Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

Emergence of IT has made a significant impact in every possible industry. IT revolution made conventional things look unconventional and abstract things look very conventional, still practically increasing and expanding horizons of business beyond limits and boundaries. Pharmaceutical industry is perhaps one of the highly regulated industries that is ever changing and ever evolving due to changing R & D scenario, increasing regulatory constraints, growing competition and diminishing returns. Industry is also changing its traditional methods of doing business and is opting for flexible IT business models, like Customer Relationship Management (CRM) and business analytics, in Sales and Marketing to: Understand customer-market dynamics Design meaningful market strategies Improve sales force effectiveness Increase returns This paper, Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT, discusses challenges of pharmaceutical Sales & Marketing, details possible strategies and role of IT in Sales & Marketing with emphasis on CRM, business analytics and emarketing.

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

About the Author

Ravindranath Babu Ravindranath Babu has been working in the IT industry for the last 2 years. He is a Functional Consultant for Pharma Sales & Marketing. He is engaged in the development of Pharma Sales & Marketing solution in Siebel Pharma analytics platform. He has experience in therapy areas like cardiovascular, critical care, gynecology, diabetes, oncology and womens health care. Earlier, he worked for Astrazeneca Pharma Ind. Ltd as a Medical Information Associate, where he handled medical information aspects of Sales & Marketing. He was also a faculty for Medical & Product Training sessions and had prepared publication alerts, designed promotional inputs with brand management team and had rolled out medico-marketing strategies to field force.

Acknowledgements
I thank Dr Babu S Nema, Head - Pharma Innovation for providing guidance and support in writing this white paper.

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

Table of Contents
1. Introduction Changing R&D Scenario Patent Expiries and Generics Prevailing Regulatory Environment Changing Customer - Market Dynamics IT in Pharmaceutical Sales & Marketing 2. Conclusion 3. References 3 3 5 6 8 10 17 17

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

Introduction
Pharmaceutical industry is one of the highly regulated industries. Various advancements like scientific, technological, medical, diagnostic and so on pose a great challenge to pharmaceutical industry as the investment in R&D is high. Thus the industry heavily relies on Sales and Marketingthe revenue generator in entire pharmaceutical value chainto maximize the returns. Sales & Marketing is also undergoing a great transformation especially in developed markets due to: Changing R&D scenario Patent expiries and generics Prevailing regulatory environment Changing customer-market dynamics

This white paper attempts to detail the cause of the transformation in developed markets; strategies that will help to cope with these transformation; and factors that will improve the revenue of the industry.

Changing R&D Scenario

As per Tufts Center for the study of drug development estimate, the cost to get an innovative new drug to market is more than USD 800 million including expenditures on failed projects and the value of forgone alternative investments. Currently, total R&D spent by top ten companies is more than USD40 bio/year. Companies spending in excess of USD1bn on R&D per annum are expecting to market a mean of 1.8 NMEs per year until 2005, a growth of 60% over the 1.1 seen between 1994 and 1998. Over a period, NMEs applications as well as approvals have shown a steady decline.

Pfizer, at $8-9 billion, spends more on R&D than the total of Indias defence budget, - Mr Kapil Sibal,
Union Minister of Science and Technology and Earth Sciences

The total number of NMEs approved each year fell from a high of 53 in 1996 to 17 in 2002.Annual approvals rebounded to 36 by 2004 but fell again in 2005, to 20.The number of applications for approval of new molecular entities has exhibited a similar pattern. Applications rose sharply in 1995the year before the peak in approvalsgenerally declined from 1998 to 2002, and rose again in 2003 and 2004.The drop in approvals since 1996 could simply mark a return to their long-term average, but even so, the pace of new-drug approvals has not matched the rise in real R&D spending, as a result, the average R&D cost per new drug has grown significantly.

Source - Research and Development in the Pharmaceutical Industry: Oct 2006: a CBO study
b 100 90 80 70

Success rate (%)

60 50 40 30 20

Source Impact of Genomics on antimicrobial Drug Discovery; Guangyi Wang, Ph: Spring 2007

10 0 I II III Reg. App.

