Saturday, December 21, 2013

A suitably bootstrapped perspective

As someone who routinely wears boots under Levi’s 511s, I understand the sheer utility of those small loops called bootstraps - Sramana Mitra’s high focus on an entrepreneur bootstrapping the start-up in her book “Seed India -How To Navigate the Seed Capital Gap In India (Entrepreneur Journeys)” helped me appreciate the criticality of this aspect in the Indian venture funding context.

The book’s USP is its brevity and the matter-of-fact, blog-like style but what keeps your interest on is the verbatim reproduction of the interviews. Spurred by the author’s knowledgeable querying, the interviewed entrepreneurs come up with some honest reflections & very useful insights into their successful entrepreneurial journey. Some statements though come across as anachronistic, particularly when Sachin Bansal of Flipkart seemingly undermines the adaptation, penetration & potential of digital books and affordability of e-readers in India - the fact that I was reading this book on my Kindle Fire HD made the assertion even more ironic.

While it is a welcome trend that Indian start-up stories are getting written about, I once again can’t help but notice that the term ‘start-up’ is gradually getting equated with IT/ITES/ Cloud enterprise.  Most other enterprise categories such as biotech, green-tech are clearly missing out being written about as interesting case-studies since they can’t quite compete with a typical cloud based start-up which (can..) starts generating income within few months of existence – As Sramana did admit passingly, the logic of bootstrapping one’s business is a very different ball-game if the start-up product offering is physical (~biotech) as against being virtual (~SaaS)

Coming back to the book, I felt that what was perhaps intended to be showcased by the author but not quite articulated is an observation that ‘bootstrapping an early enterprise’ comes quite naturally to Indian entrepreneurs given the culturally ingrained reluctance to diluting ownership/ stake of a start-up business early on & the practical jugaad (in a fair sense) mind-set of sailing in two boats before hitching on to the one of choice.

Considering this being a cluster/ market dominated by such lean business ethos & relatively more fiscally-conservative entrepreneurial attitude which by default de-risk the investor’s moolah, one’d have expected India to be a hot destination for an alternate asset fund manager looking for a safe-harbour for her/ his precious dollars, but quite obviously it is not. Of course it is also apparent that there isn’t enough fish in the pond for any LP to develop a serious strategy betting on Indian start-up scene & perhaps the only way to make this ‘LP-friendly entrepreneurial ethic’ work in India’s favour at scale is to seed more & more promising enterprises, bootstrapped or otherwise.

Afterthought

Just wondering.... the Global LPs could be a lot more interested if the Indian VCs claim to be ‘Conservative’ rather than being ‘Contrarian’ in their choice of deals :-)

Wednesday, December 11, 2013

Crowdfunding good governance

Like many other educated, emancipated, intelligent, idealistic denizens out there, I too tended to avoid politics and considered the omnipresent, overt & covert culture of politicking the bane of this country – and this till I came across the cleansing potential of the broom and relished the realization that the eye-of-the-storm is the best vantage point for any one claiming to wanting to scrub-out the corrupt political typhoon & that staying on the fringes would have only increased the chances of their getting blown away.

Like many of the aforementioned illuminati, I too was cynical about what these Gandhi-capped, broom-wielding weirdos would achieve in their fanciful war against the high and mighty of the Indian political class – and this till I came across their online campaign to collect funds to fight the elections & the success of this Obama-like model that I never assumed will gain any traction in India.

Crowdfunding models fascinated me always and I’ve been tracking this model of enterprise creation and sporadically touched upon these aspects on my blog. While I can’t really prophesize on whether crowdfunding is indeed the paradigm-shift or is more a tectonic-shift in the entrepreneurial terrain, I’m but all sold on what the broom-wielders have demonstrated, the possibility of crowdfunding clean governance or more appropriately, the possibility of crowdfunding the promise of clean governance.

What kicks me up is the fact that in order to invest in this promising enterprise, I don’t need to be an accredited investor nor comply with the lower and upper limits of individual funding - What warms my cockles is the fact that I don’t need to bother measuring my returns in absolute quantitative terms and yet cherish the qualitative outcome. And what comforts me is the fact that my exit would also mean the exit of a stagnant enterprise & that would pave way for another cycle of funding a promise.

