Submitted in fulfillment of the requirements for the Degree in Master in Technology: Marketing, Technikon Natal, 2003. / Managed care is defined by Chetty (1999: 1) as "the practice of evidence based medicine with an approach to managing both the quality and cost of medical care". Managed care was introduced into South Africa in the last decade due to increasing cost of healthcare. All forms of managed care represent attempts to control costs by modifying the behaviour of general practitioners. / M

The pharmaceutical industry is one of the fastest growing and developing industries in the world today. With the ever advancing technology and manufacturing techniques, quality assurance has become the focus of regulatory bodies all over the world. The implementation of quality management systems (QMS) that ensures that quality is built into every step of the design and manufacturing process has been the focus of many pharmaceutical companies. With the implementation of quality systems, employee’s perception of those systems and overall quality standards of the organisation is very important in establishing the quality culture of the organisation. To benefit from sustainable quality systems the organisations must ensure that employees understand the importance of the systems and that employee’s take personal responsibility for ensuring that their functions are performed correctly the first time. FKMSA has invested in a QMS that seeks to integrate all quality issues. The quality system includes documentation, deviations, corrective and preventative action (CAPA), change controls and quality risk management (QRM) in the entire facility. This system is administered by the quality control department, but each department takes ownership for their quality issues with support and guidance from the quality unit. FKMSA also firmly believes that quality cannot merely rely on the quality control test results; every step of the production process has a quality aspect built in to ensure that quality standards are adhered to. Every employee is trained, assessed and deemed competent before they can perform their duties; this is to ensure that human errors are kept to a minimum. Employee’s perception of quality is an integral part of quality assurance and it is important for the organisation to know what the employees believe to be the company’s standards of quality.

The main objective of this study was to investigate factors contributing to employee turnover in the South African pharmaceutical industry and to suggest strategies to minimize it. Employee turnover is a persistent problem facing both public and private organizations in South Africa. In addition to the costs incurred when an employee resigns, losing employees results in a loss of knowledge, skills and experience. Numerous studies have been undertaken globally on this topic. However, this problem continues to adversely affect organizations in several ways. Schwab (1991) suggests that this is because there are no clear resolutions yet to this challenge. Based on literature review conducted, there is no study undertaken in South Africa attempting to address this problem. The purpose of this study was to identify factors contributing to high turnover rate of pharmacists in South Africa (the pharmaceutical industry in particular) and to recommend strategies to address this problem. A quantitative research approach was followed when addressing this problem. Literature review was conducted on employee turnover and a questionnaire was developed. The questionnaire was used as a measuring instrument. Following a non-probability, convenience sampling method, two pharmaceutical companies in Gauteng and one in the Eastern Cape were surveyed. The results were analysed by a statistician using Epi-info and stata software as tools for statistical analysis. The following factors were found to be key factors contributing to employee turnover in the pharmaceutical industry: (i) lack of career advancement opportunities, (ii) uncompetitive salary packages, (iii) perceived inequity reflecting leadership challenges, (iv) insufficient recognition for good performance, (v) stress, and (vi) insufficient retention strategies. An effective retention strategy should address all factors that may contribute to employee turnover. A retention strategy that combines competitive salary packages, opportunities for learning and career advancement, recognition, equity and support structures (to deal with stress), should be used in the pharmaceutical industry. This will assist in creating a motivating climate, which is a pre-requisite for job satisfaction and, in turn, employee retention.

