The document discusses opportunities for diabetes management and treatment in India. It begins with background on the growing diabetes problem in India and low awareness levels. It then provides an overview of the competitive landscape for diabetes treatment companies in India, analyzing companies like Accu-Chek and Abbott. Finally, it recommends several innovations for diabetes management, including creating an online diabetes management portal and implementing behavioral science approaches to encourage sustainable behavior change among Indians for better diabetes self-management. The portal would provide resources for both healthcare professionals and consumers to support diabetes treatment and education.

1. The India Opportunity
Bayer Diabetes
August 2011

2. 2
Dr. Harshit Jain MD, MBA
Senior Vice President – Strategy Development,
VIA MEDIA GROUP
Senior Vice President -Strategy at Via Media & Communications, a
comprehensive Healthcare Communications organization based in
India. He advises the brand management of over 25 brands for
various multinational pharmaceutical and consumer healthcare
clients. Dr. Jain is former VP of Altruista Health, a health services
and technology company based in Reston, Virginia. His experience
and expertise extends across a wide range of areas including brand
management, establishment of SBUs, healthcare communications,
health insurance, disease management, direct clinical care, and
health program/benefits design. Dr. Jain completed his medical
training from University College of Medical Sciences and also has a
Masters in Business Administration from the Indian Institute of
Management.

3. 3
AGENDA
§ SECTION I – Background
§ SECTION II – Competitive Intelligence
• AccuChek
• Abbott Diabetes Care
• Lifescan
§ SECTION III – New Innovations Recommended
§ Questions and Answers

4. SECTION I: Background – Market in India
4

5. High Prevalence But Relatively Low Awareness…
5
Source: IMRB. The study was done in Oct 2010 for Novo-Nordisk in 6 cities: Bangalore, Chennai, Ahmedabad, Delhi, Kolkata
and Mumbai (600 respondents in the age group 35-60 years)
60% of urban Indians unaware that
uncontrolled diabetes affects
primary organs like the heart, eyes,
kidneys etc.
Half of the respondents (who did not
have diabetes) felt that they would
never get it..
About one fifth of the respondents
regarded obesity as the primary
cause of diabetes
About one fifth of the respondents
maintained that diabetes is primarily
inherited
> 28% of the respondents undergo
regular Blood Glucose Monitoring if
they have the disease
The survey showed that Delhi has
the highest (49%) instance of family
history of diabetes..
73% in Mumbai found to be
diabetic…88% of non-diabetics are
ignorant about blood sugar levels

6. India, Along with China and the United States, Have the Highest
Diabetic Population
6
2008: 46.4 Million
2010: 51.8 Million
Ø Age
Ø Obesity
Ø Improved screening/diagnostic procedures
Ø Increase in more sedentary lifestyles
Source: IDF Diabetes Atlas 4th ed. © International Diabetes Federation, 2009
§ <400,000
§ 400,000 -
§ 1,000,000 -
§ 3,000,000 -
§ 6,000,000 -
§ >= 25,000,000
Number of people with diabetes, 2010

7. Diabetes Stats By Demographics
7Source: NFHS - 3
Background characteristic
(# per 100,000) Female Male
Background characteristic
(# per 100,000) Female Male
Affects all ages but
the condition’s
prevalence
increases with age
(@ 5% level in
35-49 years group)
While the condition cuts across income
classes, the prevalence is significantly
higher in the upper quintile
The condition’s prevalence is similar
between genders but marginally higher
for men
While the disorder
is skewed towards
the urban
population, the
ratio of 2:1
suggests growing
prevalence in rural
areas

8. Regional Prevalence
8
2002-20071996-2001
Source: WHO India

9. Self Monitoring of Blood Glucose (SMBG)
KEY FACTORS
Availability
■ Meters are available in larger cities only and their cost
is out of reach of a majority of diabetics in India
where, the cost of health care is borne by the patient
Affordability
■ Those who can afford should buy a ‘Glucometer' and
those who cannot should use the test strips by visual
comparison which gives an approximate (but clinically
useful) result of blood glucose
Awareness
■ The inadequate knowledge of clinicians is one of the
primary reasons for late detection of diabetes and
poor disease monitoring
■ Amongst consumers, there is a lack of awareness
regarding the complications of diabetes and the
benefits of regular monitoring
Over 22% in WEST
GPs tend to treat large numbers of diabetics in India
however, companies have neglected this section and
concentrated on specialists
Ref: Frost & Sullivan 2010 Report 9
SMBG Market (India)
§ 0.3% of Diabetics use SMBG
§ Over 95% Market still untapped
§ 0.1% of the Type 1 Diabetes uses SMBG
§ 0001% of the Type 2 Diabetes uses SMBG
More than 95% still
untapped