I like change, I love the promise of a change & now I dig crowdfunding the promise of a change.

Like hell, I-am-a-glass-is-half-full guy – Cynics, eat your heart out.


Disclaimers & Disclosures:
  • I have donated Rs.1000/- to AAP, against an email appeal received from Arvind Kejriwal, vide online transaction number 6996652 on 09 May 2013 15:33.
  • Neither I nor any members of my family, friends & acquaintances have contested the recently concluded Delhi elections nor any are members of AAP 

Thursday, November 21, 2013

Will Google deliver on the promise of a Uphone**?

A smart phone you can put together like one’d assemble Lego bricks?

When I looked up the Phonebloks link my niece sent, it all sounded quite phony (pun intended..) to me, a prejudice probably not helped by my ignorance & helped in a large measure by the prominent donate button on the blog-like website. I was cynical to the extent that I didn’t quite believe the site’s claim of Motorola collaborating with them, cross verified this on Motorola site and figured it’s indeed true – apologies Dave (Hakkens), my bad!!

I then stumbled upon Project Ara, a free, open hardware platform for creating highly modular smartphones which Motorola hopes will turn out to be the Android of Hardware. If I set aside the confusion of if Project Ara is a googlified version of Phonebloks OR if Motorola was indeed working on it for the past one year, as a user the concept of a modular phone that can be customized and reinvented unendingly does sound wow!

Then again, the whole promise is based on open source hardware development & the current phase of the collaboration seems to be still at the user level (Ara Scouts & Volunteers respectively). Assuming it’s rather early to expect the real collaboration of initiating projects to build the endoskeleton/ base & bloks/ modules to start, I’d still think before embarking on development & if indeed Google has to be successful in creating, in its own words, ‘a vibrant third-party developer ecosystem’ through project Ara, the more imminent need is for the creation of the right ecosystem that supports ‘open hardware development’.

Sure there seems to be some semblance of ecosystem out there wherein the open source hardware developers adapt/ use closely representative OSS licenses &/ or use hardware specific licenses like TAPR Open Hardware License. But given the massive commercial potential of the Project Ara & the implications and complications thereon, an open slot seems to exist for a specific purpose license that carefully addresses the scope & limitations of all applicable laws (patent, copyright, distribution et al) & standards and one that simultaneously enables collaboration and protects the commercial interests of the smallest member of the ecosystem - This responsibility I guess Google’s invited upon itself now.

Another possible challenge the previous generation of OS Incubators like Apache till date didn't have to worry too much about but Google/ Motorola will need to address proactively is the issue with potential for conflict of interest** owing to their mutually contrasting roles, one that of an investor funding (& thus part-owning) newer technologies of promising start-up enterprises & another, that of an impartial administrator/ incubator of an open development platform – while Android can be showcased as a precedent, I’m sure Google will admit hardware is a different devil altogether.

**I did a quick check on the portfolio companies of both Google ventures & Motorola Solutions Ventures but did not find any investment into any hardware start-ups – simultaneously reassuring and confounding J - what say Limor “Ladyada” Fried?

While I won’t certainly join the band of naysayers (like here..), I won’t hold my breath either - I will surely watch out though for the promise to materialize.

Afterthought

Why ARA?

Wikipedia offers two options 1) Ara, a southern constellation situated between Scorpius and Triangulum Australe AND 2) Ara, a neotropical genus of macaws with long striking tails, long narrow wings and vividly multi coloured plumage.

I choose Ara the Macaw, since this beautifully assembled by the primordial open-source development platform called evolution! & exotic creature sure looks like it could represent an assorted group of engineers putting together an equally assorted and exotic device. But knowing how project names work, Ara just can’t be a bird alone.. it should be an acronym too…… Android Rear-ending (into hardware) Alliance? :-)

---------------------------------------------------------------------------------------------
Disclaimer

**Uphone is a moniker I coined solely for the sake of using in this article that discusses the proposed modular smartphone from the recently launched Project Ara.

Tuesday, November 12, 2013

Much appreciated, Namaskaar!