A significant amount of pharmaceutical marketing literature is available. Most of this marketing has doctors, physicians and specialists as main target audience due to the fact that, historically, these medical professionals were the main pharmaceutical purchase decision makers. Pharmaceutical marketing literature has, historically, also been biased towards the private health sector for obvious reasons as the private health sector constitutes the minority of the pharmaceutical market but with a significantly enormous purchasing power than the public healthcare market, constituting the biggest pharmaceutical market in numbers. It is not surprising therefore that majority of pharmaceutical marketing models have been tailor made for the private healthcare market as the growing number of pharmaceutical companies compete for a piece of the small but extremely profitable private healthcare market. South Africa is no exception as it reflects exactly the same pharmaceutical landscape as described above. For growth purposes, pharmaceutical companies have been showing a continued interest in the public healthcare market in Africa as the vast numbers of the African population present an opportunity for pharmaceutical sales. The inspiration of this research study emanated from the realisation that, in order for pharmaceutical companies to take advantage of the looming African opportunity, there is very little literature on pharmaceutical marketing in the public health sector of which majority of the African market constitutes. This study therefore investigates the impact of marketing communication mix elements on pharmaceutical purchasing decisions for pharmaceuticals in the public health sector in South Africa. Personal selling, public relations and promotions are the marketing communications mix elements being investigated in this study as they are the most commonly utilised in the pharmaceutical industry. Therefore, the study aims to develop an understanding on which of the chosen marketing communications mix elements has the most influence on the pharmaceutical purchasing decisions in the context of the public health sector in South Africa. The study also aims to explore the causal effects of such influences in the public health sector in South Africa. The findings will be valuable to pharmaceutical marketers that are trying to tap in the public health sector market as it is different from the private health sector. The study employs more qualitative approach. A small sample was utilised from the public health sector in the Eastern Cape Province in South Africa. Semi structured interviews were used to collect data which was analysed using grounded theory data analysis methodology. Empirical results revealed that personal selling influences pharmaceutical purchasing decision the most and promotions the least. Mitigating factors were uncovered to assist in optimising the marketing communication efforts for marketers in this sector.

A thesis submitted in fulfilment of the requirement for the degree of Doctor of Philosophy of the Faculty of Humanities of the University of the Witwatersrand, Johannesburg. / This dissertation attempts to document the social life of Indian generic pharmaceuticals within the broader material culture of pharmaceuticals in Johannesburg. Foregrounding the question of value created in circulation, the study explores how conduits of generic pharmaceutical flow are saturated with the global politics of humanitarianism, locally embedded profitmaking efforts by businesspersons based on risk, cultural moorings of pharmaceutical relations, and historical specificities of locations in which pharmaceuticals have been mobilized for consumption. The central method is the ethnography of circulation. By documenting the ‘moral claims’ of Indian pharma capital as manifested in the public culture of pharmaceutical business, the discussion places the intersectionality of moral and material transactions at the centrestage of pharmaceutical sales and the creation of value / MT2017

The purpose of this research paper is to examine and evaluate the economic significance of the pharmaceutical wholesaler in South Africa’s health care industry. The pharmaceutical wholesaler experienced several challenges over the last decade. These challenges originated from changes in the competitive environment of the industry and more recent changes in the regulatory environment brought on by the State in its attempts to make medicine more accessible to the South African public. The wholesaler was forced by these changes to adapt its business model drastically in order to remain competitive. Historically the wholesaler made its profits by purchasing bulk at a discount, passing a fraction of the discount to its customers and adding a mark-up to the purchase price. It was now forced to abandon the discount and mark-up scheme and distribute medicines by negotiating a fee for the services it renders. Wholesalers now not only have to compete between themselves but also with distributors on the same basis - by negotiating logistics fees with pharmaceutical manufacturers. Operating efficiency and customer service have become essential ingredients for the wholesaler in its quest to remain competitive. / Graduate School of Business Leadership / MBL

The traditional quality culture in the pharmaceutical industry is driven by the regulatory process of marketing authorisation and manufacturing authorisation. These components of the South African regulatory control system are exclusively technically-orientated, with no managerial focus. This study identifies several quality management principles which could find general application in the pharmaceutical industry. The research compares the current regulatory control system with the total quality concept, and highlights the positive contribution which the total quality approach is able to make in terms of its field of reference; the strategic business value of quality; quality policy formulation; the quality organisational structure; enhanced operations management; and management's control over quality costs, in particular / Economic & Management Sciences / M.Com. (Business Economics)

