharmaceutical companies that are, in my opinion, going to leapfrog and become their own shows without the need to connect to a large pharma company and diminish the return on their investment. It'll be the more specialist drugs that don't require the 5,000-person sales force.

You're going to see innovation in marketing coming out of these companies just out of sheer necessity—and they'll be able to execute that innovation because some of these companies are hiring very experienced US or European executives as their heads of business in the United States.

People talk about the globalization of the pharma industry as somewhat of a manifest destiny. Where's the rub?

Novartis has the weight of the industry on its shoulders [in trying to justify its patent on Gleevec in India], and people don't really appreciate the role as the heavyweight.

While the Indian market seeks to be in faithful compliance with the WTO TRIPS protocol that started in 2005, it takes a nuance on the interpretation when it comes to classifying improvements as not patentable. And you could argue, well, isn't everything kind of an improvement?

So there's this really chilling moment happening. And against that backdrop, you have India and China, which have very robust pharmaceutical industries with a lot of brand or semi-brand drugs, like branded generics. Now with Indian companies and one or two Chinese companies identifying their own novel chemical entities they want protected, suddenly it's not an East versus West issue. It's innovation versus status quo.

Drug patents are a somewhat new idea to India. What ideas surrounding healthcare do you see growing in India that could be exported around the world?

Some regions of India—like Chennai in South India—have twice the incidence of diabetes that our country has. It's so bad that there are research centers specific to just there. When I traveled to India in November, I saw companies that are not disease-management companies and not insurance companies, but rather a combination of the two. They have formularies and monthly payments for insurance—but it covers things like outcomes of diabetes, where if it is left unmanaged, it can lead to blindness or amputation. The disease-management protocol ties to a formulary, and it's how you keep your premiums low.

I saw a formulary called the Diabetes Care Program that has glucometers and drugs from Western companies, as well as a whole host of brands, largely multisource, manufactured right there in India. The formulary is designed to serve those patients—and by paying premiums, patients get those products at a reduced cost.

But as an economic model, this formulary actually connects patients to their own health. And that connection is something that's superior to anything that's going on in this country. So as we continue to live in this global economy, it's important to realize that connected markets can bring great ideas from there to here too.

Industry Insider Rob Dhoble is president of Omnicom's Diversified Agencies Services. In his role, Dhoble focuses on directing the firm's resources to align global brand communications. Before joining Omnicom in 1998, he held successive marketing and sales management positions within Lederle Labs, Wallace Labs, and Rorer Pharmaceuticals. Dhoble is a graduate of Temple University.