Final 1 - 4

FINAL RESEARCH MGU MBA
ASSESING THE FACTORS MOTIVATING DOCTORS TO

PRESCRIBE ORIGINAL BRANDS, WITH SPECAIL
PREFERENCE TO AUGUMENTIN
ABDUL GHANY WAZEER KHAN
MBA BATCH - 5
RESEARCH REPORT
Mahatma Gandhi University

Master of Business Administration (MBA) P a g e |0
Table of Contents
1 Executive Summary ......................................................................................................................... 3
2 INTRODUCTION ............................................................................................................................... 4
2.1 Background.............................................................................................................................. 4
2.2 Research Problem ................................................................................................................... 5
2.2.1 What are Antibiotics? ...................................................................................................... 8
2.2.2 Antibiotic resistance ........................................................................................................ 8
2.2.3 Antibiotics classification .................................................................................................. 9
2.2.4 AUGMENTIN* .................................................................................................................. 9
2.3 The Significance ..................................................................................................................... 11
2.4 The Objectives ....................................................................................................................... 12
3 LITERATURE REVIEW ..................................................................................................................... 13
3.1 Antibiotics classification ........................................................................................................ 14
3.1.1 Penicillins ....................................................................................................................... 14
3.1.2 Cephalosporin ............................................................................................................... 15
3.1.3 Fluroquinolones ............................................................................................................ 17
3.1.4 Tetracycline ................................................................................................................... 18
3.1.5 Macrolides ..................................................................................................................... 19
3.1.6 Aminoglycosides ............................................................................................................ 20
3.2 Motivation ............................................................................................................................. 21
3.2.1 Motivation Process........................................................................................................ 22
3.3 Brand ..................................................................................................................................... 22
4 RESEARCH METHODOLOGY........................................................................................................... 23
4.1 Theoretical framework .......................................................................................................... 24
4.2 Data collection....................................................................................................................... 25

4.2.1 Quantitative and Qualitative Data collection methods ................................................ 25
4.2.2 Sample Plan. .................................................................................................................. 26
4.2.3 The Questionnaire ......................................................................................................... 26
5 DATA ANALYSIS, HYPOTHESIS TESTING AND RESULTS.................................................................. 27
5.1 Data Analysis and Hypothesis testing ................................................................................... 27
5.1.1 Doctor Samples ............................................................................................................. 27
5.1.2 Chemists samples .......................................................................................................... 36
5.2 Objectives and research model testing through findings and the out come........................ 42
6 CONCLUSION AND RECOMMENDATIONS ..................................................................................... 43
6.1 Conclusion ............................................................................................................................. 43
6.2 Recommendations ................................................................................................................ 44
7 References ..................................................................................................................................... 45
8 Appendices .................................................................................................................................... 46

1 Executive Summary
Research Topic - Assessing the Factors Motivating Doctors to Prescribe Original Brands,
With Special Preference to Augmentin
When we have a look around the world we can understand there are several industries
that show a significant growth day by day. Among that, pharmaceuticals industries also
shows an unbelievable growth not only in Sri Lanka but also worldwide. Within that we
have took the consideration to focus on antibiotics that are used to treat infections. The
word "antibiotics" comes from the Greek anti ("against") and bios ("life"). An antibiotic is
a drug that kills or slows the growth of bacteria.
Co-amoxiclav is a widely using antibiotic also it is famous as a beta lactumase inhibitor.

Most of the doctors preferred antibiotic to treat infections. It is a drug of choice of
consultants to prescribe as well. Co-amoxiclav was invented around 1977/78 by British
scientists working at Beecham, which filed for US patent protection for the drug
combination in 1979. US patent 4441609 was granted in 1984. Augmentin is the original
name used by its inventor (GlaxoSmithKline formerly Beecham). Actually Co-amoxiclav is
a type of penicillin combination drug.
After inventing and introducing Co-amoxiclav, many pharmaceutical research based

companies studied about this Co-amoxiclav and by using the molecule structure of
Augmentin, those companies started introduce their Co-amoxiclav brands to the market
and promote those brands to doctors to prescribe.
There are many generic brands of Co-amoxiclav which was introduced by many generic
companies and export to many countries all over the world. In Sri Lanka there are many
generic brand of Co-amoxiclav promoted and distributed by companies.
This research is undertaken to identify what are factors motivating doctors to prescribe
original brand of Co-amoxiclav with special preference to Augmentin.

