Product Management THE MESSAGES KOATE-GAMUNEX-HYPERHEP-HYPERHO Product Management

Product Management THE MESSAGES KOATE-GAMUNEX-HYPERHEP-HYPERHO

Product Management KOATE

SEE the Potential Market n Hemophilia A prevalence : n Mostly Man n 1 : 10, 000 population n Indonesian : 1207 hemophiliacs n Less 40% well treated

Koate DVI n Description n Factor VIII concentrate, medium to high purity n Contains vw. F n Double Viral inactivation n Solvent detergent TNBP and PS 80 Heated 80°C for 72 hours Purified with anion exchange – column chromatography

Koate DVI n Indication n Treatment Hemophilia Classic

Koate DVI n Dose; 1 IU/kg raised 2% FVIII level n Mild Hemorrhage 10 IU /Kg BW n Moderate Hemorrhage 15 -25 IU /Kg BW n n Severe Hemorrhage 40 – 50 IU/Kg BW n n Repeated 10 -15 IU/Kg BW per 8 – 12 hours Repeated 20 -25 IU/Kg BW per 8 – 12 hours Major Surgery 50 IU/Kg BW n n Repeated 25 -50 IU/Kg BW per 6– 12 hours For total 10 -14 days

Koate DVI n Adverse Reaction n Result from administration Koate

KOATE n Positioning n The only one complex FVIII with vw. F content in Indonesia Market n Messages n n With vw. F more safe in inhibitors Pathogen safety, Bayer legacy

KOATE n User Target : n Customer n Hematologist n Pediatrician Hematologist n Purchase Manager § JAMKESMAS Hospital § ASKES § Company with Self Health Insurance Organization n Consumer n Patients n Parents n

The Market Pillars n Patients n n Organizations n n JAMKESMAS ASKES Self Health Ins Company TPTH HMHI Others NGO Physician n Pediatrician Hematologist Others specialties n n n Surgeon Rehab Medic Pathology Clinic Dentist Physiatrists Hospitals n n One Day clinic JAMKESMAS Standardization team Purchasing Management

Strategies n More selling Aspect oriented n Marketing Aspect Below the Line

STRATEGY: n Selling Aspect n Relationship § Patient : increase individual approach, less organization approach § Polyclinic physician § KOL at each local and hospital and department § Purchasing § Company with self insurance n Price Competition: keep below the competitor, keen the Marketing intelligent

Counter Act KOGENATE n Bayer Legacy of pathogen safety n r. FVIII more risk for develop inhibitor – Jenny Goudemand – Samantha Gouw n n Pd FVIII with vw. F contents, vw. F protects FVIII from inhibitors vw. F have an effect on the reactivity of FVIII inhibitors with FVIII. n More in international Unit each vial n More benefits of v. WF n n Transporting FVIII to site where it can be participate the formation of fibrins clots Prolonging the half-life of FVIII in circulation Protecting FVIII from proteolytic inactivation Increasing FVIII concentration within the forming hemostatic plug

Key Of Activities n Personal Approach - Relationship n Patient – Parents n n n Purchaser n n n Entertains Marketing intelligent for price offering competition with Kogenate Physician n n Transport – support – entertains – mobilize Do it silence and individualy Entertains Published study : inhibitor, manufacturer process, role of v. WF Discussions : small group discussion Organization n Selective gathering

Key Of Activities n Price Competition n Always below competitor’s price n Support with invoice info : give us a prove n Keep the Stock Level n Hospital : don’t let’s the stock run out n Distributors : trace and follow the purchasing and delivering.

Key Success Factors n Costumer Intimacy : patient, KOL, physician, logistic, purchaser management n Omni Presence : always there when the KOL and patients need n Quick Response : never delay the process, always follow up the status. Never abandoned and ignore the KOL n Product Availability

Product Management PLASBUMIN GROUP

Plasbumin 25% 20 ML n Description n 25% Sterile solution of albumin in aqueous water n Stabilized with 0. 02 M sodium caprylate and 0. 02 M acetyltrytophan n Every 20 ml contains 5 grams albumin n Treated at 60°C for 10 hours

Plasbumin 20% 50 ML n Description n Sterile solution of albumin in aqueous water n Stabilized with 0. 016 M sodium caprylate and 0. 016 acetyltrytophan n Every 50 ml contains 10 grams albumin n Treated at 60°C for 10 hours

Plasbumin 25% 20 Plasbumin 20 % 50 n INDICATION n Emergency treatment of Hypovolemic Shock n n Burn Therapy n n n Expand the plasma volume by withdrawing fluid from interstitial spaces Beyond 24 hours Plasbumin 25/50 can be used to maintain plasma colloid osmotic pressure Crystalloids infused to restore the depleted extra cellular fluid volume Hypoproteinemia n n Major surgery patient can lose over half albumin with attendant complication of oncotic deficit Similar situation happen in sepsis

Plasbumin 25% 20 Plasbumin 20 % 50 n ARDS n Hypoproteinemia with fluid overload n Cardiopulmonary Bypass n Neonatal hemolytic diseases n Exchange transfusion, to bind free bilirubin

PLASBUMIN n Positioning n The Wide range Convenience Albumin n Messages n n n Latex free stopper packaging Wide range concentration and volume benefits Pathogen safety Manufacture process

STRATEGY PLASBUMIN n Target doctor : n Pediatric ICU n NICU n Rawat inap n Low Marketing Efforts – High Selling – Relationship Efforts n Relationship to Success Element Business n Pricing Strategy n Combines each Concentration and volume for the right Grams albumins needed.