10. Market Trends & Consumer Behavior
■ There is a shift in consumer mindset towards preventive medicine. The rise in income
levels and the simultaneous increase in the diabetic population will also go a long way in
augmenting the sales of these products
■ Self-monitoring of Blood Glucose Systems Market in India, finds that the market earned
revenues of $49.7 million in 2009 and is expected to grow at a CAGR of 17.4 percent in
the next five to six years
■ Innovative marketing campaigns to
l Educate clinicians and end-users about the benefits of monitoring diabetes
l Attractive offers to distributors, retailers, and end-users
l Substantial price cuts for meters
are likely to give a leg up to the INR 1.4 billion glucose meters and strips market.
■ As Indian consumers are not well aware of the benefits of various features offered in a
glucose meter, purchase decisions are influenced by retailers and/or clinician
recommendations
Ref: Frost & Sullivan & PwC Reports - 2011 10

11. SECTION II: Competitive Intelligence
11

12. SWOT Analysis
12
• Emergence of
New and Bigger
Players Vying for
Market Share
• Strategic Alliances
• Changing
Leadership
• Non Sustenance of
Initiatives
• Long Hierarchical
Process
• Trust & Branding
with Consumers
• Unique Consumer
Initiatives
• Relationship with
Trade / Retailers
STRENGTH WEAKNESS
THREATOPPORTUNITY

13. DIABETES CHECK UP CAMPS - TRADE / RETAILER
13
■ Excellent engagement
activity to reach directly to
consumers
■ 75 Field Representatives
conduct Awareness Camps
every Saturday in their
coverage zones
■ Turnout of 35 targeted
audience / camp / rep
■ Total estimated consumer
reach = 75*35*4 = 10,500 /
month
RETAILER
Better
Customer
Retention

14. Movie – Special Screening for Children
14
■ 70 minute feature film on
Childhood Diabetes
■ Innovative tool for behavior
change
■ Premiered on Nov 13, 2010
■ Now showcased in schools
across the country in partnership
with non-government
organizations , state government
departments

15. Strategic Alliances
15
MANKIND PHARMA
■ Roche Diagnostics and Mankind Pharma recently announced an exclusive marketing and
distribution agreement in India wherein the latter will undertake marketing and distribution
activities for 'Accu-Chek Go', a newly launched blood glucose monitoring device by Roche
Diagnostics
■ With Mankind's strong distribution and marketing force, Accu-Chek Go will be available
across 500 cities in India. The purpose of this co-operation is to raise awareness for
diabetes and to spread the message of self-monitoring in Indian homes
BRITANNIA NUTRICHOICE – IN PROCESS
■ Nutrition partner for all diabetes awareness related activities with doctors , retailers
■ Sharing of ad expenditure
■ Joint pack promotion opportunities

16. • Price war
• Government /
Institutes – time
consuming
• Government
Business – HUGE
• Tier II & tier III cities
• Small team in India
• Expansion plan not
clear – with
consumers / doctors
• Institutional /
hospital relations
• Government
relations with the
biggest contract on
diabetes
screening
STRENGTH WEAKNESS
THREATOPPORTUNITY
SWOT Analysis
16

17. National Programme for the Prevention & Control of Cancer,
Diabetes, Cardiovascular Disease, & Stroke – NPCDCS
17
■ Abbott awarded the first ever NPCDCS
tender for the supply of glucometers &
consumables in Oct. 2010
■ Pilot project of 1 year valued at Rs 10 Cr.
■ 21 states & 30 districts
■ Excellent opportunity to explore market at
small towns
■ Offer training to health workers on blood
glucose
■ Working towards positioning itself as
“Preferred Partner of Choice” with the key
relevant stakeholders
STATE DISTRICT
Andhra Pradesh Nellore
Vijayanagaram
Assam Dibrugarh
Jorhat
Bihar Vaishali
Rohtas
Chhattisgarh Bilaspur
Jharkhand Bokaro
Madhya Pradedsh Ratlam
Maharastra Washim
Wardha
Sikkim East Sikkim
Orissa Naupada
West Bengal Darjeeling
Gujarat Gandhinagar
Surendranagar
Haryana Mewat
Himachal Pradesh Chamba
J & K Leh (Ladakh)
Udhampur
Punjab Bhatinda
Rajasthan Bhilwara
Jaisalmer
Uttarkhand Nainital
Uttar Pradesh Rae Bareli
Sultanpur
Karnataka Shimoga
Kolar
Kerala Pathanathitta
Tamilnadu Theni

