The challenges of marketing to Russia's doctors

Oxana Kolosova explores the Russian pharma market and looks at the unmet needs of Russian healthcare providers and patients.

Although Russia spends just 4.5% of its GDP on its healthcare, on a per capita basis it has more physicians, hospitals, and health care workers than almost any other country in the world. It is mainly a state-run single payer system. Private healthcare sector is limited, with leading private chain of Russian clinics accounting for only 1.3% of the total market.

Russia has the oldest population among the emerging markets, with 17% per cent of its citizens being aged 60 or older. Prevailing diseases are diabetes, cancer, cardiovascular diseases, AIDS and others. At a primary care level there is still a relatively low level of knowledge about prevention, diagnosis and treatment of many health problems. Evidence-based medicine is mostly favoured by younger doctors while the older generation treats it with suspicion, relying on the familiar opinion-based medical practices. Russian physicians are quite conservative in their clinical decisions and tend to prefer tried-and-trusted medications.

Russian patients do not generally trust doctors, and are often reluctant to follow their recommendations - 37% of them double check their doctors' recommendations online.

The Russian pharmaceutical market is the 11th largest in the world, according to IMS Health and stood at $29bn in 2012. It is predicted that for the next four years it will see an average growth rate of 13.4% annually.

"Russia has the oldest population among emerging markets, with 17% aged 60 or older."

Up to 70% of the pharmaceutical products are financed out-of-pocket by patients. The existing state reimbursement system covers around 20% of medication costs and guarantees free drug provision only to certain vulnerable groups of patients.

Russia currently contributes only 0.2% of the world's supply of pharmaceuticals and its domestic market is dominated by imported drugs (75%). The Russian government aims to increase the share of local drug producers to 50% by 2020. As a result, a regulatory regime that favors local manufacturers was introduced. This left foreign companies to operate within a reduced commercial segment and therefore proper marketing strategies became of a paramount importance for them.

Marketing medicines in Russia - more and more challenging

Marketing pharmaceuticals in Russia was never easy, yet it is becoming more and more challenging as promotional opportunities continue to shrink. Despite 10% increase in field force spend in 2011 the number of reps' visits grew only by 2% and just 34% of Russian physicians were ready to start or increase a brand prescription following a rep visit. Furthermore, in 2012 access to physicians was significantly restricted legally and in 2013 steps were taken to stop OTC products' advertising to public.

As the traditional communication channels have declined, new web-based tools have emerged. The internet penetration in Russia is expected to grow from 33% in 2009 to 55% in 2015 and mobile use is already very high. Daily audience annual growth in web use relating to medical matters was at 60% with a third of all searches related to healthy lifestyle and eating advice, as well as information on medical conditions and their symptoms.

The proportion of physicians with internet access and usage has increased significantly over the past few years as well, with only a small minority of doctors distancing themselves from this technology. In 2012, 65% of Russian doctors reported using the internet for professional purposes and 52% said they have accessed HCPs professional networks.

Inspired by these trends, pharmaceutical companies and healthcare service providers have begun to employ new digital formats to enhance their communication with physicians and patients. Dealing with digital media inevitably requires going through a learning curve, and many pharmaceutical companies are developing digital experience by appointing dedicated personnel and launching various digital projects. The results so far have been very positive and promise to bring considerable opportunities for the global pharmaceutical industry in addressing the unmet needs of Russian HCPs and patients.

About the author:

Oxana Kolosova is Managing Partner at iVrach.com – the leading professional network for Russian speaking physicians.

A graduate of Moscow Medial Academy, Oxana started her carrier in medical marketing with multinational pharma before focusing on medical communications and market research in the agency world. Originally from Moscow, Russia, Oxana worked for several years in Ukraine and then at Dendrite Europe in Windsor, England.

Oxana's cross cultural professional experience helped her a lot in developing iVrach to become the major online knowledge and information sharing hub that supports Russian-speaking physicians in making the best decisions for the care of their patients.