Competitor n Each plasma product have the same “raw” material but might be different resources. n What makes different are : How plasma collected and treated n Purification methods n Viral remove and inactivation methods n Validation test n package n

Competitor n Manufacture plasma product concern with : n Tolerability n Pathogen Safety n Efficacy n Convenience n And it is so with Albumin products

The Competitors n Cealb from Sanquin n Albuminar from CSL n Robumin n Octalbin

The Competitors n Counter attack Features benefits n Still studying for Ce alb and Albuminar and Octalbin Product information n Due date 7 May 2009

Grass Execution Strategy n Target Element Success Business n Physician – Pediatrician n n ICU – NICU RAWAT INAP DOKTER JAGA KONSULEN Nurses n n ICU – NICU RAWAT INAP NURSES Station Nurse’ Chief

n Target Success Element Business n Purchasing Management n n n Pharmacist Purchaser Warehouse Deliverer/Courier Pharmacist DEPO Satellite ASKES/JAMKESMAS Management n Hospital Management n n n Committee Medic Standardization team

KEEP in MIND n Pricing Strategy only for “first Attack” / GATE Opener n Main Strategy always on the Physician n Balancing the attention and power between purchasing-RS-Physician-Nurses n Never Abandoned the Physician

Product MANAGEMENT GAMUNEX®

Product GAMUNEX® n Positioning n The Only One IGIV with Caprylate Treatment. n Messages n Caprylate made Gamunex better in efficacy, high in pathogen safety, high tolerability, more convenient to patient and doctor

Consumer / Patients Segmentation n Segmented Patient n Up and High Economic background n Urban Demographic n Productive age n Patient Behavior n Smart patient n “full of Knowledge” internet sourcing n Need Community – Sharing each other n Very Rich Community n Indonesian Population n Total 230 million, n 3% rich people

This potential Market- Our Target Cases Body initial maintenance Rich Pop Weight kg Dose mg Dose repeats/3 mg weeks Consta Prevalence The Cases Gamunex 10% 50 m. L vials cases CIDP 1 100, 000 69 50 2, 000 16 12, 420 Cases GBS 1 100, 000 69 50 2, 000 0 0 1, 380 Cases ITP 5 100, 000 345 35 2, 000 0 0 4, 830 Cases PIDs, births 1 50, 000 4 3 400 16 17 Cases PIDs, Cases Kawasaki Diseases 2000/year 1 100, 000 69 5 400 16 469 1 2, 000 25 2, 000 0 0 20, 000 Gamunex need Population Segmented : • 3% from Indonesian Population • 6, 900, 000 people 39, 116 Birth Ratio : 3% • 3% from segmented population • 207, 000 / year

Customer / Doctors : Segmentation & Targeting n Specialties n Neurologist n Hematologist Oncologist n Allergist-Immunologist n Pediatrician [allergy immunologist, tropic infection, Emergency] n Pulmonologist n Hospital n Teaching Hospital with “swadaya” facilities n Private Hospital with criteria : n Institution Insurance n Other Attributes n Head of Department in Teaching Hospital n Key Opinion Leader, Influencer

Strategy n INSIDE STRATEGY n OUTSIDE STRATEGY n COSTUMER/DOCTORS n CONSUMER/PATIENT

OUTSIDE : spot the BRAND Doctors/Hospitals n Market Penetration n Targeting existing physicians who still have a good relationship with Dipa / team n n n Targeting Hospitals which historical purchased Gamimune n n n Detail Pareto visits Scientific activity Sponsorhips Brand Awareness : mailing-brochures All IGIV are not same Life Saving product service Standardization National Launching Gamunex

n MARKET DEVELOPMENT n Build relationship with KOL at each Department of targeting specialties on Teaching Hospitals n Round Table Discussion § Labelled Indications § Non labelled Indication based on Published Clinical Study n Events Participant § The organization: 1. Perdossi and Branches 2. Allergy Immunologist [Peralmuni] 3. PAPDI and Branches 4. PHTDI

n Approach new fresh user n Internal Survey n Approach Company with Self Health Insurance n n Air Transport Bank Oil Company Others

KEY of ACTIVITIES n TRAINING PROGRAMS n MAILING TO DOCTOR/PHARMACIST/HOSPITAL n BROCHURES-PROMO MATERIAL/DETAILING AID n RECENT PUBLISHED CLINICAL TRIAL n RTD, EXPERTS MEETING n NATIONAL NEUROLOGY MEETING/CONGRESS n NATIONAL INTERNIST MEETING n ADVERTISEMENT at DOCTORS MEDICAL JOURNAL n SPONSORSHIP KOL / POTENCIAL USER FOR INTERNATIONAL SCIENCE MEETING

How to Sell Guidance n Counter Gamaraas n n n n Clinical indications 5% solution Virus inactivation/removal studies Sorbitol as stabilizer no provision for room temperature storage in the shelf life as defined by the PI. not as convenient for high dose applications such as patients suffering from neurological disorders. does not state US FDA labeling for removal of pathogenic prions that may cause TSE disease in humans, No latex free packaging or tamper evident vials with cap over wrap.