Stage of development

Figure 1: Stage of Development 3

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

The success rate of NMEs, inclusive of all therapy areas, especially in phase III (see Figure 1), registration and final approval, is less than 10-20%. Though the expenditure on R&D in US pharmaceutical industry has increased, the number of patents per dollar has considerably reduced. Due to weak late stage pipeline, the Sales & Marketing teams are compelled to improve revenues from existing product port folios. Possible Strategies Some possible strategies from Sales & Marketing perspective that are relevant to current R & D scenario and that can aid companies in realizing & improving the revenues from the existing product port folios are listed in this section. 1. Proper Product Life Cycle (PLC) management or brand management based on: Creating proper market segmentation, targeting and positioning Producing right kind of products for right customers with right promotional mix Tracking market changes and trends Monitoring disease/therapy area and competitor trends Building robust customer-campaign management 2. New indications based on: Guidelines Clinical trials/studies Recommendations made by medical and regulatory bodies Market and therapy area trends 3. Indication penetration and expansion based on: Physician experience, patient compliance and usage levels of the drug in an approved indication. Extent of usage. Span of usage. New areas of usage. 4. Subgroup focus based on: Drug preferences and usage in various subgroups (based age or disease). Adoption or usage levels of a drug by different physician groups in different subgroups. Gaps in the management or treatment options. 5. Focus on combination therapies and co prescriptions based on: Most widely used combinations. Most preferred combinations. Commonly used co prescription drugs and impact on outcomes. Combination and co prescription patterns in various specialties. 6. DTC marketing with a focus on: Retailer business and purchase trends Promotional strategy and impact Channel and campaign management

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

Patent Expiries and Generics

Not only reduced number of NME applications, decreased number of drug approvals and decreased periods of exclusivity (see Figure 2) has led to drying up of late stage pipeline, but also led more number of patented drugs (that include blockbuster drugs) in the verge of patent expiries. Thus, companies have become more vulnerable to market threats. As per Datamonitor analysis:

on average across the six markets, branded manufacturers faced a 35% erosion of their franchise revenues and 45% erosion of volume after two years of generic competition, with brand volume erosion most severe in UK and US at 57%, and the least severe in Spain and Italy at only 22%.
Figure 2: Declining Periods of Exclusivity for Novel Classes of Products

The generics market globally has grown by 20% in 2005, four times that of patented drugs and over three times that of pharmaceutical market. It is estimated to grow at a Compound Annual Growth Rate (CAGR) of 13.62% during the five-year period 2006-10 with revenues reaching $83.9bn. The market expansion and growth has been triggered by the rising number of patent expiries of blockbuster drugs and increasing healthcare expenditure. With over 39 major drugs, due to lose their patent protection before 2010 and branded drug growth rates beginning to falter with growth rates of only 5-7%, generic companies are prepared to gain even further market share. The US has the largest generics market and account to 44% of the global generics market. Teva Pharmaceuticals, based in Israel is the market leader in this industry followed by Sandoz. Currently, one of the prime challenges of Sales & Marketing teams is to sustain revenues by alternative means and approaches for their block buster drugs that are going off patent. Possible Strategies Many originator companies are trying to sustain revenues of their block buster drugs either by entering into agreements/pacts with generic companies or by launching their own generic versions. The Sales & Marketing efforts can be planned based on: Ratio analysis Historical trend analysis Linear regression analysis Forecasting and Cause-effect analysis Some possible strategies to improve the revenues of block buster drugs in terms of Sales & Marketing that have more relevance and significance with patent expiries and generics are listed in this section. 1. Line extensions based on: Market size and market share. Competitive differentiation. Promotional support, pricing and launch timing. Value add and customer acceptance.

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

2. Focus on emerging markets or BRIC markets to improve returns is based on: Geographical, demographical, behavioral and psychographic details of the markets. Understanding customer-market needs. Estimation of market potential. Evaluation of different therapy areas. Proper Market strategy 3. Aggressive product launches to gain maximum share of voice (including BRIC or emerging markets) and it requires: Thorough market understanding. Robust market strategy. Market and customer specific approach. 4. More focus on planned pre-launch and early launch activities to get: Better customer-market insight. Competitor understanding. Evaluation reports on all major stake holders in the value chain. Mileage over competition. 5. Switch patients to next generation drugs to balance existing brand defense strategies based on: Current usage patterns of various drugs. Disease/Therapy area trends. New practices or approaches in disease management. 6. Licensing and market cross over strategies based on: Strength of the individual companies. Demographic details, market trends and regulations. Market potential and forecasting. Market strategy.