I would be kidding if I say the thought never crosses my mind, it does too…..,

Like many, I’m privy to regular counsel on what’s actually right for me vis-à-vis’ what I feel is right for me. A lot of what comes my way is a casual reflection, some of it indeed is a studied observation and all of it out of genuine concern --- Like hell I’d like to believe, but didn't George Carlin say, it’s all about ‘their stuff is shit & my shit is stuff’? & the other way around?……..this is when the thought sweeps-in, of resorting to the very western gesture involving closing my fingers tightly & raising the middle one.

Then again equanimity trumps aggression and of late I’m tending to using more (mentally) this very eastern gesture of closing my palms together & raising them to my head - after all, Thyagaraja swami did say a long time ago, ‘endaro mahaanubhaavulu, andarikee vandanamulu’, to mean  ~Great souls galore, I salute them all.


                  /\
                 / I \
                /  II \
     -------/  /  \  \---------
 __________/   \____________

Sunday, November 10, 2013

So what's wrong if your drug-candidate is likely better-off as a dietary-supplement?

In a case-study, the Nov '13 issue of HBR showcases the dilemma of a R&D head grappling with the prospect of a failing clinical program & simultaneously a likely re-positioning of the candidate in question as a dietary supplement and asks its readers if the company should market it as a supplement.  The few 'responses' of some experts below the case-study expectedly range from saying aye to nay and in between.

Here's my response that I posted as a comment at the above link.

* I actually first accessed the full article through my Kindle subscription of HBR & not through the blog, hence the delay in my comment. 






------------------------------------------------------------------------------------------------------------------

Should Caliska market L-39 as a nutraceutical?.....

A unexpectedly simplistic question at the end of a rather complex case-study by Toby E. Stuart. The question would’ve been a lot more appropriate had the case-study focused more on Caliska’s capability & track-record in development, marketing of probiotics instead of giving it a passing mention.

The question is also inappropriate since the immediate decision is not about marketing, but is about developing – Since it has been established that the launch of L-39 as a nutraceutical/ dietary supplement/ medical food is at least a year or two away (two independent, placebo controlled, randomized trials), the question should’ve been “Should Caliska develop L-39 as a nutraceutical”?

Nonetheless, here’s what I have to say against original question;

My answer is a NO & YES!

NO --> Caliska should not market the current strain of L-39 since the translocation risk can prove a greater calamity in the uncontrolled scenario of nutritional supplements.

YES --> Caliska should eventually & simultaneously market L-39 as a nutraceutical too, the why, what & how of it is as follows;

      Why?
  • Few investigational drug candidates have the potential to be developed as a drug as well as a supplement & foregoing one against the other is sure a lost opportunity
  • Caliska’s primary strength & track-record seems to be that of (successfully) developing and marketing nutraceuticals while also understanding the rigors of the pharmaceutical development (the very same ‘split-personality’ Hilde took an unkind and unnecessary dig at…)
  • Given the super-high rates of clinical attrition in general & specifically for probiotics (quoted by the author in context of EMA never till date approving any probiotic as a therapeutic….) the odds of L-39, even as a new improved strain, of making it to the market are very low & it makes immense sense to let the consumer get some benefit of the scientific rigor that Genbac got to Caliska – If the plan-B for L-39 is a nutraceutical launch, the chances of Genbac’s science going waste are already minimized
  • Finally, the fortunes L-39 would bring in as a therapeutic are limited by admission
     What?
  • A new strain of L-39 that minimizes the risks associated with Bacterial Translocation (BT) – Since it’s a given that scope of translocation cannot be eliminated fully as it happens for most other native flora (within the gut) too when the subject is immunosuppressed, the developmental focus should be on the L-39's relative non-proliferative nature outside it's natural ecosystem.

