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Launch Plan: Monocryl Plus
On a warm Monday afternoon in August 07, Amit Goswami the marketing manger synthetic
absorbable sutures in the Ethicon Business of J&J Medical India was worried about a new
product launch. Waiting outside the MDs office he was reviewing his pitch to New Brunswick
managers that was to be cleared with the MD of J&J Medical India first.
J&J Medical is into many invasive and non invasive diagnostic and healthcare solutions
providing businesses. (See annexure 1)
New Brunswick (Global J&J headquarters) wanted a quick plan for launch of Monocryl plus, a
new innovation in the existing Monocryl suture. Sutures primarily are closure products used to
close incisions made by surgeons and/or accidental wounds.
The Monocryl suture was launched some ten years back for skin closure and had not been as
successful in India as it was in other parts of the world. Though ready with the plan, Amit was
worried what would happen to the brand extension of a product which had already received a
lukewarm response from Indian Surgeons.
This plan had been prepared with help of external consultants. For the purpose of this case,
kindly assume that you are that consultant.
To prepare a quick launch plan for the new Monocryl Plus suture.
Nuts and bolts:
Ethicon has been the global leader in the wound closure business and India was no different.
But as of the last 10 years sutures were fast becoming a commoditized category. Many new
“compromised quality/low cost” producers had entered into the market. The compromised
quality raw material (threads and needles) was easy to produce and due to low internal
quality benchmarks/ low overheads the competition was able to sell the finished goods at
nearly half the price of Ethicon products.
There had also been an additional problem of Chinese Imports hitting Indian hospitals.
The mainstay brand Vicryl (contributing to 40% of Suture top line) was under threat.
Then three years back a new innovation “Vicryl Plus” with additional antibacterial coating had
been launched. In 3 years Ethicon team had converted 18% of Vicryl users to plus. This was
Ethicon’s reply to the low cost threat to Vicryl. “Move the surgeon higher on the benefit
ladder rather than competing on cost and hence keeping the value intact.” Said Amit
Goswami. The whole sales team is really upbeat about the plus platform due to the recent
success of Vicryl plus.
Having taken the credit (and a good bonus) for Vicryl Plus success Amit was thinking whether
the same strategy would work for Monocryl. Market realities for Vicryl and Monocryl were
very different. Vicryl was a 80 crore product and Monocryl had just reached 3 crores in 10
years. Also Vicryl was used for many layers closure (Skin,fat,fascia) in nearly every specialty
and Monocryl was popular only with plastic surgeons for great cosmetic effect on skin during
With a smaller playing field even if we upgrade 100% of existing Monocryl users, will a 3 cr
topline justify a new product? We need new applications/new markets/new surgical
specialties for this product, said Amit talking to himself.
Vicryl had been popular across private hospitals, government hospitals and nursing homes.
Amit had to make a choice of which segment to choose for Monocryl plus.(See Annexure 4).
From the specialty lens there were many segments in the market. General Surgeons(20,000),
Gynaecs(25000), Plastic(1000), cardiac (500), Orthopaedic ( 6000). Whilst he could pitch this
product on all of them or one of them, the fact holding him back was that Monocryl is only
indicated for skin closure. Hmmm…….. I wish this product could be used for more than one
layer of closure wished the thoughtful marketing manager. Till then let me see if I can make it
a multi specialty product for skin closure.
Currently 60% of surgeons were using silk, nylon, Vicryl etc for skin closure. Surgery being very
skill driven, it was difficult to make a surgeon shift from one material to other. Therefore
professional education (teaching surgeons how to use) had been the mainstay of J&J medicals
In terms of willingness to upgrade the latest “Trigger and barrier “ research on sutures named
CV surgeons as the quickest to upgrade, followed by Ortho, General surgeons and then
Whilst thinking about the promo plan Amit remembered the constraint of not being able to
advertise in mainline media as these were ethical/prescription products and not OTC.
Surgical conferences, newsletters, surgical journals, one on one meetings were the options
that traditionally people had been using.
During lunch Amit told the consultant on how impressed he was by marketing people in other
categories using digital media successfully and how he wished medical device marketers could
do the same.
Just before he was about to leave office he received the plus suture essential prescribing
information.(Annexure – 3). Promptly Amit handed it over to the consultant. Let’s discuss this
Tomorrow you have to present your plan to Amit and then the MD. You may use Internet to
do some more data mining if you like. The expectation is to present a refreshing strategic
direction supplemented with implementation plan on the new product launch.
Annexure 1: Information about J&J businesses active in India
Since its establishment in 1959, Cordis Corporation has been a pioneer in circulatory disease
management. Dedicated to helping physicians and other healthcare professionals enhance the
lives of patients suffering from cardio vascular disease, Cordis is driven to transform the future
of vascular care through its commitment to R&D.
