Wednesday, 06 July 2016 22:29

Canadian Pharma: Know Your Patient

Commentary by Rohit Phillips in Aurora, Ontario

The fast-growing multicultural consumer segment of Canada represents a potential opportunity for pharmaceutical companies, especially if they can improve patient outcomes on a national scale.

For a small or mid-tier drug company battling to make headway in the general market, capturing a large portion of the multicultural market may be the path to improved profitability and growth. 

Ethnic (or “Diversity”) Healthcare is all about the ‘culturally sensitive connection’ to effectively address ‘health and healthcare disparities’ that result from cultural differences. These differences influence the health and well-being of Canada’s growing visible ethnic minority population, which made up to 20 per cent of the total population in 2013 and is projected to grow to 32 per cent by 2031.  

Fifteen years from now, it’s projected that visible minorities will make up 63 per cent of Toronto, 59 per cent of Vancouver, 31 per cent of Montreal.  Together, these three areas will account for 70 per cent of Canadian GDP.

Genetic, Environmental and Cultural Factors 

The factors contributing to varied drug responses are complex and inter-related. Differences in drug response among racial and ethnic groups are determined by genetic, environmental, and cultural factors. These factors may operate independently of one another, or they may work together to influence outcomes.

Biological Factors: The genetic makeup of an individual may change the action of a drug in a number of ways as it moves through the body. Clinically, there may be an increase or decrease in the intensity and duration of the expected typical effect of the drug.

Environmental Factors: Diet, climate, smoking, alcohol, drugs, pollutants —may cause wide variations in drug response within an individual and even wider variations between groups of individuals.

Cultural Factors: Cultural or psycho-social factors, such as the attitudes and beliefs of an ethnic group, may affect the effectiveness of, or adherence to, a particular drug therapy.

Being Culturally Sensitive

Multicultural marketing isn’t just attaching a face to your campaign.

It has more to do with presenting information in a culturally relevant way and context. Isn’t all communication and marketing about better connecting with the audience?

So, what aspects of any ethnicity do marketers and advertisers need to understand to connect their brand messages well?

Here are a few important ones:  

1.       Language: It’s not just about translation from English. The message must be written for and from the perspective of the minority language audience. Health promotion communication should also take into account the visual and oral cultural cues, like pictures and music.

2.       Beliefs: Beliefs can be powerful forces that affect our health and capacity to heal. Whether personal or cultural, they influence us in one of two ways – they modify our behaviour or they stimulate physiological changes in our endocrine or immune systems. Many cultural beliefs have implications for healthcare, which may be direct or indirect.

As an example, many Asians believe that the number four is unlucky because when pronounced in Japanese or Chinese it sounds very similar to the word for “death”. Thus, items arranged in groups of four, such as pills or syringes, can symbolize bad luck for those people who believe in numerology.

3.       Behaviours: Culture has a bearing on the way a person acts in response to a particular situation. Buddhist teachings emphasize ‘’face’’ or dignity. An individual’s wrongdoing causes the immediate family to lose face. Such behaviours have a direct bearing on disease screening and diagnoses as patients may not admit or realize they have health problems, especially mental health problems, as this may bring shame upon their family.

4.       Communication style: Refers to ways of expressing oneself to others and can be very different for a Chinese-Canadian compared to an Indo-Canadian. Older Chinese patients tend to be polite and may smile and nod. Nodding does not necessarily indicate agreement or even understanding of medical facts. Understanding of verbal and non-verbal communication styles of these cultures is critically important during screening, diagnoses and outreach programs.

5.       Notions of modesty: Modesty is highly valued in South Asian culture. An example is an elderly woman who may be soft-spoken and not advocate for herself. Important decisions are made in this culture only after consulting with family members or close family friends. Involving the family and friends in intervention/prevention programs and long-term care for specific ailments like diabetes, cardiovascular disease and cancers can go a long way in increasing compliance, raising awareness and generating brand loyalty.

Despite the many differences among the cultures that make up our nation, we all have the same basic needs: to be able to convey the symptoms and concerns of an illness, to receive competent care, to be acknowledged and valued.

A few fundamentals

When conducting situation analysis and a SWOT analysis of your business plan, the following are important for success:

·         Explore implications of demographic changes (regional and national)

·         Segment patient population by ethnicity

·         Identify differences in disease incidence (determine if your product treats a condition in which a health disparity exists between the ethnic and general populations. For example, is mortality different among ethnic groups in your disease category?)