18. In Discussion For Exploring The Direct Consumer Market
18
■ After becoming leaders in institutional sales, Abbott is working towards entering the
consumer market
■ Exploring with various partners and channels to establish as a brand amongst consumers
■ No public action yet

19. SWOT Analysis
19
• Price wars
• Competition
• Doctors –
competitors
realizing the
Importance
• Childhood diabetes
care
• Saturation
• Consumer equation
– relatively weak
• Relationship &
equity with doctors
• J & J brand with
doctors
STRENGTH WEAKNESS
THREATOPPORTUNITY

20. HCP Focus – General Physician
20
■ Very strong equation with specialists
■ More focused efforts on building relationship with general physicians
■ No significant innovations noticed

21. SECTION III: New Innovations Recommended
21

22. Product Lifecycle
22
PRODUCT
DEVELOPMENT
INTRODUCTION
GROWTH
MATURITY
DECLINE
ü Sales – RISING
ü Cost per customer – AVERAGE
ü Profits – RISING
ü Target Audience – EARLY ADOPTERS
ü Competition – GROWING
DISTRIBUTION
TARGETTED
PROMOTION
PRICING
4 P’s of Marketing
1. Product
2. Price
3. Promotion
4. Place

23. Recommended Aproach
23
• Bayer loyalty
program
• Online interactive
portal
• Partnership with
Diabetes India
• World Diabetes Day
- 2011
• Online interactive
portal
• Cross promotions
& partnerships
• Online interactive
portal
• Certificate training
programs
• MDG advocacy
campaign
Health Care
Practitioner
Institution
Trade /
Retailer
Consumer

24. Consumer
Healthcare
Practitioner
Institution
/ Cross
Partner
Online
Interactive
Portal
24

25. Background
25
The prevalence of diabetes/ other lifestyle related diseases is increasing globally and the
prevalence in India is a growing concern
Research Insight
■ Non-healthy choices are tempting and it requires considerable effort to resist cravings for
unhealthy foods and to make time for exercise. The required amount of effort increases
as people perceive more freedom to choose whether or not to have the unhealthy option,
and stress may make it more difficult to exert this effort
■ People have conflicting attitudes to healthy options or practices – they know healthy
options are good for them, but find them unattractive or difficult. This ambivalence could
cause health information to backfire
■ Non-conscious attitudes are important because people often possess feelings that they
are unable to retrieve from their memories, or are unwilling to admit to others. These
non-conscious attitudes may be particularly important causes of spontaneous, unhealthy
behaviors
■ People take the importance of their health for granted and are unable to explain why they
value it. This may change only when they suffer a heart attack or other serious illness
that gives them good reason to seek better health
■ Proactive Management of Health – Completely Missing from Indian Scenario

26. Behavior Modification for Better Diabetic Disease Management
26
■ The treatment of choice for diabetes patients is the combination of medical management
& diet, exercise, and behavior modification.
■ Since behavior modification is a key component of all chronic disease management
approaches, this assumes a critical importance in the long term goal of the campaign
detailed in this presentation
■ Behavioral approaches to diabetes management are based on three assumptions:
l Eating and exercise behaviors are related to body weight
l Regular monitoring and tracking of blood glucose is important
l And that behaviors can be modified by changing both the antecedents that come
before the behavior and lead to its occurrence, and the consequences, or re-
enforcers, that come after the behavior which increase its frequency
Rena R Wing,PhD, Professor of Psychiatry and Human Behavior, Brown Medical School. Endotext.org

27. If You Want to Change Behavior, Change the Mindset
27

28. The Philosophy
28
CREDIBLE
INFORMATION FLOW
BEHAVIORAL SCIENCES
Science
Sustainable
Behavior
Modification
§ The aim is to stimulate a sustainable behavior change in Indians with respect to
diabetes management
§ The proposed process would be to use ‘Science’ (evidence based medicine) in a
manner that is understood and acceptable by common man to change the
attitude and behavior with regards to better diabetes management