2 INTRODUCTION
2.1 Background
In Sri Lankan context market for pharmaceuticals has shown a negative growth in the
last quarter of 2014 according to the latest IMS report (Intercontinental Marketing
Services in pharmaceuticals), within that the anti biotic market is also shows a significant
2.2 negative growth.
There are various classes of antibiotics used by the doctors to treat to their patients. The
continuous growth of these markets encourages the researchers innovative new
molecules resulting different types of therapeutic classes are introduced constantly
treatment of various infections.
Co-amoxiclav is the British Approved Name for the combination antibiotic containing
(amoxicillin+clavulanic acid) amoxicillin trihydrate, a -lactam antibiotic, with potassium
clavulanate, so it is a -lactamase inhibitor. This combination results in an antibiotic with
an increased spectrum of action and restored efficacy against amoxicillin-resistant
bacteria that produce -lactamase.
Co-amoxiclav was invented around 1977/78 by British scientists working at Beecham,

which filed for US patent protection for the drug combination in 1979. US patent 4441609
was granted in 1984. Augmentin is the original name used by its inventor
(GlaxoSmithKline formerly Beecham). Actually Co-amoxiclav is a type of penicillin drug.
Generic brands are marketing operation in Sri Lanka even though they couldnt reduce
the gap between (Augmentin). The Augmentin was the first brand launched in Sri Lanka.
But there are few generic brands which are in the market for longer period too.
Certain generic brands are also in the market for last few decades. There is a decent
market growth for the original brand Augmentin, manufactured and market by GSK.
But branded generics have only a slight growth when we compared with Augmentin.
(Reference from IMS data) Hence there is a clear understanding that doctors prefer to
prescribe Augmentin even though quality branded generics available in the market for a
reasonable price.
There for through this study will put an effort to assess the factors motivating doctors to
prescribe original brand with special emphasis made to Augmentin.

2.2 Research Problem
When analyse the IMS data CAGR (last four years average growth) shows a positive trend on
antibiotics and Co-amoxiclav as molecule picking up the market strongly and rapidly. This clearly
goes to say that the antibiotic market in Sri Lanka is extremely important and attractive market
for those who market antibiotic products.
There are various types of antibiotic drugs used in the management of infections. The
consistent rapid growth of this market itself encourages the researches to innovate new
molecules resulting different types of therapeutic classes are introduced constantly for the
treatment of bacterial infections. But the Co-amoxiclav is drug of choice in treating Urinary tract
infection (upper & lower), respiratory tract infection such as Sinusitis, Otitis Media and other Skin
& soft tissue infections. The first brand to Sri Lanka introduced by Glaxo SmithKline (GSK) which is
Augmentin (Original). This brand own the most of the market share of Co-amoxiclav. According to
IMS data, number one brand and market leader in Sri Lanka. Following is the list of brands ranked
by IMS
Augmentin Glaxso Smith Kline
Enhancin Ranbaxy (Hemas)
Novaclav Cipla City Health
Clavamox Kalbe (Hemas)
Myclav Unichem Baurs
When we see the trend of prescription there is a big question why doctors are prefer
to give Augmentin to their patients even though the quality generic products available
which is its quality is equal to Augmentin and price wise generic brands is the most
suitable and affordable in Sri Lanka. Following figures ensure the price advantage.
Brand Name Strength Each tablet/bottle price Rs.
Enhancin 625mg tab 60.00
Enhancin 375mg tab 36.60
Enhancin 156mg syrup 288.00
Clavemox 625mg tab 67.00
Clavemox 375mg tab 42.00
Clavemox 156mg Syrup 252.00