·         Examine the growth patterns of your customer base

·         Find out from physicians and managed care organizations what issues they encounter in an increasingly diverse population. Then identify challenges and opportunities your company can pursue

·         Find out what your competition is doing to serve the needs of the “emerging majority”

Rohit is a seasoned healthcare marketing and advertising professional with an entrepreneurial instinct and a degree in pharmacy. Rohit is currently employed with The Gibson Group, a healthcare communication agency in Canada.

Published in Health

Canada has stopped the importation of several drugs and drug ingredients from two Indian factories, as concern mounts in North America over health products sourced from the multi-billion dollar South Asian pharmaceutical industry. The products on the Canada blacklist range from medicines like blood pressure pills to chemotherapy drugs, anti-psychotics and painkillers.

Canada’s action comes after a U.S. trade representative's special investigation noted: "Reports indicate that anywhere from 10 to 40 per cent of drugs sold in Indian markets are counterfeit and could represent a serious threat to patient health and safety."

India produces nearly 40 per cent of the generic drugs used in the U.S. and Canada and has been stepping up production in anticipation of increased demand. 

At Health Canada's request, Canadian importers have agreed to quarantine health products from the following two India-based sites due to data integrity concerns: Dr. Reddy's Laboratories in Srikakulam, India and IPCA Laboratories in Pithampur, India.

It said the action comes in light of recent information from a trusted regulatory partner that raises concerns about the reliability of the laboratory data generated at these sites. 

A quarantine means that the Canadian importers have agreed to stop the importation and distribution of products from these two sites. At this time there is no identified risk to health, and Health Canada is not requesting a recall of any of the products.

Health Canada said it will continue to work with international partners and Canadian importers to gather and assess information regarding the situation and take action as needed to help protect Canadians.

Amir Attaran, Canada research chair in law and population health at the University of Ottawa, questioned why Health Canada has not blocked the sale of those medicines that had arrived on shelves earlier from the factories.

"How can the product be too dangerous to import, but safe enough to go down a Canadian's throat?" Attaran said in a interview with the National Post.

He said the integrity problems could range from relatively innocuous data-entry shortcomings to clearly fraudulent behaviour, such as fudging results on drug-stability tests.

Canada's increasing use of Indian-made medications, coupled with India's antiquated regulatory system, points to the need for more drastic action, such as barring all imports if the country fails to modernize its rules, Attaran said.

A newspaper in India reported that inspectors from the U.S. Food and Drug Administration had earlier found problems at the plants - Dr. Reddy's Laboratories in Srikakulam and IPCA Laboratories in Pithampur. 

The Indian government has said it is investigating reports of generic versions of some medicines being manufactured without proper testing.

Health Minister J.P. Nadda. said that the government was aware of the reports regarding manufacturing of generic versions of some drugs without proper testing.

"The Indian Council of Medical Research has taken up the matter with the Drug Controller General of India (DCGI) for action against such erring companies," he said.

Earlier, as part of efforts to ensure that Indian pharmaceutical products meet international standards, New Delhi said it is spending about $500 million to build the capacity of the country's drug regulators.

National drug controller G.N. Singh said part of the money is to be used to set up a National Drug Regulatory Academy to train professionals who test drugs in the laboratories.  Singh said the government was also compiling a national pharmacopia to guide in the manufacture of drugs. 

He said the government's zeal to bring about affordable quality drugs to the people could only materialize if the government's zero tolerance for poor quality drugs was monitored by implementing laws that punished those who violated the rules.

Sudhanshu Pandey, joint secretary in the ministry of commerce and industry, said Indian generic drugs have become globally accepted and respected, and for this reason, there was the need to send a loud message out that the government was ready to ensure that the manufacturers met the standards required of them.

Pandey said patents for about 160 drugs would be expiring soon and that would give manufacturers more opportunities but, at the same time, he cautioned that it meant that innovations in the industry will have to be transparent so that global regulators would not question the standards.

Pharmaceutical Export Council of India (Pharmexcil) says that eight out of the world's top 25 generic companies come from India. 

Re-published with permission from South Asian Post.

Published in Health

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