Thesis (MComm)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: New products are indispensable to the growth of the modem business enterprise. Increased global and local competition, better informed consumers, rapidly changing technology and the short life span of products are typical of the reasons why it is necessary to develop new products. Traditionally new product development took place in accordance with a rigid new product development process where a next phase was dependent on the completion of preceding phases. The increased pressure to produce new products in shorter time spans has led to the development and application of less streamlined and rigid processes for the development of new products. The pharmaceutical industry has certain unique characteristics important for new product development. It spends more than five times than the average of all industries on research and development. New product development in the pharmaceutical industry largely depends on the discovery of new clinical entities and the development process is furthermore also highly regulated by governments. The focus of product evaluation in the pharmaceutical industry has also undergone a major shift. Traditionally the industry dealt with diseases which were defined broadly and as such the focus was on diseases and not individuals. The result was that consumer acceptance was virtually never evaluated. The shift is now to consumer acceptance because consumers become increasingly better informed and take part in decisions regarding their health and medical care. A further reason for the consumer focus lies in the genetic understanding of patients and this enable pharmaceutical companies to segment patients on the basis of pharmaco-genomic descriptions. The objectives of the study are twofold. In the first instance, the study assesses whether marketing practitioners in the South African pharmaceutical industry agree with the fundamental principles of new product development which are identified in academic literature. The responses from marketing personnel were obtained and analysed to establish their beliefs regarding new product development. The fundamental principles of new product development which form the focus of this study, were those that Calantone, Di Benedetto and Haggblom (1995) used in their research. The second objective of the study is to compare the findings in respect of the South African pharmaceutical industry with those of the study undertaken by Calantone, Di Benedetto and Haggblom in 1995. The purpose of the study is to establish whether the new product development principles taught in marketing management courses are relevant for the pharmaceutical industry. The method of investigation was divided into two sections, i.e. a literature overview and an empirical study. The literature study commenced with research on new product development in the South African Pharmaceutical Industry and other parts of the world. The Calantone, Di Benedetto and Haggblom (1995) questionnaire was also used in this study for data collection. The 91 pharmaceutical companies listed in Volume 34 of the 1999 MIMS Desk formed the population of the study. After contacting these companies a more accurate list was set up. After taking into account all the mergers that took place, 65 companies eventually constituted the population. Twenty nine of the questionnaires sent were returned and could be used. This represents a response rate of 44.6%. The organisations involved were responsible for 69.4% of the annual turnover of the total pharmaceutical industry in 1998 and their responses could therefore be regarded as representative of the pharmaceutical industry of South Africa. The questionnaire attended to the following principles of new product development: • Product innovation • New product development and launch tasks • Product diffusion • Interface between marketing, research and development • Organisational issues The information collected in respect of each pharmaceutical company was the following: • Annual turnover • Number of products manufactured and marketed • Number of employees • Number of new products launched during the past five years The findings of this study indicate that marketing staff in the South African pharmaceutical industry strongly agreed with those fundamental principles of new product development which were identified in academic literature. There was also a significant correlation between this study and the study undertaken by Calantone, Di Benedetto and Haggblom with respect to the percentage agreement on the various statements. It may thus be concluded that new product development principles taught in marketing managing courses are relevant for and are applied by marketing staff in the pharmaceutical industry in South Africa. / AFRIKAANSE OPSOMMING: Nuwe produkte is onontbeerlik vir die groei van die moderne sake-onderneming. 