     How?
  • Caliska should continue the current clinical program of L-39, while in parallel registering the dietary supplement  trials with European Food safety Authority.
  • The efforts of Hilde’s team at identifying the right strain will benefit both the trials above and that’s a good use of funds in these lean-times
  • Caliska’s plan for both the above trials should factor-in the possibility of they having to repeat whenever the strain under evaluation is found to be inadequate & Hilde’s team comes up with a better strain
  • Once some positive results are in place, Caliska should seek partners for the drug program with an intention to finance its trials (just drug not the supplement) & eventually out-license the same to the partner for marketing

Thursday, November 7, 2013

Les Propheties Pharmaceuticale : Prophesying on where the pharmaceutical outsourcing is headed

It is either an after-effect of all that powwow with the old-worldly Chippewa (the ‘real-Indians’, who aren’t Indian really ;-)) in the round house OR, it’s the paradoxical audacity stemming from my ironic inability to predict my own future!! - Either way…….,

......I have this compelling urge to play an oracle for once & mouth some prophecies!

My prophesying though is limited to pharmaceutical manufacture, outsourcing & is inspired by what’s going on right now all around in the pharmaceutical industry. While on first-look most of the recent happenings appear to be standalone in nature, there is a tangible pattern that isn’t too tough to decipher. My attempt is merely to speculate on what this pattern means for pharmaceutical manufacturing scenario, a few years from now, albeit a little prophetically.

Listed below are a some of my observations, statements & surmises (not still prophecies....), in no particular order, based on a handful but trend-indicative news alerts that I received over the past two weeks;
  • Big pharma shutting-down small molecule manufacturing sites but investing in Biologics facilities - Merck, Pfizer, Novartis, AstraZeneca etc in shutting-down mode & Roche, Genzyme (Sanofi) et al in investment spree
  • CMOs & Pharma companies scramble to strengthen ADC manufacturing capabilities in an apparent response to the visible thrust by drug developers to biologify (sic) unsuccessful small molecule candidates as ADCs & reposition them as targeted therapy candidates - SAFC, Lonza & Roche strengthening ADC capacities
  • Indications that compulsory license issuance in developing countries is driven more by ‘access to cost-effective first-line therapies’ than ‘access to later-generation therapies’  - Indian Patent office Upholding CL for Imatinib & rejecting CL application for Dasatinib
  • Federal complicity (vis-à-vis’ regulatory) with the innovator belief that biosimilar is an Oxymoron – The recent passage of SB-598 bill constraining use of biosimilars by State of California
  • Regulators mellowing, but playing-safe with approval of biosimilars? - The first ever biosimilar approval by EMEA is for Remicade (infliximab) indicated in the ‘relatively non-fatal” auto-immune disorders
  • Geographical re-alignment and consolidation of biosimilar manufacturing assets - Dr. Reddy’s  signing a deal for getting it’s biosimilars manufactured & marketed within the USA by Merck-Serono; Lonza’s scrapping of biosimilar venture with Teva and it’s going slow on India expansion; DSM launching a large-scale biosimilar facility in Australia et al
  • The increased focus of Big-pharma on having a lean & integrated supply chain for their off-patent assets – As indicated by the on-going race of backward-integration by formulation CMOs & forward integration by API CMOs
  • Drug Discovery & Development (primarily chemistry, biology & clinical) service providers progressively getting consolidated within NA, EU with clinical development centers in low-cost countries – As indicated by the flurry of activity each passing day
  • Clinical API synthesis tending to be retained within the shores by the partly to de-risk late-stage regulatory risks & mostly to engage residual in-house R&D facilities – As indicated by the outsourcing strategy adopted by most Big & Mid-sized pharma
  • Spurred-on by increasing regulatory wariness, high focus by the outsourcer' on ensuring supply chain integrity for key Intermediates and starting material for both marketed as well as developmental drugs – As indicated by the uncharacteristically massive press-coverage of  WuXi successfully facing a FDA pre-approval inspection for the ‘Intermediate’ of a new drug under review for approval



While the observations tell a story of their own, here’s my promised prophecy in the form of three quatrains, which very unlike the good old Nos’, I went about decoding myself – so much for my quest to be understood in my lifetime!