In India, Cordis has four specializations: Cardiology, Endovascular, Neurovascular and
Over one in ten people above the age of 55 suffer from Arthritis. DePuy aims to empower
sufferers by increasing awareness about arthritis and its management on the one hand and
training surgeons to increase the specialist pool on the other. DePuy Orthopaedics Inc., a
subsidiary of Johnson & Johnson, is a company that designs, manufactures and distributes
orthopedic devices and supplies including hip, knee, extremity, trauma, orthobiologics, and
operating room products.
(Knee & Hip
A market leader in the joint replacement sector, DePuy has always stayed ahead of the curve
with its speed to market the latest technology products. With this, DePuy aims to serve
patient needs and restore the joy of motion.
Innovation is a key factor that drives business at Ethicon, one of the world’s most respected
brands in surgical and health care. Today Ethicon has a range of over a thousand products in
the area of wound closure, women’s health and urology and cardiovascular solutions. On an
average Ethicon products touch the lives of 11 million patients in a year making it one of the
largest surgical product brands across product categories.
Minimally invasive surgery is the way of the future. Ethicon Endo-Surgery markets advanced
medical devices for minimally invasive and open surgical procedures. Focusing on procedure-
enabling devices for the interventional diagnosis and treatment of conditions in general and
bariatric surgery, as well as gastrointestinal, gynaecology and surgical oncology.
Popularly called the "Hospital Division of J&J", Johnson & Johnson Hospital Supplies helps
healthcare providers touch, save and improve countless patient lives across the country, by
saving blood and preventing infections. Its range of infection prevention products, are used for
environmental disinfection inside hospitals, for disinfection and sterilization of surgical and
endoscopic instruments, and skin disinfection of surgeons and patients.
Passionate to improve the safety of patient, environment and healthcare workers, the
company is dedicated to protecting patients, healthcare workers and the environment with
products that focus as much on safety as they do on efficacy and cost-effectiveness.
Dedicated to improving the quality of life for people with diabetes by developing,
manufacturing and marketing a wide range of glucose monitoring systems and software for
use by people with diabetes and by health care providers, Lifescan, Inc. The ONETOUCH®
Brand of consumer and institutional products includes portable electronic meters and
disposable reagent test strips to provide accurate, less painful glucose readings and the
software tools to transform this information into actionable health care decisions.
Ethicon Institutes of Surgical Education
Ethicon Institutes of Surgical Education (EISE), at Delhi, Mumbai (Bombay) & Chennai
(Madras), symbolizes the commitment of Johnson & Johnson Medical, India towards the field
of Professional Education. Dry and Animate Labs for ‘hands-on’ experience form an integral
feature of courses at EISEs. These state-of-the-art Institutes house modern operating theaters
equipped with latest patient monitoring and life support equipment to simulate real life
situations. The conference rooms are ergonomically designed with the latest audio-visual aids
including equipment for distance learning. EISEs are recognized by the Royal College of
Surgeons, Edinburgh, U. K., as centers of excellence for conducting their “Basic Surgical Skills
Courses” in India.
Business Knowledge Centre
An Asia Pacific initiative, the Business Knowledge Centre is a state of the art, scalable, captive
model. Established in 2006, at a tech park in Pune, India; it is based on the time-proven
concept of Regional Planning. It aspires to support, with a long-term view, various initiatives,
in areas of Operational Excellence, Global Process Outsourcing and Knowledge Development.
BKC adds value, by bringing operational excellence and in depth industrial and functional
knowledge to JJM affiliates' critical business processes. It provides high-quality execution of
these processes, monitors them against multiple performance metrics, and seeks to improve
them on an ongoing basis. BKC achieves its objectives, by providing service based on the five
verticals of: Business Analytics, Distribution Analytics, Financial Analytics Regional Information
Technology and Information Technology Strategic Sourcing
Annexure 2: Suture market
Volume share 61% Value 74%
Total suture market = 3.42 MM doz Total suture value = Rs. 2184 MM
Essential Prescribing Information
Vicryl Vicryl Plus Monocryl Monocryl Plus
Type of suture Synthetic Absorbable Synthetic Absorbable Synthetic Absorbable Synthetic Absorbable
Material Polyglactin 910 Antibacterial coated
Poliglecaprone 25 Antibacterial coated
All tissue layers All tissue layers Ideal for skin tissue,
Ideal for skin tissue,
Most smooth suture
Most smooth suture
Key Benefit Offers easy handling
Offers easy handling
Less risk of Surgical
Offers very good
Offers very good
Less risk of Surgical
General surgeons &
Information for Use
SYNTHETIC ABSORBABLE SUTURE, USP, EXCEPT FOR DIAMETER
MONOCRYL Plus Antibacterial sutures are indicated for use in general soft tissue
approximation and/or ligation, but not for use in cardiovascular or neurological tissues,
microsurgery or ophthalmic surgery.
MONOCRYL Plus Antibacterial suture is a monofilament that elicits a minimal acute
inflammatory reaction in tissues and in growth of fibrous connective tissue.