Prevailing Regulatory Environment

Prevailing regulatory environment is a result of behavioral aspects of the industry in the market as well as growing health concern, increasing awareness, rising public interest, issues and negative events within the pharmaceutical industry due to fierce competition, increasing R&D costs and diminishing returns. As per Michael Rasmussen and Laura Ramos:

Pharmaceutical companies paid more than $3 billion in regulatory settlements and criminal fines since 2000 as the US Department of Health & Human Services (HHS) Office of the Inspector General (OIG) and state attorneys general put their sales, pricing, and promotional activities under closer scrutiny.

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

Regulatory Bodies and their Principles 1. European Medicines Agency (EMEA) EMEA mission statement is:

To contribute to the protection and promotion of public health

2. Medicines and Healthcare Products Regulatory Agency (MHRA) MHRAs primary objective is:

is to safeguard public health by ensuring that all medicines on the UK market meet appropriate standards of safety, quality and efficacy.
3. European Federation of Pharmaceutical Industries and Associations (EFPIA) EFPIA is conscious of the importance of providing accurate, fair and objective information about medicinal products so that rational decisions can be made as to their use. 4. Division of Drug Marketing, Advertising and Communications (DDMAC) DDMAC mission is

To protect the public health by assuring prescription drug information is truthful, balanced, and accurately communicated.
5. Pharmaceutical Research and Manufactures of America (PhRMA) PhRMA follows the highest ethical standards as well as legal requirements. This code reinforces that interactions with healthcare professionals are to benefit patients and to enhance the practice of medicine. 6. International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) IFPMA and its members provide educational and promotional efforts that benefit patients and promotional programs and collaborations that enhance the practice of medicine. IFPMA also preserves the independence of the decisions taken by healthcare professionals in prescribing medicines to patients. Promotional compliance includes: Advertisements and mailings Detail Aids, brochures and others Internet sites Exhibition panels, videos and others Gifts, samples and others Reprints and others Hospitality Representatives Activities. Meetings/Symposia Public Relations Any other communication Promotional activities exclude: Medical Information o Responses to specific enquiries Shareholder/business communications o Prescribed Information Patient Information Leaflets o Price Lists
Source Sales and marketing standards in US and EU: Speaking the same language?-Paul woods, AstraZeneca

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

Possible Strategies Some possible strategies to comply with current prevailing regulatory environment from an Sales & Marketing perspective are listed in this section. An unbiased approach in terms of communication, education to physicians to improve prescribing habits and in turn patient outcomes are based on: Appropriate and right communication to right customers. Evaluating type, ways and means of communication. Validation of communication. Promotional activities with focus on providing optimal cost effective treatments are based on: Physician-patient interests Meaningful and effective communication that can balance the business and customer benefits. Third-party financial arrangements should incentivize compliance all along the supply chain. Focus on pharmacovigilaince and drug safety activities that have tremendous impact on entire product life cycle (PLC) are based on: Tracking adverse effects and untoward side effects for the marketed product in a proper form or method. Post market surveillance studies

Changing Customer - Market Dynamics

Pharmaceutical industry is witnessing one of the greatest transformations in terms of customermarket dynamics. Not only the key changes like emergence of specialty and super specialty segments, increased regulatory constraints, focus on sub groups in various therapy areas and information explosion in recent times have made the situation complex, but also complicated for the pharmaceutical companies to have a right and meaningful market strategy that can address customers in an appropriate way. Past Scenario in Customer-Market Dynamics Majority of doctors were general practitioners and physicians Specialty medicine and super specialty were at the verge of emergence Needs, wants and expectations were not given importance in companys expectations Products had clear cut benefits over predecessors Scientific data was simple, understandable and easily interpretable Manageable R&D costs and less burden on Sales & Marketing teams Congenial and flexible regulatory environment with very less specifications and norms Less legal and insurance hassles Current and Emerging Scenario in Customer-Market Dynamics Emergence of sub-groups as important areas of focus Specialty and super specialty segments Emergence of physicians as valued partners Patient as a focal point Direct to consumer marketing Healthcare network Personalized medicine Rising R&D costs Increased medical and regulatory constraints More legal and insurance hassles

