THYROX

Macleods Pharmaceuticals Ltd, MPIA – Day 3 Lonavala, 21st Oct 2019

Brand

Product Definition: Is a brand of Levothyroxine Sodium for treatment of hypothyroidism

Product SKU’s: 10 SKUs of different stengths (all tablets)

Micro titration: Thyrox 12.5mg/25mg
Precise dosing :50mg/75mg/100mg/125 mg/150 mg/200mg
Dosing flexibility: 62.5mg,88mg

Market Definition & Target Market Segment(s):

Hypothyroidism market for treatment of :
- Hypothyroidism
- Sub clinical hypothyroidism
- Special populations like Infertility in Hypothyroidism & Pregnancy
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Executive Summary
• Brand Vision: To be the most preferred and trusted brand of L-thyroxine among physicians

• Financial Objectives: To be the no.2 brand in L-thyroxine market by 2022 with value sales of Rs. 225 Crs & 3 yr CAGR of
20%

• Core strategy for Physicians & Endos:

1. At CPs increase market share aggressively by 3% every year targeting Thyronorm –
a) Improving perception about quality among CPs b)Being disruptive in diagnostic camps in areas not covered by Thyronorm
c)Increase activation in form of CMEs/pt education/advisory meetings/Education prog/user experience/case studies
2. At ENDOS increase market share by 2% every year targeting Thyronorm -
a) Improving perception about quality among CPs b) Advisory panel of 100 Drs c) Faculty in local/national
CMEs/conferences d) User experience

Key Drivers (Specialities):

-Using Endos as influencers –Targeted scientific initiatives at ENDOS
-Endos as influencers –Quality (Thyrox) discussion at CMEs
Business drivers for Thyrox:
Communication: About quality (bioequivalence) and superiority 2. Geography-Driving shares in weak states like
AP/Kerala/Ktk 3.Specialty:Increase Rx share and P/D at ENDOS and CPs 4.Activities –improved diagnosis and detection of
patients who become opportunity for Thyrox Rxns 5.Line extensions for micro titration doses
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Macro Analysis

Political
1. NCDs (Non communicable disease) programmes can present opportunities to partner with governments for
increased detection and awareness 2..State and central government implementing centralised purchase
programmes which hinders access to govt institutions 3. DPCO-price control on new strengths
Social
1.Lifestyle changes leading to increase in chronic diseases and therefore correlation with hypothyroidism
2.Improved awareness among patients-Patients proactively get tested for Thyroid profile thus improved
diagnosis of hypothyroidism

Technological
1.Novel packaging (bottles/caps etc)

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Micro Analysis – Part 1
(complement with other slides to enhance insights)

Market, Market Segments Summary and Insights on Size, Growth Rates, Market Shares, Market Trends.
1.L-Thyroxine market is valued at 675 cr on MAT basis with a growth of 16% 2. Top 3 brands contribute to nearly 98% of market 3. Thyronorm is
the market leader with 51% MS followed by Eltroxin at 27% MS and then Thyrox at 20%4.Total of 28 brand in the market 5. Market grows at
a CAGR of 10%
Some insights:
1. Drs hesitant to shift brand unless patient is uncontrolled
2. Drs sensitive to the quality of products being a hormone preparation and L Thyroxine having NTI(Narrow therapeutic Index)
3. All 3 brands hold a strong quality perception among Drs
Market Drivers
1. Specialty: Endos,CPs,Cardio,Gynaecs are the main drivers of growth within specialties
2. Entry of new brands is also driving growth
3. Improved awareness through diagnostic camps ABBOTT and MACLEODS both are major players in improving diagnosis hence detection of
hypothyroidism

Key Customers, Summary on source of business, Rx contribution and what guides their Rx, their needs, trends, etc.
Key customers: Endos (10% of Rx ,P/D- 51),Gynaec (19% Rx,P/D- 22),CP (28%,P/D-32),Cardio (14% rx share ,P/D-51)
Source of Business:
1.New patients (10% unit growth on the market) .Additionally camp data suggests 10% new detection of cases of hypo
2.Exisiting patients who are uncontrolled on other L:-Thyroxine brands, maybe shifted on Thyrox depending on beliefs of Dr.Above is also a
source of business in camps
Notes: Validate the new and old patients as well as ROI of camps/Rx generated from new/old patients/substitution from other brands etc)

Patients/Caregivers/Payers/Trade – their key needs, trends

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Micro Analysis – Part 1
(complement with other slides to enhance insights)