Quatrain 1


Decoded:
The Indian &/or Chinese CMO/ CDMO/ CROs will see the outsourcing getting limited to;
·        Manufacture of generic, low-tech (applicable to DP) small molecule, high volume & predominantly disease-maintenance/ management therapeutics (as against curative therapeutics)
·        Manufacture of (ideally integrated) potent, cytotoxic therapeutics    
·        Non-GMP/ GMP manufacture of key intermediates requiring large capacities/ ~ economies of scale of both patent-case & generic APIs for big/ mid-sized pharma
·        Large-scale manufacture of OTCs & Medicinal Products (components of med devices)
·        Early development (preclinical through PIII) of investigational drugs belonging to small/ mid & big-pharma (since this stage demands a lean-cost model)
·        Late-stage development (leading to NDA) of investigational drugs for small/ virtual biotechs
Quatrain 2

Decoded:
The North American, European CMO/ CDMO/ CROs will see the consolidation of the following opportunities in their favor;
·        Manufacture of Biologics, Biosimilars(authorized?)  
·        Manufacture of high-tech, specialty small-molecule APIs (ADCs, PDCs et al); formulations & devices
·        Late-stage development (leading to NDA) of investigational drugs for Mid & Large-sized pharma
·        Integrated Drug-discovery, development for Big pharma
Quatrain 3

Decoded:
Finally & a tad controversially – the Indian pharmaceutical players (& probably Chinese too) in general will aggressively pursue;
·        Compulsory licensing opportunities for the first-line therapies of small-molecule drugs for the NON-orphan disease segments
·        Biosimilar/ biogeneric development (for potential global alliances) and for eventual direct commercialization (with likely alliances again..) within India – with emphasis on curative biologics for non-fatal disease segments not addressed by small-molecule therapeutics    

As is evident, this list of predictions is by no means exhaustive & is only a brief compilation based on some core-opportunity types focused on within the outsourcing domain.

I know Nostradamus has more detractors than believers, so go ahead and flame me, I’m all game! ............ Only, make sure your rebuttals are in Quatrains too…., Just kidding :-)


    


Tuesday, October 15, 2013

Deal-Flow : Value-addition :: Silicon-rapids : Organic back-waters

Reacting to the rather weird scenario wherein some VCs are trashing their own brotherhood, Bruce Booth wonders in his latest article if this is an outcome of a Lake Wobegon-like illusion or if it is the Dunning-Kruger effect in action.

In my comment against this post, I offered my own little suggestion for this apparent case self-deprecation (OR is it not) and more....

My comment:
---------------------------------------------------------------------------------------------
If I go by what Mahendra Ramsinghani said here on LPs bothering more about deal sourcing capability than value-add by VCs, Khosla’s indictment of ‘95% zero-value add VCs’ shouldn’t really rock the boat more than the supposed shake-up caused by the AngelLists’ & Kickstarters’ of the world – The ‘80% negative-value-add’ rhetoric though is way below the belt & confounding.
Perhaps these intriguing proclamations are a manifestation of nervous energy of the PE biggies that are ‘but-of-course rattled too’ by the progressive warming of the PE globe and thus eager to reaffirm their value-add alternate asset investor status to the larger LP universe.
Can’t help but note again that a lot of the above paradigms, shake-ups, prophesies & reactions are all still relevant mostly to the 'silicon-rapids' (IT et al) and much less to the 'organic-back-waters' (~biotech) – taking a cue from what you said about the CEO, I’d think the loneliest job in the world at present probably is that of a biotech venture capitalist :-)


Wednesday, October 9, 2013

Isn't 'Syndicate' a worrisome term on an online crowd-funding platform?

A recent article by Lora Kolodny on Venture Capital Dispatch raises some interesting aspects on how VCs perceive the impact of likes of AngelList (online crowd funding platforms) on VCs - all but the potentially most impactful feature of investment 'Syndicates'
Below's my comment on the above article;   
--------------------------------------------------------------------------------
I was waiting for something on this – a much needed & timely insight.
It’s good to see all four VCs cautiously optimistic & none too worried about the online equity participation platforms impacting the role of a VC – couldn’t agree more!
From what has been said by the VCs, my key takeaways are as follows;
  1. Fundamental changes to the proprietary-deal-flow showcase of the VCs ~Rory Eakin, CircleUp
  1. The additional costs of investing associated with online platforms ~Annie Kadavy, Charles River Venture
  1. ‘Tragedy of the commons’ Risk – to mean the relative disengagement of investors owing to a portfolio comprising of multiple small investments ~Jeremy Liew, Lightspeed Venture Partners
  1. The risk of misreading or missing a signal by investors – owing to low signal to noise ratio of all online leads ~Alfred Lin, Sequoia Capital

While all these pose some but varying levels of risk, I feel the evolving ecosystem (of online equity platforms) will soon equalize the same & make the impact minimal.
One aspect that hasn’t been discussed is the potential risk of ‘investment bias’ stemming from the syndicate approach – which may inadvertently shift focus from a few worthy signals that already suffer a low S/N ratio - What say Alfred Lin (& AngelList)?