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

New business models that focus on emerging markets, mass blockbusters and so on Proactive involvement of Sales & Marketing departments in drug development These factors led the pharmaceutical companies to cut costs with an objective to become lean and agile organizations. And Sales & Marketing teams had to focus on diminishing for the following reasons: Declining cost-effectiveness of existing sales force combined with diminishing returns from incremental sales team (see Figure 3) End market fragmentation

Figure 3: Declining Cost Effectiveness of Sales Force

Possible Strategies All though some of the previously mentioned strategies have some relevance to changing customer market dynamics, following are some specific and possible strategies. 1. Multi-channel approach to customer (call centre, internet and others) based on: Using the right channel to the right customer based on the market data and customer information. Evaluation of the channel based on the target customer group. Tailor-made design and customized messages to answer individual needs of specific customer group. Understanding of physician preferences and prescribing habits that can be helpful to Sales & Marketing teams in streamlining communication strategy to physicians. Follow up and feedback. 2. Value added services to improve patient compliance to therapy/treatment based on: Patient education/awareness programmes. Relationship management centers. Ease of availability of medicines or drugs. 3. MarketingCo-promotions using Strength, Weaknesses, Opportunities and Threats (SWOT) analysis based on: Understanding of market size. Understanding customer preferences. Equity and customer base. Market plan and customer approach.

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

4. New distribution models based on: Flexibility. Adoptability. Consistency and reproducibility. 5. Mass block buster business models based on: Epidemiology and demographic details of the markets. Market potential and forecast. Therapy area and disease trends. Market strategy and approach.

IT in Pharmaceutical Sales & Marketing

Traditionally Sales & Marketing from pharmaceutical industry considered physician as prime target (see Figure 44) and sales representative as only medium of communication with very less or no focus on patients and retail outlets.
Traditional model of pharma Sales & Marketing

Company

Depot or CFA

Static detailing aids Paper reporting

Wholesaler or Superstockist Sales Rep

Influences
Doctor Patient

Rx Drugs

Retailer (Hospital Pharmacist or Pharmacist)

Prescription Generation

Figure 4: Traditional Model of Pharma Sales & Marketing

Due to competition, pharmaceutical industry focus shifted from product centric through market centric to customer centric with renewed focus on physicians, patients and other major stake holders in the value chain (see Figure 5). Hence, managing and maintaining customer relationship became a strategic imperative for pharmaceutical Sales & Marketing. Thus, Customer Relationship Management (CRM) has become one of the most significant areas of focus for Sales & Marketing organizations in pharmaceutical industry.

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Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

New model of pharma Sales & Marketing

Company
Direct supply, DTC

Depot or CFA

Advertising,DTC CRM(SFA)
Web portal

BI, e-detailing

Online mktg Awareness/edu campaigns

Wholesaler or Superstockist

Sales Rep
Influences Rx Drugs

Doctor

Patient

Retailer (Hospital Pharmacist or Pharmacist)

Prescription Generation

Figure 5: New Model of Pharma Sales & Marketing

Kalustian et al. observed that CRM has become a pharma buzzword, but few companies actually practice it.
CRM Objective of CRM To sustain and enhance the intensity of customer interaction at one or more customer touch points with proper channel management To allow and establish a multilevel and uniform view on customer data It helps: To address prospective and attractive customers through proper channel To decrease the customer service costs and improve returns, and To improve customer retention by providing customized and tailor made offerings to existing and new customers Many big pharma companies have made significant investments in the area of CRM and it is currently focused on sales force automation and call center support. H1 2007 Tech trends indicates that CRM solutions are the second most deployed applications in terms of frequency The CRM market for services will grow to nearly $2.8 billion by 2012. This is a Compound Annual Growth Rate (CAGR) of 12.1% from 2007 to 2012. Certain segments of the market, such as the enterprises with fewer than 100 employees and those with 100 to 1,000 employees, are set to grow even faster, reaching a CAGR of 14% to 16 %