Patients/Caregivers/Payers/Trade – their key needs, trends

Patients:
1. Conscious about managing Thyroxine levels
2. Need more awareness about management

3. Caregivers: Not major stakeholder in determining the prescriptions

4. Payers: NA . Only 10% of business through institution which is led by special rates/discounts

5. Trade: a)Chemists have limited role in determining the brand to be sold;led by prescriptions of the doctor b) However some major
attached retailers may insist on discount and may determine access

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Micro Analysis – Part 2
(complement with other slides to enhance insights)

Competition: Summary of their sales, market shares, Rx shares, brand strategy, organization, key promo programs, differentiation, etc.
Thyronorm Thyronorm Eltroxin
Val: 344 cr MS: 51% Gr: 15% rx share: 48% Dedicated sales team Textbook brand
Eltroxin Brand Ambassador Sells majorly in institutions

Val:180 cr MS:27% gr: 13% rx share :24% High brand awareness/diagnostic/scientific initiatives
Tot mkt: 674 cr gr:16%

Your Brand: Summary of sales, market shares, growth rates, Rx,Key

and trends.
strategyKey strategy and promo programs, learnings from
Keylast year
learnings
Thyrox:
Val: 132 cr 20% MS 23% gr 22% Rx share Communication-Bioequivalence to pioneer brand (quality) Monitoring awareness camps for ROI
Awareness/Diagnostic camps New stengths add to the growth
CRMs/Campaigns at CPs

Company capabilities relevant to the brand

1. Equity at CPs 2.Key focused brand (BOY for incentives) 3.Reach to tier 2/3 towns and 4.Detection camps

Business Drivers for the brand in future:

1. Communication: About quality(bioequivalence) and superiority 2. Geography-Driving shares in weak states like AP/Kerala/Ktk 3.Specialty:Increase rx
share and P/D at ENDOS and CPs 4.Activities –improved diagnosis and detection of patients who become opportunity for Thyrox rxns 5.Line extensions
for micro titration doses

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Micro Analysis-
Data/Insights Summary and Actions

Data/Insights:
Levthyroxine marked is led by 3 major brands contributing 98%
Thyronorm is the leader across specialties
Diabetologists,Cardios,Gynaecs and CPs are the major driving specialties for the market
Thyrox has a MS of 20% rx share 22%.Characterised by a low share at ENDOs

Actions:
1.Continue focus on communication about quality
2.Work on Endo/CP specialty to improve share and advocacy
3. Maintain gynaec share

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Attribute Mapping-
Data/Insights Summary and Actions

Top attributes : 1.1 Brand trust 1.2 Ease of availability 1.3. All strengths 1.4 Company image 1.5 Quality of
product
2.1 Symptom control 2.2 Diagnostic camps 2.3 Source of manufatcuring 2.4. Scored tablet 2.5 Monthly pack

Primary strategic indicators:

Improving perception on brand trust and quality superior to Thyronorm

Secondary :
1. Scaling up diagnostic camps
2. Making scored tablet an important yardstick while choosing L-Thyroxine therapy

Defensive:
1. Increasing educational/scientific interventions in the market

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Attribute Mapping - Validation

Before After

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Attribute Mapping - Scoring

Since Brand Trust and Quality were among the top attributes core strategy does not undergo
any change
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*Scoring taken from 11 doctors ©2018 Innovara, Inc. All rights reserved.
SWOT Analysis

Strengths Weaknesses
Where are we strong relative to our competitors? Where are we weak relative to our competitors?
-Strong equity with physicians ( For Thyrox 32% cont vis-à-vis 29% for market) -Low P/D and rx share at ENDOS -25% Endo share P/D-29
-Proven quality and bioequivalence -Less coverage and low rxn share at Gynaecs
• BE study vs. Eltroxin -Low scale of scientific initiatives
•Better dissolution profile -Low trade discounts
-Dosing flexibility
•All strengths ,scored tablets, different colored tablets Note: Gynaec importance to be reassessed,relative share at CPs only 25%
-Packaging : Drs/SE gap of 23% vsThyronorm.Therefore look at including new CPs
•MRCP,individual carton and glass bottle

Opportunities Threats
What changes/ emerging trends can we exploit? What changes/ emerging trends could threaten us?
ST = 1yr ST = 1yr
Opportunity MT < 3yrs Size Threat MT < 3yrs Size
LT = 3-5yrs LT = 3-5yrs
New line extensions ST ~6 cr on MAT Euthyrox creating negative perception on quality MT