Wednesday, September 25, 2013

End of the day it's all about the Benjamins', impressive TVPIs not withstanding!

In a wake-up call of sorts, Super LP Chris Douvos cautions GP universe that end of the day it's 'all about the Benjamins', impressive TVPIs not withstanding!...

'tis the central dogma of investing alright, but still leaves enough scope for a small repartee of my own - here goes;







My comment
---------------------------------------------------------------------------------------------
Not sure if it’s a norm, but it’d surely surprise me if the GP takes an investment call in a particular portfolio company without as much as doing a cursory review of its exit potential & potential exit valuation – they probably do too, but don’t necessarily assign a value, given the magnitude of arbitrariness in doing so. It hence is somewhat ironic that the exit valuation in this model is merely a derivative of the overall size/ value of the fund raised by the VC and doesn’t factor-in anything that’d determine the potential of an individual investee enterprise – confounding this  further is the VC having to justify this derived value.

So while the proposed analysis does sound like a non-nonsense approach to assessing the fund performance, that part about “reality checking those putative outcomes” would still remain the single most challenging & expectedly the most contentious aspect even as LP-GP engage with an intent to cracking the funding arithmetic.

Nonetheless, it’s good to be reminded that for all practical reasons the sum of individual valuations of portfolio companies in a particular fund is but an unexciting statistic to the PE Portfolio manager in the LP organization keen on showcasing something akin to the promise of an ‘absolute return’ his hedge-fund counterpart typically presents :-)

We are all just prisoners here, of our own device!

Where does this notion that every mild ache or pain might be the harbinger of something particularly nasty, or even fatal, come from? asks drug baron in a recent post pondering on the Origins of Hypochondria

Since hypochondriacs too are prisoners of their own device**, I wondered in my comment if one can choose a device of well-being than of ill-health...
**Thank you Eagles, for penning such profound lyrics (and of course out-of-the-world music...) one can interpret in a zillion ways & still love.
My Comment
---------------------------------------------------------------------------------------------
A brave admission and a sound rationale...
Psychologically speaking…,
I'll try and link the three plausible reasons stated for being a hypochondriac to three personality types using the widely known MBTI system;

Domain Knowledge & (over)Exposure to Information - THE THINKER (INTP)
........applies knowledge & available information to connect the dots and map the domains - and at times create phantoms

(Supreme) Self-Confidence - THE SCIENTIST (INTJ)
.........pragmatic, believes in things that can be explained through well validated scientific rationale - at times negating viable but unsubstantiated dogmas

An Entrepreneurial Spirit - THE DOER (ESTP)
..........the risk-taker who's not always a conformer & who takes things into own hands with an intention of chasing the desired outcome - at times not reaching the goal

Probably being a hypochondriac is an outcome of the incremental edge the SCIENTIST has over the DOER in a quest set-out by the THINKER. What could probably change the equation is spooning-in a dollop of a few other personalities from the 14 others to choose from :-) (MBTI types again)
Physiologically speaking…,
I think though that one needs to believe in things for them to work for them - particularly so in matters of health & well-being! If the SCIENTIST questions how?, I'd try saying that since most disease conditions are manifestations of biochemical & ion-channel imbalances & brain plays a understandably important role, influencing the thought/ brain is perhaps important too as medicine is? Perhaps, there’s some rationale behind why placebo's routinely give new drug candidates a run for their money when it comes to efficacy?
Hippocrates did say... "Men ought to know that from nothing else but the brain come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentations”
Just perhaps.... he also meant to include disease?