14% 16% 12% 18% 40%

Sales Force Automation Customer Service Automation On-Demand CRM

Marketing Automation Customer Analytics

Figure 6: Pharma Sales & Marketing Analytics Architecture 11

Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

Business Analytics Analytical CRM brings together data from operational CRM applications and other data sources and uses and analyzes this information so that companies can maximize the value of the data or information available in various repositories. The effective analysis of data may enable pharmaceutical companies to get an insight into available customer- market data and in developing a meaningful, customer centric Sales & Marketing strategy. Business analytics allows seamless integration of data from various disparate sources, that is, transactional, operational and analytic sources, and provides actionable insight into Sales & Marketing activities. They can be rolebased business intelligence applications that combine comprehensive physician profiles, promotional activities, campaigns, and medical education events with prescription and market share data.

In the Post Enron Economy the need for transparency has also impacted the way global pharmaceutical CXO's think about their particular business processes, and continued heightened regulatory environment. Business Intelligence systems for pharmas have become what ERP was for manufacturers in the late 1980's. HIPAA, drug discovery pipeline, and overall business score carding dashboards, are mandatory in the competitive global pharma landscape. Malcolm Frank
CEO, President CXO Systems October, 2003 Source - Business Intelligence Solutions for the Pharmaceutical Industry: The Gantry Group LLC: 2004

The integration of business analytics with CRM data sources or companys internal data sources, prescription monitoring and marketing management/product management tools or various market research tools can Give insight into market, market potential, forecasting, market trends (current and future), segmentation, therapy area trends (current and future), competitor presence, companys strengths, market strategy and so on. Help to understand market and therapy area trends, current and future prescription trends that can be helpful to devise an appropriate market strategy for line or brand extensions. Give customized view of the market with a thorough understanding of sales, trends and market share by product or therapy area in respective markets. Provide deep and meaningful insight into successful launches, which can in turn help Sales & Marketing teams in devising ideal product launch strategy. Give insights into availability, prescriptions, sales, competitor information (pricing, promotional spent), physicians prescribing and diagnostic patterns that can help in building up an appropriate marketing strategy, before the launch of a product. Provide insights into current and emerging prescribing patterns along with therapy area trends that can be useful in understanding level of acceptance and adoption to new or next generation drugs. This can in turn be helpful in developing a market or sales strategy.

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Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

Pharma Sales & Marketing Analytics Architecture

Source Data ETL Database Layer Presentation Layer
Sales Force Alignment CRM Customer Segmentation

Business Analytics

Identify details IMS Transformation NDC

Forecasting Sales Analytics ROI Analytics Meded Analytics Executive Analytics Marketing Analytics

OLAP Database

Incremental Load

Other Sources

Business Analytics: comprises an entire set of prebuilt pharma sales, services, and marketing analytics components and toolset that enables a uniform, complete and multidimensional view of pharmaceutical customer relationship, affiliations, call activities, medical information requests, product issues, matket share & sales, prescriptions, sales quotas, territory planning, forecasting, ROI analysis and segmentation. Figure 7: Pharma Sales & Marketing Analytics Architecture

e-Marketing e-Marketing is designing, developing and implementing marketing strategies or programmes through internet and other technologies of communication to satisfy customer needs thereby achieving specific marketing goals. Conceptually, e-marketing is same as marketing or part of marketing, but methods and approaches are different. All e-marketing programmes should attract and involve customers; retain the customers by building relationships and motivate them to action. e is another way of marketing or selling a product. It is primarily used to increase the reach and expand the customer base. It is used to improve communication (speed, specificity, access and so on) that is heart of any marketing strategy and to reduce cost and improve returns. e-Marketing includes e-detailing, Web sites, Personal Digital Assistant (PDAs), Point of care devices(PCD), Web casts and e-congresses, Mobile phone access, e-mail, online calculators and other tools. e-Marketing or the integration of business analytics with SFA, CRM applications, market management tools, market research tools or companys internal data sources and S&D applications provided by IT in pharmaceutical industry helps: Develop a communication strategy for a specific channel and get an insight into communication impact. Develop a comprehensive strategy by giving insights into managed care markets. Provide customermarket understanding, customer base and reach of the company, strength of the company based on therapy area, product, prescriber and patient type that can be useful in developing go-to market plan. Customize Sales and Distribution (ERP) applications based on the dynamic requirements of the company or the market or the customer. Get thorough market understanding, disease and therapy area trends of respective markets. Also useful in estimating market potential, forecasting, developing market strategy and so on. e-Marketing is useful to expand customer base, speed up communications, and offer better customer services leveraging internet.
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Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