Novaclav 625mg tab 49.00
Novaclav 375mg tab 29.00
Novaclav 156mg Syrup 233.00
Myclav 625mg tab 55.25
Myclav 375mgtab Not Available
Myclav 156mg Syrup Not Available
After visit to many chemist to gather information, most of the pharmacist they gave
valuable feedback of both the generic and the original of Co-amoxiclav, also they said
because of the economical situation when doctors are prescribed Augmentin to the
patients first question raised by the patients from the pharmacist is about the price of the
drug, and after that patient decides to reduce the dosage of the drug for example if it is
prescribed for 7 days they are getting it for 3 days. Discontinuation of the treatment will
cause here so it is not a good positive thing for the patient in the future of treatment.
Patients wont get the full dose because of the price and they wont fully get recover of
the disease. Its not even good for the doctors reputation.
Eg:- If the doctor prescribed Augmentin 625 bd (twice daily) for 7 days the price will be
(72*2*7 days) = Rs 1008 only for one drug. But if we consider about generic brands in an
average 625 bd for 7 days cost will be Rs. 588 (42*2*7days).
According above mentioned situation it is interested to assess what are the factors
motivating doctors to prescribe Augmentin when compared to Generic brands. Here its
very important to study why doctors show more preference to Augmentin rather than
Generic brands. And need to identify what can be done to sustain Augmentin market
share.

Figure 01 Co-amoxiclav Market share In Sri Lanka
Source IMS- A Pharmaceutical Research Agency report 2008
The above mentioned pie chart indicates the different brands of Co-amoxiclav used in
Sri Lanka and the market share of each leading brands. According to the IMS data above
pie chart shows that Augmentin enjoy the maximum market share of 42%. But Generics
Own a small market share. This research is to assess the motivating factors to prescribe
Augmentin compared to generic brands. And get the optimum idea how to sustain and
grow market share by giving valid recommendation.

2.2.1 What are Antibiotics?
The word "antibiotics" comes from the Greek anti ("against") and bios ("life"). An
antibiotic is a drug that kills or slows the growth of bacteria. Antibiotics are one class of
antimicrobials, a larger group other antimicrobials also available which includes anti-viral,
anti-fungal, and anti-parasitic drugs. Antibiotics are chemicals produced by or derived
from microorganisms (i.e. bugs or germs such as bacteria and fungi). The first antibiotic
was discovered by Alexander Fleming in 1928 in a significant breakthrough for medical
science. Antibiotics are among the most frequently prescribed medications in modern
medicine.
Antibiotics are used to treat many different bacterial infections. Antibiotics cure
disease by killing or injuring bacteria. Bacteria are simple one-celled organisms that can
be found, by the billions, all around us: on furniture and counter-tops, in the soil, and on
plants and animals. They are a natural and needed part of life. Bacteria cause disease and
infection when they are able to gain access to more vulnerable parts of our bodies and
multiply rapidly. Bacteria can infect many parts of the body: eyes, ears, throat, sinuses,
lungs, airways, skin, stomach, colon, bones, and genitals.
Some antibiotics are 'bactericidal', meaning that they work by killing bacteria. Other
antibiotics are 'bacterial static', meaning that they work by stopping bacteria multiplying.
Each different type of antibiotic affects different bacteria in different ways. For
example, an antibiotic might inhibit a bacterium's ability to turn glucose into energy, or
its ability to construct its cell wall. When this happens, the bacterium dies instead of
reproducing.
Some antibiotics can be used to treat a wide range of infections and are known as
'broad-spectrum' antibiotics. Others are only effective against a few types of bacteria and
are called 'narrow-spectrum' antibiotics.
2.2.2 Antibiotic resistance
Antibiotics are extremely important in medicine, but unfortunately bacteria are

capable of developing resistance to them. Antibiotic-resistant bacteria are germs that are

not killed by commonly used antibiotics. When bacteria are exposed to the same
antibiotics over and over, the bacteria can change and are no longer affected by the drug.
Bacteria have number of ways how they become antibiotic-resistant. For example, they
possess an internal mechanism of changing their structure so the antibiotic no longer
works, they develop ways to inactivate or neutralize the antibiotic. Also bacteria can
transfer the genes coding for antibiotic resistance between them, making it possible for
bacteria never exposed to an antibiotic to acquire resistance from those which have. The
problem of antibiotic resistance is worsened when antibiotics are used to treat disorders
in which they have no efficacy (e.g. antibiotics are not effective against infections caused
by viruses), and when they are used widely as prophylaxis rather than treatment.
Resistance to antibiotics poses a serious and growing problem, because some