HOW to Sell n Selling Skill n n n Suggestion doctors to divide prescribing by day Suggestion Purchaser to divide purchasing Suggestion to try with half dose, story telling others physician success We are premium price for quality product Detailing the benefits

CONCLUSION – Key Success Focus to Market indication Target n ITP n PID n CIDP n GBS n Kawasaki Disease n Focus to Physician Target n Neurologist n Hematologist-Oncologist n Allergy-immunologist n Pediatrician n n n Immunologist Emergency [KEGAWAT-DARURATAN] Neurologist Cardiologist Infection tropic pulmonologist

Hyper. HEP Product Management

Hyper. HEP Market : Vertical Mother with Hepatitis B : Horizontal Populasi Wanita usia subur : Dept Kependudukan th 2005 -2006 : 50, 820, 586 jiwa bayi lahir resiko hepatitis B : 118, 157 jiwa per tahun

Hyperhep Positioning n “The only Hb. Ig Prevent Hepatitis vertically from mother to a baby Key Message n Hyper. Hep-TM drug of choice for Prevent Hepatitis on Mother HBSAg positif. ……

Consumer / Patients Segmentation n Segmented Patient n Middle to High Economic background n Urban Demographic n Productive age n Patient Behavior n Smart patient n Caring patient n Indonesian Population n 118, 157/ year baby with infectious risk

Potential Market n 118, 157/ year baby with infectious risk n With urban demographic 20% n 23, 630/year syringes n 1970/ month? n Now…. 300 syringes/month

Target Costumer n Physician n Obstetrician n Pediatrician n Nurse n Fetomaternal / VK room n Place n Hospital n Delivery Hospital

Key to Success n Hbs. Ag check standardization n Mechanism on Hospital n Pediatrician n Obstetrician n Nurse

Strategy n INSIDE STRATEGY n OUTSIDE STRATEGY n COSTUMER/DOCTORS n CONSUMER/PATIENT

Strategy n INSIDE STRATEGY n Training n Test Evaluate n Right doctors n n Pediatrician Obstetrician

Key Of Activities n Marketing ASPECT n Product Presentation n n Hospital Fetomaternal events Perinasia events Symposium n Perinasia Events n Selling ASPECT n n n Detailing to Physician Visits to VK room Scientific supports n n Direct Indirect

Strategy n OUTSIDE STRATEGY n COSTUMER/DOCTORS n n n Detailing VK visits CONSUMER/PATIENT n Looking forward for events

Key Of Activities n Selling skill n Suggest physician to motivate patient to save money long before delivery n Suggest physician to standardize the lab check for Mother include Hbs. Ag for the sake of physician and paramedics whose help the delivery

Hype. RHO Positioning n “The Wise Treatment to Prevent Hemolytic Disease of The New Born” Key Message n Hyper. Rho-D drug of choice for Prevent HDN on Mother Rhesus negatif with born Rhesus positive

Key Of Activities n Marketing ASPECT n Product Presentation n n Hospital Fetomaternal events Perinasia events Symposium n Perinasia Events n Selling ASPECT n n n Detailing to Physician Visits to VK room Scientific supports n n Direct Indirect

Strategy n OUTSIDE STRATEGY n COSTUMER/DOCTORS n n n Detailing VK visits CONSUMER/PATIENT n Looking forward for events

Special Strategy n Campaign Hyper. Rho D n 5 bulan menjelang ED campaign 2+1 berdasar pemakaian 1 pasien adalah 3 syringe Untuk outlet baru. n 4 bulan menjelang ED didonasikan utk PMI dan user baru. Tentang jumlah akan didiskusikan lebih lanjut. n Utk outlet lama campaign kondisi akan berbeda sesuai dengan potensi

Special Strategy n Segera sosialisasikan program ini. n Untuk donasi Buat secara sistematis, PMI mana saja yang akan anda donasi Hyperrho n Demikian juga untuk programs Kondisi khusus, segera di Petakan. Dan estimasikan berapa Hyper. Rho yang bisa diserap di masing-masing program; baik program Donasi maupun Program Kondisi/Diskon

Any Question or Comments You can addressed to n peterkrisnomo@yahoo. com n peters@dipa. co. id n Facebook with user name : Peters Krissna n Mobile fren 08886130147 n Mobile gsm 081671220 n Black Berry pin : 20 DD 00 B 3 n roadrunnerdipa@yahoogroups. com