Improved share at ENDOS (gap-7 Endos vs MT ~36 crs New brand entrants ST
mkt)
Corporate/instt sales ST 48 cr New prohibitory regulatory laws(NMC) LT

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Key Challenges/Critical Success Factors

KEY CHALLENGES CRITICAL SUCCESS FACTORS

Lack of advocacy from KOLs Using Endos as influencers
Low rx share at ENDOS -Using Endos as influencers –Targeted scientific
initiatives at ENDOS
Improving quality perception -Endos as influencers –Quality discussion at CMEs

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Brand Objectives

Brand Vision: To be the most preferred and trusted brand of L-thyroxine among physicians

2019 2020 2021 2022

Sales Value (in 128(current 156 188 225
crs) trends)
Growth % 22% 22% 20% 20%
Market Share 20% 21% 23% 25%
Brand Qualitative Objectives
Qualitative Objective 1
Aggressively increase CP share by 3% every year

Qualitative Objective 2
Use Endos as influencers/advocates; increase rxber base by 2/SE

Qualitative Objective 3
Launch new extensions successfully
Overtake Eltroxin by 2022
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Core Brand Strategy - CPs
Target Customers:
Their Key Needs:
Primary Competitors
Their Key Product Differentials:
Your Brand’s Key Product Differentials:
What other added value brand solutions could
help you develop differentiation
What is competition doing in that space
Your Brand’s Objective:
Core Brand Strategy:
At CPs increase market share aggressively by 3%
every year targeting Thyronorm.We will achieve
rxn share by
CPs
1. Good quality brand 2/Reliable efficacy 3.Easy availability 4.Service needs: Camps,CMEs,CRMs
etc
Thyronorm
1. Claims of international quality 2.Leader brand worldwide with extensive experience
Better quality (Dissolution/purity/content uniformity) led by manufacturing in US FDA dedicated
facility
1.Improved packaging/scored tablets 2. Scientific or diagnostic initiatives
1. High no of diagnostic camps 2.Local CMEs at high frequency 3.Aggressive participation in
regional/national/intl congress
To be the no 2 ranked brand in Levo Thyroxine market by 2022
1. Improving perception about quality among CPs
2.Being disruptive in diagnostic camps in areas not covered by Thyronorm
3. Increase activation in form of CMEs/pt education/advisory meetings/Education prog/user
experience/case studies
4. Line extension for better titration and all strengths availability
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Core Brand Strategy – Diabeto / Endos
Target Customers:
Their Key Needs:
Primary Competitors
Their Key Product Differentials:
Your Brand’s Key Product Differentials:
What other added value brand solutions could
help you develop differentiation
What is competition doing in that space
Your Brand’s Objective:
Core Brand Strategy:
At ENDOS increase market share by 2% every year
targeting Thyronorm. We will achieve rxn share by
Diabetologists/Endos
1. Good quality brand 2)Reliable efficacy 3.Easy availability 4.Partnering with Dr for his scientific
initiatives
Thyronorm
1. Claims of international quality 2.Leader brand worldwide with extensive experience
Better quality (Dissolution/purity/content uniformity) led by manufacturing in US FDA dedicated
facility
1.Improved packaging/scored tablets 2. Scientific participation=-Congresses/CMEs/Special
Days/Grants
1.Local CMEs at high frequency 2.Aggressive participation in regional/national/intl congress
To add at least 2 Endos/year per SE
1. Improving perception about quality AND reinforce availability of all strengths
2.Advisory panel of 100 Drs nationally
3. Faculty in local and national CMEs
4.User experience
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Strategic Imperatives-CPs

Core Brand Strategy At CPs increase market share aggressively by 3% every year targeting Thyronorm.We will achieve rxn
share by
1. Improving perception about quality among CPs 2.Being disruptive in diagnostic camps in areas not covered by Thyronorm
3. Increase activation in form of CMEs/pt education/advisory meetings/Education prog/user experience/case studies
SI Element Strategic Imperative Statement
Marketing Focus on communicating quality differential through multiple channels and if possible
communication validated through reputed institutes like PGI/KEM etc
Diagnostic camps Focus on areas/doctors where competitors do not have access or less access and gain
new patients.Bring differential in the camp (total profile for eg)
Physician/Pt education Conduct CME programs and physician education programs which enhance ability of
physician to treat Hypothyroidism (tie up with assn/bodies)
Advisory Meetings Create a panel of top physicians for educating other physicians (focus on areas
strategically)-100 physicians
User experience/case Create Indian experience with Thyrox for improving confidence among physicians
studies
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Strategic Imperatives- ENDOs