'n Toename in globale en lokale mededinging, beter ingeligte verbruikers, snel veranderende tegnologie en die kort lewensduur van produkte is tipies van die redes waarom dit belangrik is om nuwe produkte te ontwikkel. Tradisioneel het nuwe produk ontwikkeling volgens 'n rigiede nuwe produk ontwikkelingsproses plaasgevind waar 'n volgende fase afhanklik was van die voltooiing van voorafgaande fases. Die verhoogde druk om nuwe produkte in korter tye te vervaardig het tot die ontwikkeling en toepassing van minder stroombelynde en rigiede prosesse vir die ontwikkeling van nuwe produkte gelei. Die farmaseutiese bedryf het sekere unieke eienskappe wat belangrik is vir nuwe produk ontwikkeling. Die farmaseutiese bedryf bestee meer as vyfkeer die gemiddelde van alle bedrywe op navorsing en ontwikkeling. Nuwe produk ontwikkeling in die farmaseutiese bedryf is grootliks afhanklik van die ontdekking van nuwe kliniese entiteite en die ontwikkelingsproses word verder ook intensief gereguleer deur regerings. Die fokus van produkbeoordeling in die farmaseutiese bedryf het ook 'n verskuiwing ondergaan. Tradisioneel het die bedryf gehandel met siektes wat breed omskryf is en die fokus as sulks was op siektes en nie op individue nie. Die gevolg was dat verbruikersaanvaarding feitlik nooit beoordeel was nie. Die verskuiwing is nou na verbruikersaanvaarding omdat verbruikers toenemend beter ingelig word en deelneem aan besluite wat hulle gesondheid en mediese sorg raak. 'n Verdere rede vir die verbruikerfokus is daarin geleë dat pasiënte nou geneties verstaan kan word en dit maak vir farmaseutiese maatskappye moontlik om pasiënte op 'n farmakologies-genomiese basis te segmenteer. Die doelstellings van die studie is tweeledig. In die eerste instansie beoordeel die studie of bemarkingspersoneel werksaam in die die Suid-Afrikaanse farmaseutiese bedryf, saamstem met die fundamentele beginsels ten opsigte van nuwe produk ontwikkeling wat in die akademiese literatuur geïdentifiseer is. Die response van bemarkingpersoneel is verkry en ontleed om hulle oortuigings ten opsigte van nuwe produk ontwikkeling vas te stel. Die fundamentele beginsels van nuwe produk ontwikkeling wat die fokus van hierdie studie vorm, is dié wat Calantone, Di Benedetto en Haggblom (1995) in hulle navorsing gebruik het. Die tweede doelstelling van die studie is om die bevindings ten opsigte van die Suid-Afrikaanse farmaseutiese bedryf te vergelyk met dié van die studie onderneem deur Calantone, Di Benedetto en Haggblom in 1995. Die doel van die studie is om vas te stel of die nuwe produk ontwikkeling beginsels wat in bemarkingsbestuurkursusse onderrig word, relevant is vir die farmaseutiese bedryf. Die metode van ondersoek is onderverdeel in twee gedeeltes, naamlik 'n literatuuroorsig en 'n empiriese studie. Die literatuurstudie het begin met navorsing oor nuwe produk ontwikkeling in die Suid-Afrikaanse farmaseutiese bedryf en ander wêrelddele. Die Calantone, Di Benedetto en Haggblom (1995) vraelys is ook in hierdie studie vir die insameling van data gebruik. Die 91 farmaseutiese firmas wat in Volume 34 van die 1999 MIMS Desk gelys is, het die populasie van die studie gevorm. Na gesprekke met hierdie firmas en nadat alle samesmeltings in ag geneem is, is 'n meer akkurate lys opgestel en het die populasie uiteindelik uit 65 firmas bestaan. Nege en twintig van die vraelyste wat terugontvang is kon gebruik word. Hierdie verteenwoordig 'n responskoers van 44.6%. Die organisasies wat gereageer het was verantwoordelik vir 69.4% van die jaarlikse omset van die totale farmaseutiese bedryf in 1968 en die responses sou dus as verteenwoordigend van die farmaseutiese bedryf in Suid-Afrika beskou kon word. Die vraelys het aandag aan die volgende beginsels van nuweprodukontwikkeling gegee: • Nuweproduk ontwikkeling en loodstake • Produkdiffusie • Koppelvlakke tussen bemarking, navorsing en ontwikkeling • Organisatoriese kwessies Die inligting wat ten opsigte van elke farmaseutiese firma ingesamel is, is die volgende: • Jaarlikse omset • Aantal produkte vervaardig en bemark • Aantal werknemers • Aantal nuwe produkte wat gedurende die afgelope vyf jaar geloods is. Die bevindings van hierdie studie toon aan dat die bemarkingspersoneel in die Suid-Afrikaanse farmaseutiese bedryf sterk saamstem ten opsigte van die beginsels van nuwe produk ontwikkeling wat in die akademiese literatuur geïdentifiseer is. Daar bestaan ook 'n betekenisvolle korrelasie tussen hierdie studie en die Calantone, Di Benedetto en Haggblom studie ten opsigte van die persentasie wat saamgestem word oor die verskillende stellings. Die gevolgtrekking kan dus gemaak word dat die nuwe produk beginsels wat in bemarkingskursusse aangebied word, relevant is vir en toegepas word deur bemarkingspersoneel in die farmaseutiese bedryf in Suid- Afrika.