infectious diseases are becoming more difficult to treat. Resistant bacteria do not
respond to the antibiotics and continue to cause infection. Some of these resistant
bacteria can be treated with more powerful medicines, but there some infections that
are difficult to cure even with new or experimental drugs.
2.2.3 Antibiotics classification
Although there are several classification schemes for antibiotics, based on bacterial
spectrum (broad versus narrow) or route of administration (injectable versus oral versus
topical), or type of activity (bactericidal vs. bacterial static), the most useful is based on
chemical structure. Antibiotics within a structural class will generally have similar
patterns of effectiveness, toxicity, and allergic potential.
Most commonly used types of antibiotics are: Amino glycosides, Penicillins,

Fluroquinolones, Cephalosporins, Macrolides, and Tetracyclines. While each class is
composed of multiple drugs, each drug is unique in some way.
2.2.4 Augmentin
Augmentin is an oral antibacterial combination consisting of amoxicillin and the beta-lactumase

inhibitor, clavulanate potassium (the potassium salt of clavulanic acid).
Amoxicillin is an analog of ampicillin, derived from the basic penicillin nucleus, 6-

aminopenicillanic acid. The amoxicillin molecular formula is C16H19N3O5S3H2O, and the molecular
weight is 419.46. Chemically, amoxicillin is (2S,5R,6R)-6-[(R)-(-)-2-Amino-2-
(phydroxyphenyl)acetamido]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic
acid trihydrate and may be represented structurally as:

Clavulanic acid is produced by the fermentation of Streptomyces clavuligerus. It is a beta-lactam

structurally related to the penicillins and possesses the ability to inactivate some beta-lactamases
by blocking the active sites of these enzymes. The clavulanate potassium molecular formula is
C8H8KNO5, and the molecular weight is 237.25. Chemically, clavulanate potassium is potassium
(Z)(2R,5R)-3-(2-hydroxyethylidene)-7-oxo-4-oxa-1-azabicyclo[3.2.0]-heptane-2-carboxylate and
may be represented structurally as:
Inactive Ingredients
Tablets-Colloidal silicon dioxide, hypromellose, magnesium stearate, microcrystalline

cellulose, polyethylene glycol, sodium starch glycolate, and titanium dioxide. Each tablet
of amoxicillin/clavulanate potassium contains 0.63 mEq potassium.
Powder for Oral Suspension-Colloidal silicon dioxide, flavorings, xanthan gum, and one or
more of the following: hypromellose, mannitol, silica gel, silicon dioxide, succinic acid,
Chewable Tablets-Colloidal silicon dioxide, flavorings, magnesium stearate, mannitol, and

one or more of the following: D&C Yellow No. 10, FD&C Red No. 40, glycine, sodium
saccharin, and aspartame.
Following table will explain about the price and pack size of AUGMENTIN*
Strengths Price Pack size
Augmentin* 375mg Rs. 41.00 20 tabs
Augmentin* 625mg Rs. 72.00 14 tabs
Augmentin * 156mg Syr Rs, 299.00 1 bottle

2.3 The Significance
It is interesting and important to recognize the factors influencing the doctors to

prescribe original brand with comparison to branded generics in the market. There are
more than 30 brands of Co-amoxiclav available in local Sri Lankan market. Most
importantly all the other Co-amoxiclav products hold a small market share and slight
growth when compare to Augmentin. So we need to study the marketing activities
implemented by Augmentin to increase and maintaining their market share.
In companys point of view by increasing the sales of Augmentin, there are few
benefits that company can enjoy. They are;
Growth of the company will ensure and further can increase the quality by
allocating more budgets for research and development.
And will be able to expand the operation by getting new staff.
Can go for new molecules various diseases.
New job opportunities will create. It is good for the country as well.
In countrys point of view,
According to the current economic situation low income and cost of living are very
high, is the common complains. But people can enjoy with their current income by
spending less amount for healthcare instead of going for originals by using
branded generics.
New Job opportunities will come out.
Can reduce the flow of money out from the country
In doctors point of view,
They can prescribe good quality products for reasonable price.
Better patient compliance or good feedback.
Doctors can build the reputation among the patients.
Doctors can stock those products in their indoor pharmacy because of less price
compare to original.