Core Brand Strategy At ENDOS increase market share by 2% every year targeting Thyronorm. We will achieve rxn share by
:1. Improving perception about quality among CPs 2.Advisory panel of 100 Drs 3. Faculty in local/national CMEs/conferences
4. User experience

SI Element Strategic Imperative Statement

Marketing Focus on communicating quality differential through multiple channels and if possible
communication validated through reputed institutes like PGI/KEM etc
Advocacy Creating a panel of 100 advisors nationally for advice to marketing
programs/conducting medical education
User experience/case Create Indian experience with Thyrox for improving confidence among ENDOS
studies

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Tactical Plans

In-Clinic/Ex clinic Tactical (Activity) Programs:

Strategic Imperative: Marketing communication

Tactical Program/ Activity/Timing Objective Benefit to Customer Differentiation Desired Result KPIs

Creating Helps him to Drs choose

1. Perception
Better study 3 times a
perception of choose a quality Thyrox as year during FW
1. Sales force promotion better quality vs
dissolution/Ass brand of
brand that he Rx/SE added
Thyronorm ay purity/CU choice
2.

can trust MOM

Creating Better Drs choose
Helps him to
perception of dissolution Thyrox as 1.Perception
Digital videos to be played better quality vs choose a quality /Assay brand of
2. about video-
during CMEs Thyronorm brand that he purity/CU choice feedback
can trust

3.

4.

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Tactical Plans

Ex-Clinic Tactical (Activity) Programs:

Strategic Imperative: Advisory Panel
Tactical Program/ Activity/Timing Objective Benefit to Customer Differentiation Desired Result KPIs
Drs become 1.100 Drs each being
1. Advocacy Will be advocates & reached in the year
Catering to Dr
1. Advisory Panel (Endos/Physicians) 2. Quality designed in potential 2. No of meetings
needs users of conducted 3.Rx
perception content
Thyrox support

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Tactical Plans

In-Clinic Tactical (Activity) Programs:

Strategic Imperative: Diagnostic camps

Tactical Program/ Activity/Timing Objective Benefit to Customer Differentiation Desired Result KPIs
Drs choose
Diagnostic camps 1. New patient
1.Subsidised Thyrox for
1. Total profile
and existing diagnosis treatment in
1. 2. Only player newly detected
patient 2.New patients and existing
conversion to reach uncontrolled
of hypo patients

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Tactical Plans

In-Clinic /Ex clinic Tactical (Activity) Programs:

Strategic Imperative: Physician education/scientific intiatives
Tactical Program/ Activity/Timing Objective Benefit to Customer Differentiation Desired Result KPIs
1. No of Non
Macleods perceived as Helps physicians to Case study module Drs choose prescribers
a partner in improving attending the meet
1. CMEs hypothyroidism treat and identify Fixed panel of Thyrox as brand
of choice Rx generated from
management difficult cases better speakers 2.
delegates

Macleods perceived as Guiding patients

a partner in improving Drs choose Thyrox
Patient awareness charts/booklets/digital about better Personalised 1. Dr feedback about
2. hypothyroidism as brand of choice
inputs management management of Multilingual input during FW
hypothyroidism
Macleods
Helps physicians to
perceived as a Drs choose 1. Feedback
treat
Physician certified programme in tie up partner in Thyrox as about
hypothyroidism Association/body
3. with assocn/bodies improving brand of programme
better Content
hypothyroidism choice 2. Rx
management Certification/credit
progression
points

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Tactical Plans

In Clinic Tactical (Activity) Programs:

Strategic Imperative: User experience

Tactical Program/ Activity/Timing Objective Benefit to Customer Differentiation Desired Result KPIs
Improve Dr
confidence
User trial of Thyrox for Endos and and trust in Dr
Physicians the brand Data chooses 1.Rx
1. Investigator generated by Thyrox as progression
Generate the study brand of from the Dr
data for choice
dissemination
to other Drs

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Summary & Next Steps

Thyrox currently valued at 125 cr (MAT 19)

Current rank: 3
Current MS: 19%

Objective for 2022 -225 cr

Rank:2
MS:25%
Key Drivers: Physicians, Diab,Endos and GPs
Prioritised specialty: CP/ENDO

Next step:
1.Identification of areas/customers where Thyronorm access is low-ongoing
2. Validating the customer attributes with the doctor-done
3.Putting in place feedback mechanism and metrics during FW/Customer meetings
4.Look into possibility of higher coverage of CPs
5. ROI of camps –data collection and feedback mechanism

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