e-detailing Money spent on promotional activities is one of the largest expenditure in pharma industry. About 45 % of that money is spent on sales representatives. So cost of detailing a doctor face-to-face is highly expensive and it is $150 $200 per visit and at least $3,000 per hour of face time with a physician. Research shows that only 7% of the sales representatives in the U.S. are able to interact with the physician for duration of more than 2 minutes. Three prime reasons are: Decreased effectiveness Physicians with tight schedules and little time to med representatives Access to internet These reasons were drivers for the concept of e-detailing. Research shows customer stay to a tune of 8 minutes for an online or e-detail. This clearly exhibits potential of e-detailing over conventional methods of static detailing.

A six-month 1,130-doctor study with i-PhysicianNet showed a 25% reduction in detailing cost. In addition, the average length of each detail doubled as did the number of details per rep per day.
Figure 8: Survey Results of E-detailing

e-detailing and a strong CRM understanding can be complimentary to the sales force to understand a customer and customizing the key messages based on customer information, need, requirement and situation and gives an opportunity to improve quality as well as quantity or time of interaction. Sales & Marketing solution or Pharma Sales and Managed care solutions (integrated with pharmacovigilance or drug safety reporting systems) can be customised depending on the promotional policy (IFPMA, PhRMa and so on) of the company. The functional requirements with specific controls based on key areas will ensure compliance. The Sales & Marketing solution provided by IT in pharmaceutical industry helps to: Decide, evaluate and validate communication strategy with a focus on customer type and compliance. Facilitate Sales & Marketing teams to develop effective market strategy that can balance business returns and physicianpatient interests and also has compliance as an integral part of it. Get useful and good insight about adverse events or side effect profile of the drug in a much larger population after market availability and wide usage for the medico-marketing teams.

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Changing Scenario in Sales and Marketing of Pharmaceutical Industry: Role of IT

Conclusion
Currently in pharmaceutical industry, where innovation in true sense is taking a new shape in the form of new business models, outsourcing, collaborations, still leadership in Sales & Marketing is the crux for any commercial strategy. Companies can see success, when they aggressively involve all major stake holders in a tactful engagement.

One-to-one marketing solutions like personalized communications have a powerful impact on customers. They increase response rates by 34%, order size by 25% and repeat business by 48%. - Industry analyst Info Trends direct web-driven marketing sales this year is nearly $1.9 billion and by 2012 this will double, reaching nearly $3.8 billion. - DMA report, 2008

Though there are certain limitations like geographical, developmental, educational, market and operational, success in Sales & Marketing is only possible by adopting a robust IT strategy. This involves optimal utilization of CRM, BI and other web-based services based on mode of operation, extent of operation and level of operation in a given location with a right application framework in place, which can lead to optimal channel management, better insight into Sales & Marketing outcomes and ultimately increased sales.

References
A CBO study - Research and Development in the Pharmaceutical Industry: Oct 2006 Business Intelligence Solutions for the Pharmaceutical Industry: The Gantry Group LLC: 2004 Closed Loop Marketing solutions for sales and marketing effectiveness Updated: March 30, 2005 (www.microsoft.com) Credit Suisse/Scott Levin, 2001 Global Pharmaceutical Industry Facts and Figures As at July 2007: MEDICINES Australia Impact of Genomics on antimicrobial Drug Discovery; Guangyi Wang, Ph: Spring 2007 PhRMA, 2001 Reference materials from TCS Internal data Sales and marketing standards in US and EU: Speaking the same language?-Paul woods, AstraZeneca Transformation in the Pharmaceutical Industry Developing Customer Orientation at Pharma Corp: 16th Bled eCommerce Conference eTransformation Bled, Slovenia, June 9 - 11, 2003 Value Driver Report Business Intelligence Solutions for the Pharmaceutical Industry: The Gantry Group LLC:2004 www.I-PhysicianNet.com

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