Thursday, September 12, 2013

Ambrosia for food, Palm-top engagement, Iterative decision making – A preview into evolving expectations of the healthcare consumer

Understanding consumer preferences has always been of paramount importance in most product segments. Within the pharmaceutical domain however even as there’s a constant ideation, speculation on future of healthcare; outlook on disease incidence, burden and pharmaceutical consumption patterns, this particular aspect has not been focused on, possibly owing to the prescriptive nature of the medicine where decision-making seldom lies with the patient & the power to influence product development lies more with the medical professionals & payers. To an extent this disengagement of consumer does justify the disinterest of Industry to understanding the consumer as against understanding the prescriber & the payer/ insurer.

Having said that, a number of disorders these days are getting close to being categorized as lifestyle-diseases & with early detection, diagnosis and routine monitoring getting simpler, it’s only imminent that the insurer will increasingly resort to rationalizing what treatment-regimens can be covered thus significantly shifting the onus of payment to consumer. Then again, owing to the abundance of open-source information and availability of validated healthcare gamification apps, the consumer is getting more knowledgeable & hence empowered. Seen together, these trends indicate that the average pharmaceutical consumer is well poised to be the key decision-maker on therapeutic choices, particularly on maintenance therapies that form a predominant portion (vis-à-vis’ the curative therapies) of all pharmaceutical revenues.

It also hence would not be overtly speculative to state that the hitherto quintessential practitioner-dependent healthcare consumer is evolving quick & is looking at an iterative role for her/ him-self rather than merely wanting to being ‘prescribed health’, literally & figuratively. Continued negligence of factoring-in consumer behaviour in the product development process can thus be a serious lapse of judgement in an industry that’s been groping around for the next paradigm shift for a few years now.

The Health 2025 survey I floated in early July is a token attempt to gain some basic perspective into the altering behaviour of an ‘aware pharmaceutical consumer’ which I hope either in its promise OR in its inadequacy will instigate more such studies in-depth and at a larger scale. While I can’t claim to have gotten a great number of responses, I fortunately received quality responses (& some incidental endorsement*) as indicated by consistency of the trend that was showing up right from early stages to till plateauing of response flow.

Even as I was compiling the final results I came across this rather well received fund raising pitch of Stefan Broda (Founder/CEO of BeforeWeDo) at the end of which one particular GP lauded the Consumer Iteration built into the business model which is worth emulating by other healthcare start-ups! – If not a sign from the heavens, a sweet coincidence nonetheless.

SAMPLE POPULATION, STATISTICAL ASSUMPTIONS & SURVEY DESIGN

I chose the sample population of pharmaceutical professionals who I believe are very representative of the above breed of ‘aware pharmaceutical consumers’ & to whom I have ready access through the Pharmaceutical Discussion Group I founded and manage on Linkedin & Groupsite.

Based on a guestimate of ~5million pharmaceutical professionals world-wide, I derived my target sample size as 350, using a Confidence level of 95%, which is the mostly used default level & a Confidence interval of 5, which again is the oft-employed default figure. By the time I chose to start the compilation (the survey is still active) I however had only 159 responses which translated amount to a confidence interval of 7.7 while the confidence level remains at 95% - That, I guess is my cue to you for taking the results with a pinch of salt :-)

Finally, I am neither a professional statistician nor a qualified analyst and it’s likely the design of survey may not fully please many out there. I however did consciously try and keep the questionnaire short, the questions specific & the choice of answers broad in order to minimize any chance of a bias setting-in – the trends indicated by the responses, as I see, justify some if not all questions.

PRESENTATION OF RESULTS, ANALYSIS

The survey is based on ten questions out of which the first three are essentially filters namely age, sex & nationality that enable some level of demographic segmentation of responses. While the charts of responses to individual questions looked very pretty on Surveymonkey dash-board, I agonized nonetheless quite a bit deciding on an ideal approach to presenting the results on my blog without sounding too pedagogic – I hence chose to weave the details around certain KEY OBSERVATIONS and then go about detailing on those further.