Using zone of inhibition studies, Irgacare MP (triclosan) in MONOCRYL Plus Antibacterial
Suture has been shown to inhibit colonization of the suture by Staphylococcus aureus,
Staphylococcus epidermidis, Methicillin Resistant S. aureus, Methicillin Resistant S.
epidermidis, Escherichia coli, and Klebsiella pneumoniae which are microorganisms known to
contribute to surgical site infections. Animal studies have demonstrated that MONOCRYL*
Plus inhibits bacterial colonization of suture after direct in vivo challenge with bacteria.
This suture, being absorbable, should not be used where extended approximation of tissue
under stress is required.
MONOCRYL Plus Antibacterial suture should not be used in patients with known allergic
reactions to Irgacare MP(triclosan).
Users should be familiar with surgical procedures and techniques involving absorbable sutures
before employing MONOCRYL Plus Antibacterial suture for wound closure, as risk of wound
dehiscence may vary with the site of application and the suture material used. Physicians
should consider the in vivo performance (under ACTIONS section) when selecting a suture for
use in patients. The use of this suture may be inappropriate in elderly, malnourished, or
debilitated patients, or inpatients suffering from conditions that may delay wound healing.
Do not resterilize. Discard opened packages and unused sutures.
As with any foreign body, prolonged contact of any suture with salt solutions, such as those
found in the urinary or biliary tracts, may result in calculus formation. As anabsorbable suture,
MONOCRYL Plus Antibacterial suture may act transiently as a foreign body. Acceptable surgical
practice should be followed for the management of contaminated or infected wounds.
As this is an absorbable suture material, the use of supplemental nonabsorbable sutures
should be considered by the surgeon in the closure of the sites which may undergo expansion,
stretching or distention, or which may require additional support.
Skin sutures which must remain in place longer than 7 days may cause localized irritation and
should be snipped off or removed as indicated. Subcuticular sutures should be placed as
deeply as possible to minimize the erythema and induration normally associated with
Under some circumstances, notably orthopedic procedures, immobilization of joints by
external support may be employed at the discretion of the surgeon. Consideration should be
taken in the use of absorbable sutures in tissue with poor blood supply as suture extrusion and
delayed absorption may occur.
In handling this or any other suture material, care should be taken to avoid damage from
handling. Avoid crushing or crimping damage due to application of surgical instruments such
as forceps or needle holders.
MONOCRYL Plus Antibacterial suture knots must be properly placed to be secure. Adequate
knot security requires the accepted surgical technique of flat and square ties with additional
throws as warranted by surgical circumstance and the experience of the surgeon. The use of
additional throws may be particularly appropriate when knotting monofilaments.
Avoid prolonged exposure to elevated temperature. To avoid damaging needle points and
swage areas, grasp the needle in an area one-third (1/3) to one-half (1/2) of the distance from
the swaged end to the point. Reshaping needles may cause them to lose strength and be less
resistant to bending and breaking. Users should exercise caution when handling surgical
needles to avoid inadvertent needle sticks. Discard used needles in "sharps" containers.
Adverse effects associated with the use of synthetic absorbable sutures include wound
dehiscence, failure to provide adequate wound support in closure of the sites where
expansion, stretching, or distension occur, failure to provide adequate wound support in
elderly, malnourished or debilitated patients or in patients suffering from conditions which
may delay wound healing, infection, minimal acute inflammatory tissue reaction, localized
irritation when skin sutures are left in place for greater than 7 days, suture extrusion and
delayed absorption in tissue with poor blood supply, calculi formation in urinary and biliary
tracts when prolonged contact with salt solutions such as urine and bile occurs, and transitory
local irritation at the wound site, as well as allergic reaction to Irgacare MP (triclosan).Broken
needles may result in extended or additional surgeries or residual foreign bodies. Inadvertent
needle sticks with contaminated surgical needles may result in the transmission of bloodborne
See Package Insert for Full Prescribing Information.
Annexure 4: Traditional market segments
Nursing Homes Private Hospitals Government Hospitals
50,000 nos 850 nos 4750 nos
High sales coverage Good sales coverage
Fragmented Group based buying –
very high buyer power
change after 1-2 years
Buy at MRP Low profit realizations Very low realization
KSF: Relationship with
KSF: Key Success Factor
KOL: Key Opinion Leader
Annexure 5: Pricing Matrix
Average Price of 1 Vicryl Suture = Rs.280
Vicryl Vicryl Plus Vicryl Rapide Monocryl PDSII
Price Index 100 120 90 110 115
Rules for Submission
Your launch plan can be submitted in a word document (not exceeding 10 pages)
Please submit a 5-6 slide Powerpoint presentation capturing the essential points of
your Launch plan along with your Word document
Though there is no maximum limit to the number of words or slides special credits will
go to the strategists for clear, concise communication
For Round 1 Selections:
Criteria of evaluation
Ability to arrive at core business issue, marketing issue & final
Ability to provide succinct solutions
Analytical ability in problem solving
Demonstration of clarity of thinking
Process followed in arriving at final solution
For Final Presentation:
Criteria of evaluation
Verbal & Written Presentation skills
Demonstration of clarity of thinking
Any decisions pertaining to the judging of the competitors by the panel of judges from
Johnson & Johnson will be held final. It can’t be contested on any account.
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