29. Concept – The Behavioral Approach
■ Behavioral approaches for diabetes / other risk factors management involve:
l Developing specific and realistic goals that can be easily measured (e.g. fasting blood sugar level,
walking for 20 minutes, three times per week)
l Developing a reasonable plan for reaching those goals
l Making incremental changes (rather than large changes) to promote successful experiences which
can be used as a foundation for additional lifestyle alterations
■ Monitoring the behaviors
l Food & exercise journal
l Daily, monthly, quarterly blood glucose journal
■ Changing antecedents
l Behavioral approaches assume that the environment is an important determinant of behavior
l Eating and exercise behaviors can be influenced by social cues (the behaviors or attitudes of others
around the person)
■ Changing consequences / re-enforcers
l Increasing re-enforcers for new and appropriate behaviors
l Recognize small positive changes in behavior to be rewarded verbally or with small tangible rewards
for the progress
29

30. DIABETES
MANAGEMENT
PORTAL
HCP
Partnership with
Diabetes
Centers in
Hospitals
Behavior
Management
Workshops for
Dietitians
Certificate
Training
Courses for
General
Physicians
Continuing
Medical
Education
Series
CONSUMER
Diabetic
Education
Camps
Mass
Awareness &
Mention on
Packs
Diabetes Management Portal

31. Online Diabetes Management Program
31
■ Create a portal that is clearly focused on “diabetes management”
Specific identity to be created:
■ Totally focused on “diabetes”
■ Creates and maintains a clear brand identity
■ In line with and takes forward the pyramid of influence

32. Digital Interface
32
ª Healthcare Professionals
ª Registry
ª Training / Education
ª Resources / Tools
ª Updates
ª News
ª Case Studies
ª Feedback Channel
ª Consumers
ª Online Diabetes
Management Program
ª Information
ª News
ª Guides
ª Testimonials
ª Profile in Focus
HEALTHCARE
PROFESSIONALS CONSUMERS

33. Program Specific Features
33
■ This program would provide guidelines for the registered profiles for a diabetes
management plan
■ Each plan would be customized to each individual
■ Users would have the option to regularly (weekly or biweekly) update their
information into their campaign profile
■ The program would then provide feedback, recommendations and updates on
how the person is progressing
■ Users would be able to see trends of other users and how they benefitted from
the program (no names and personal information – just trends)
■ Program users would also have access to all existing features of the site:
l Community forum (message boards)
l Share my stories
l Get special advice (ask an expert)
l Access to diet charts (matched and customized)
l Notifications and alerts
l Toll-free helpline – to speak to counselors

34. Diabetes Registry
■ A registry is a database (register) to capture demographic or clinical data of
defined patients or people
Types of registries –
l Drug/Device registry: Includes subjects receiving the drug or device regardless
of indication
l Disease registry: Includes patients with the disease regardless of drug or device
exposure
■ Objectives of Registry
l Disease epidemiology (incidence, demography)
l Evaluate treatment availability, effectiveness, safety
l Outcomes research – prognosis, cost effectiveness, etc.
l Technology assessment
l Clinical audit
l Support clinical trial/ clinical research
■ Benefits of Registry Program
l Epidemiological data (Indian data)
l Outcomes research – intervention, prognosis, etc.
l National and international publications

35. Program-Specific Features
35
§ Diet charts and recipes would be available
under the following categories
§ Regional (states and territories)
§ Types (vegetarian / non-vegetarian)
§ Gender (women / men) [applicable to diets]
§ Once a user reaches this section, the user
would be presented an interactive Graphic
User Interface (GUI) that works through a map
of India
MY NUMBER TRACKER
§ Ability to view numbers over a period of time
§ Possible associations with related factors
§ Relationship with other body functions
MY FOOD MY WAY
§ This section will include diets and recipes that are adaptions of traditional Indian diets
with minor modifications to make them low fat, high protein, high in fiber and low GI

36. Analyze yourself
Set your goals
Get started
Connect
Share
Track
Achieve
Recommend
Profile, calculators, experts, call for advice, etc.
Identify goals, timelines, personalized plan, etc.
Generic and customized diets, recipes and
management plans
HCPs, motivators and counselors, community,
experts, peer group
Successes, failures, challenges, queries, answers,
experiences
Progress charting, status, alerts, reminders, check/
motivate/counsel
Goals vs. achievement, success, gratification and
incentives
Testimonials, tell the world – “I made it”, etc.
Program Flow
36