Since it may help put things in perspective, I have uploaded the primary results document* to file cabinet on Pharmaceutical Discussion Group – please note that this link opens the document only when you are logged in, (i.e. if not a member already, you will have to join the group)

**I’ll be happy to share the master data file too with anyone interested.

KEY OBSERVATIONS

In hindsight I realize some of the questions are pretty skewed & some fairly meaningful, but overall they seemed to fall in two broad categories, one set wherein the standalone overall response is itself strongly indicative of a trend & a second set wherein an interesting picture emerges only when the responses are separated out and compared across demographics. I however will spare the mundane trends and go straight to top observations based on the percentage response towards a trend-indicating response;

I.
Not just food, Ambrosia is what the consumer wants - a huge thumbs-up for Functional Foods!

Quite ironic that the top trend in a health survey is food & not medicine! - A whopping 87% of the respondents see/ want the food in 2025 to be more than nutrition, out of which 46% see a potential for food being a curative!








Women make up the majority of the ‘food as a curative’ advocates (60% as against 30% among men) – which simultaneously underscores & endorses the greater influence of women in the functional food promise.







More Indians (56%) believe in the promise of curative food than the North Americans (40%) or Europeans (44%) – a possible connection to the expectations influenced by prevailing, predominant ethno-cultural dietary practises?








II.
Consumers want to take things into their hands, literally – Mobile Health Tools all set to Rule

At 68%, a clear majority of the respondents are bullish on the role & significance of personal mobile apps in an individual’s health management. (25%, Indispensable & 43%, Very crucial)









Once again this is a trend driven primarily by women, the percentage of women who chose ‘Indispensable’ (40%) being significantly higher than the men, a majority of whom (67%) chose the mildly-tempered but still bullish, ‘Very crucial’ as their answer. This clearly establishes women as the ‘early adaptors of the health mobile tools & apps’ & possibly that mobile apps are more amenable to woman’s health management and finally that factoring-in gender into the development of a mobile healthcare app can be a key determiner of the success of the same.


When the Geography filter is applied, the trend expectedly peaks in North America with an overall bullish-ness at 76% - within which women once again stand-out strongly with 55% responding ‘Indispensable’. The dominant European response is however ‘Very crucial’ (60%) which probably indicates a currently lower penetration of mobile health apps within this geography – this holds good for India too.



III.

They seem to say, keep the Doctor away – Eating an apple isn't the only way

While the question has some unfortunate bias & choice of ‘You’ sounds like a given…, the responses still indicate an increasing role for non-physician health professionals. If the choice of ‘You’ (53%) is ignored, only 12% see the physician playing the single most crucial role towards an individual’s health much below the diagnostician at 18%.






There’s an interesting contrast in choice of physician v/s diagnostician among the female & male respondents’ viz., Female: 7% (P) v/s 21% (D) & Male: 14% (P) v/s 16% (D) – probably again owing to the essential nature of women’s health issues vis-à-vis’ male issues – nonetheless, a potentially important alert to the healthcare industry.

In-line with the number one trend above, the nutritionist polled 10% of the vote. Quite surprisingly, of all respondents who chose Nutritionist, 70% belong to the age group of 35-44 yrs. This read together with the first trend gives a great demographic insight into who could be the prime target demographic segment for promoting functional foods – Women between the age group of 35-44.






NOT-SO-KEY OBSERVATIONS

Apart from the above three observations, the rest of the observations though interesting aren’t necessarily great insights into the health consumer psyche - the same are listed below in no specific order;

  • 78% of the respondents feel medicines should target cure as against 22% that are okay with maintenance – expectedly, the 78% group is populated majorly with people under 55 years of age.
  • 87% of the respondents prefer oral medications to parenterals – Interestingly though, there’s a strong geographical variation with NA & EU preferring oral medications at 92%, while the Indian respondents still retain some of the cultural trust of ‘injections’ (26%) 
  • 89% of all respondents still believe the necessity of medicines per se’ in-spite or despite the preference of the ambrosial foods – if anything, this seems to showcase the omnipresence of the pills.


While the results may not qualify as astonishing findings, the unmistakable relevance of the trends thrown up by a mere seven-question survey still underscores the value of understanding the health consumer’s perspective and using the knowledge to build, refine the road-map of pharmaceutical product development.

Functional Food for thought! :-)