Transcript CHEMOPREVENTION FOR LIVER CANCER

CHEMOPREVENTION FOR LIVER CANCER:
MARKETING AND ETHICS
Organization of presentation
 Marketing: an overview
 Components of marketing
 Objective of the section
 Market size
 Market analysis
 Marketing strategy
 Ethical issues
 Summary
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Why do we need to care our health?
 Complex issue-associated with different factors
Figure: Health linkage and dynamics
Source: MoPH, 2004
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Marketing: an overview
 A process to introduce products to the consumers
 Conducts research and analyzes the consumer
needs and demands (Market research)
 Caters the needs of consumers by developing
products and providing services (Marketing plan)
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Objective of the section
 To introduce and promote the sales of newly
manufactured chemopreventive herbal food
supplement for prevention of liver cancer
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Components of marketing
Why do we do?
 Launching of the product
 Advertising and publicity
 Sales promotion and distribution
What does it require?
 Pricing
 Naming and labeling
 Market research
 Marketing plan
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What do we need to know?
“MARKET SIZE”
Why?
 The ultimate determinant of production and
distribution
 Determines the economical viability
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Market size
General information
 Target population (country): Thailand, 64 million
 Age structure:
0-14 years
22%
15-64 years
70%
over 65 years
8%
 Population growth rate:
 Life expectancy at birth:
0.68%
72.25 years (all)
(male: 69.95 years and women: 74.68 years)
 Literacy rate:
92.6%
(CIA, 2006)
 GDP growth rate:7.0% (estimated)
 GDP per capita income: US $2,221
(NESDB, 2003)
(CIA- Central Intelligence Agency; NESDB- Office of National Economic and Social Development Board)
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Liver cancer incidence
 430,000 new cases worldwide (WHO, 1999).
 Three quarters of which is in Southeast Asia alone.
 Frequency: Southeast Asia and sub-Saharan
countries-30/100,000 population/year; 5/100,000
population/year in Europe and America
 Thailand: 11,868 new cases (ASR=37.4/100,000
population in males, ASR=15.5/100,000 in females)
in 1993 (Petcharin, et.al., 2004).
(ASR= Age-standardized incidence)
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Existing practices of treatment
 Highly sophisticated treatment facilities, not
affordable by everyone;
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Surgery
Chemotherapy
Radiation therapy
Immune therapy
Vaccine therapy
Liver transplantation
Note: options are dependent on the stage and severity
of underlying disease.
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Cost associated with liver cancer treatment
 Calculation:
Incidence (male+female) = 53/100,000
Incidence in whole population = 33,920 (Total
population at present is 64 million)
 Treatment cost for 1 patient
 Diagnosis cost
Service charge=
 Doctor’s fee=
 Other associated costs =
(Nurse/ Medical officer’s fee)
Sub total (A) =
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Calculation (contd.)
 Treatment cost
(eg; chemotherapy)
 Service charge =
 Doctor’s fee =
 Other associated cost =
 Cost of drug used = dosage x unit price
Sub total (B) =
Total treatment cost required (C) = No. of chemotherapy cycles x B
Cost per 1 incidence of liver cancer (D) = A+C
Cost for whole population = D x Estimated incidence in whole
population.
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Risk Factors
 Hepatitis B virus infection
 Hepatitis C virus infection
 Aflatoxin B1 contamination in food
 Alcohol consumption
 Cirrhosis
Best Approach?
Prevention!
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Prevention strategies for Liver cancer
 HBV vaccination
 Reduction in aflatoxin consumption
 Improvement in diets and lifestyle
 Chemoprevention: Oltipraz, Chlorophyllin; Natural
products (cruciferous vegetables-cabbage,
cauliflower, broccoli sprouts, etc.); Products organicOxygenze, Alfalfa leaf powder.
(Source: John, 2006; Supplementary information)
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Market analysis
 Income status
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Huge gap between rich and poor
Highest income group: rising from 49.8% in 1962 to 56.7% in 1996
Lowest income group: falling from 7.9% in 1962 to 4.2% in 1996
 Expenditure on health
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Is in rising trend
Rising from 3.8% of GDP
in 1980 to 6.1% (US $124
per capita) in 2002
Figure: Expenditure on drugs and
health in relation to GDP, 1980-2002
Source: MoPH, 2004
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Health insurance policy
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30-Baht health care policy of the government
Implementation of universal health care policy
since 2001;
The health insurance coverage increased from
71.0% in 2001 to 94.3% in 2004;
73.5% under the universal health care scheme;
5.7% are uninsured.
(Source: MoPH, 2004)
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Marketing strategy
 Market research (shopping habits, lifestyles,
potential buyers, wants, price, market barriers
& competitors)
 Marketing plan (consumers: products,
services they want, promotion and advertising
strategies)
 Factors influencing the market (Govt. policy,
distribution channel)
 Assessment of accessibility
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Customers of preference
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HBV carriers
Children
General public
Both urban and rural dwellers
How do they know?
Promotional activities
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Promotional strategies
 Publicity and advertisements prior to the launching
 Poster/pamphlet productions
 Tele-broadcasting/ radio programming
 Dissemination of information through internet and
websites
 Free distribution upto limited number of customer
(first come first serve basis) during launching period
 Membership scheme and discount facilities
 Counseling
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Risk associated with liver cancer
Cost associated with liver cancer treatment
Benefits of using the products
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Why herbal chemoprevention?
 Vaccination- not enough for all, not able to reach to
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the poor
No vaccine for HCV
Easy availability, easy to use
Psychologically acceptable
No side effects
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Ethical issues
 ‘Prevention is better than cure’ because:
 It saves human being from the onset of dreadful
disease
 Helps provide longer and healthy life
 Saves large amount of money- helps entire nation in
revenue generation
 Early detection is the best approach to control liver
cancer as it:
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Helps in reduction of incidence and mortality
Makes treatment more effective
Improves life for cancer patient and their families
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Ethical issues (contd.)
 Ethics of chemoprevention clinical trials are much complicated
especially when normal human beings are used and for the
reasons that:
 it lies at the intersection of different approaches to the
management of disease and the promotion of health;
 several conflicting perspectives are competing in these trials;
and
 multiple values play a role in determining the nature and
magnitude of the risks and benefits.
 Products and product quality assurance-approval from National
FDA
 Consumers will be benefited by getting balanced dosage
 Advantage over vaccination-will reach to the poor
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Summary
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Marketing- introduces products, analyzes and
caters the consumer needs
Market size- the determinant of production,
distribution and economical viability
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Thailand- 64 million (total population) with 11,868
new cases of liver cancer (1993 data)
Highly sophisticated treatment facilities
Prevention- the best approach both ethically and
economically.
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THANK YOU!
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