37. Call 1800 XYZ 1235
Identify the
Need
Provide
solutions
Support
and
Motivate
Engagement Platform
37

38. Other User Centric Features
38
■ Expert panel to include
l Behavioral experts
l Diabetes management counselors
■ Consumer connect programs
l Toll- free number
l My food my way
l Interpret my numbers
l A doctor near me
l Additional interactive features
– Quizzes
– Polls
– My stories

39. Prospective Partners
39
■ Health Insurance Organizations
■ Fitness / Wellness Centers
■ Diagnostic Laboratories
■ Hospitals
■ Consumer Healthcare - NUTRITION

40. Certificate Training Programs ( ONLINE + OFFLINE )
40
■ Diabetes educator program – dietitian + nurses
■ Online fellow in diabetes care – general physician à expert in diabetes care

41. LOYALTY PROGRAM
Retailer /
Pharmacist
Sales Force
Consumer
Institution /
Cross
Partner
41

42. Retailer Loyalty Program
42
Objectives
l Consolidate relationship with trade / retail to increase Bayer loyalty & sustain its
leadership position
l Retail development
l Blocking competition
l Enhance noise level in market
l Expand POS advertising

43. Program Structure & Benefits
43
ü Branded loyalty card for
consumers
ü Discounts on Bayer
products
ü Discounted wellness
packages at GYMs
ü 25% discount at diagnostics
for check ups
ü To be given to pharmacists
for passing on to their
diabetic customers
ü Membership of the diabetes
wellness portal
ü Others
ü Branding at the retail store
ü Value addition to the
existing customer –
improved retention
ü Extra source of
income – 10% of the
amount spent on
diagnostics
ü Special camps for
membership card
holders families
ü More stocks of Bayer
products
ü Save money on
regular disease
expense
ü Confidence
building
BENEFITS
§ Trade Activation
§ Sales Force Motivation
§ Increased Sales
§ POS Branding
§ Customer Retention

44. &
44

45. Diagnostics
45
■ Awareness campaigns on World Diabetes Day or any other time of the year – 100%
Targeted REACH
l Branded campaign material – brochures , standees , banners etc.
■ Collaborated corporate wellness programs
■ Loyalty card partner
■ Online interactive platform partner & improved REACH

46. Nutrition
46
■ Reduced spend on consumer advertising – sharing of media & spend
■ Utilizing nutrition sample as an input for the field team
■ Expanding reach through the combination of both field forces
■ Partner in the online engagement platform and provide nutritional expertise
■ Nutrition as a subject is able to attract more consumers’ attention
■ No conflict of interest

47. Pharmaceutical
47
■ Cross promotion through field forces , helps in expanding reach and number of doctors
■ Input utilization
■ More ambassadors for the brand
■ Any non conflicting organization

48. 2011
48

49. MILLENIUM DEVELOPMENT GOALS ADVOCACY
49
■ MDG - The Millennium Development Goals (MDGs) are 08 international development
goals that all 192 United Nations member states and at least 23 international organizations
have agreed to achieve by the year 2015
■ They include eradicating extreme poverty, reducing child mortality rates, fighting
disease epidemics such as AIDS, and developing a global partnership for development
■ A huge global advocacy campaign for inclusion of NCD in Millennium Development Goals
is going on
India – Once World’s Diabetes Capital – No Efforts in India yet
OUR OBJECTIVE
UNITE KEY OPINION LEADERS & DECISION MAKERS & PRESENT RECOMMENDATION
CONSENSUS FOR INCLUDING DIABETES AS A PART OF MDG
FOCUSED ON DIABETES, NOT TAKING INTO ACCOUNT OTHER NCDs

50. 50
Advisory
committee
Recommendation
consensus
Signature
endorsement
campaign with
doctor & key
opinion leaders
Presentation of
recommendations to
the MDG Committee
in New York

51. Summary
51
Consumer
CHEMIST /
RETAILER
HEALTHCARE
PRACTITIONER
HOSPITAL /
INSTITUTION
ONLINE INTERACTIVE
PORTAL
BAYER LOYALTY
PROGRAM
CROSS PARTNER /
PROMOTION
WORLD DIABETES DAY -
2011

52. Questions & Answers
52