Thesis (MBA)--Stellenbosch University, 2012. / Analgesics are the medication most-generally used by modern society. The pain management market has therefore experienced substantial growth over the last few years. This research report aims to provide a critical review of pain management in the pharmaceutical market in South Africa, in order to establish and evaluate the most significant growth factors. This research report provides an overview of the history of pain, the basic physiology of pain and pain classification systems. There are three categories of analgesics - opioid analgesics, non-opioid analgesics and adjuvant analgesics. These categories of analgesics have been analysed according to the most generally-used MIMS pharmacological classification system referring to the analgesic therapeutic classes. These are narcotic analgesics, analgesics and antipyretics, combination analgesics, others such as tramadol and musculo-skeletal agents which consist of NSAIDs and COX inhibitors. Growth over the last four years (from August 2009 to July 2012) will be determined by analysing data per molecule, per product and per manufacturer. Splits between branded and generic drugs will also be analysed. Top prescribers by healthcare professionals will be examined, analysing scripting data from ImpactRx, which covers 85% of the private market data nationally. There are currently approximately 41 analgesic molecules in the assessed pain market which has produced 738 analgesic products. The analgesic market (worldwide and in South Africa) has seen the launch of only a few new drugs. New molecules of the same drug class or family have been launched, but in effect they can be viewed as mere line extensions with claimed reduction in side effects, advanced delivery times or improved efficacy. Two new molecules have been launched in the South African market in the narcotic analgesic class, (oxycodone and hydromorphone), however these molecules have been available internationally for years. Accelerated growth of the pain management market has mainly been met by combination analgesics, which in essence are not new, but rather a combination of different active ingredients or new drug delivery systems. The impact of product withdrawals on market share is also evaluated. The development and acceptance of generics are highlighted as key contributing factors in the growth of the analgesic market. Important to note is that generics often compete in their own generic market share. This may be the reason why the generic market does not show a significant increase over branded products. Another significant trend evident in the increased acceptance of generics, is that manufacturers, in order to keep market share, may choose to produce their own generic medication after their branded products patent has expired. Pain is one of the main reasons why patients seek medical attention and it is the physician’s ethical responsibility to treat patients and provide them with effective pain relief medication. The WHO analgesic ladder as a guideline for treating pain has proven to be effective after 25 years in practice. It is forecasted that an increase in the narcotic analgesic class will be noted. Pain is heavily undertreated worldwide and in South Africa, Increased awareness, education, new advanced research and knowledge may help to address this dilemma.

The purpose of this research paper is to examine and evaluate the economic significance of the pharmaceutical wholesaler in South Africa’s health care industry. The pharmaceutical wholesaler experienced several challenges over the last decade. These challenges originated from changes in the competitive environment of the industry and more recent changes in the regulatory environment brought on by the State in its attempts to make medicine more accessible to the South African public. The wholesaler was forced by these changes to adapt its business model drastically in order to remain competitive. Historically the wholesaler made its profits by purchasing bulk at a discount, passing a fraction of the discount to its customers and adding a mark-up to the purchase price. It was now forced to abandon the discount and mark-up scheme and distribute medicines by negotiating a fee for the services it renders. Wholesalers now not only have to compete between themselves but also with distributors on the same basis - by negotiating logistics fees with pharmaceutical manufacturers. Operating efficiency and customer service have become essential ingredients for the wholesaler in its quest to remain competitive. / Graduate School of Business Leadership / MBL