In patients point of view,
They no need to spend extra money for the same quality products.
Can follow the whole course of drug due to reasonable price.
No need to discontinue the treatment.
2.4 The Objectives
Overall objective of this study is to assess the factors motivating doctors to prescribe
original brand, with special preference to Augmentin
Specific objectives;
To assess what factors affecting doctors to prescribe original brand of Co-amoxiclav.
To identify the specific reason that should be confident if a doctor is to prescribe Generic
Brands.
To examine whether there is a correlation between willingness to prescribe Generic

brands and the inputs been provided.

3 LITERATURE REVIEW
This report tries to examine the factors motivating doctors to prescribe original brand
with comparison to Generic. There would be some key words constantly used in this
research such as Inputs, Generic, Original, Brand, Motivate, Augmentin, Enhancin, Co-
amoxiclav etc...
Following are the explanation of those key words.
Inputs This refers to promotional inputs that a company uses to promote their brands
and motivate doctors towards their brands. According to the company it consists of
various inputs like samples, complements, sponsors, use of local promotional budgets,
foreign tours, bonus schemes etc...
Original Brand These are the drugs which are first invented by scientists after many
research and development. These are innovative drugs also they brand it in a mass way
and it will include in the medical journal named BNF (British National Formulary).Eg:
Augmentin.
Branded Generic Chemical is designed by following the structure of the original drug,
using a brand name for the generic to market and differenciate it from the generics. Eg:
Myclav, Novaclav, Clavamox (Branded generic names)
Generic The chemical name of a drug, or a term referring to the chemical makeup of a
drug rather than to the advertised brand name under which the drug is sold or a term
referring to any drug marketed under its chemical name without advertising. Eg: Co-
amoxiclav, Paracetamol
Co-amoxiclav Is the British approved name for the combination antibiotic containing
amoxicillin trihydrate, a -lactam antibiotic, with potassium clavulanate
(www.patient.co.uk)
Augmentin Contains a combination of amoxicillin and clavulanate potassium(co-

amoxiclav). Amoxicillin is an antibiotic in a group of drugs called penicillins. Amoxicillin
fights bacteria in the body. This is the original brand of co-
amoxiclav.(http://www.drugs.com/augmentin.html#ixzz10T1ZYnzw)
Branded generic - product of Co-amoxiclav or molecule designed same as original co-

amoxiclav (Augmentin).
An antibiotic - An antibiotic is a drug that kills or slows the growth of bacteria.
Antibiotic resistance - Antibiotics are extremely important in medicine, but unfortunately

bacteria are capable of developing resistance to them. Antibiotic-resistant bacteria are

germs that are not killed by commonly used antibiotics. When bacteria are exposed to
the same antibiotics over and over, the bacteria can change and are no longer affected by
the drug.
3.1 Antibiotics classification
Although there are several classification schemes for antibiotics, based on bacterial
spectrum (broad versus narrow) or route of administration (injectable versus oral versus
topical), or type of activity (bactericidal vs. bacteriostatic), the most useful is based on
chemical structure. Antibiotics within a structural class will generally have similar
patterns of effectiveness, toxicity, and allergic potential. Most commonly used types of
antibiotics are: Penicillins, Aminoglycosides, Fluoroquinolones, Cephalosporins,
Macrolides, and Tetracyclines. While each class is composed of multiple drugs, each drug
is unique in some way.
3.1.1 Penicillins
The penicillins are the oldest class of antibiotics. Penicillins have a common chemical
structure which they share with the cephalopsorins. Penicillins are generally bactericidal,
inhibiting formation of the cell wall. Penicillins are used to treat skin infections, dental
infections, ear infections, respiratory tract infections, urinary tract infections, gonorrhea.
There are four types of penicillins:
The natural penicillins are based on the original penicillin-G structure. Penicillin-G types
are effective against gram-positive strains of streptococci, staphylococci, and some gram-
negative bacteria such as meningococcal.
Penicillinase-resistant penicillins, notably methicillin and oxacillin, are active even in the
presence of the bacterial enzyme that inactivates most natural penicillins.
Aminopenicillins such as ampicillin and amoxicillin have an extended spectrum of action

compared with the natural penicillins. Extended spectrum penicillins are effective against
a wider range of bacteria.
Penicillins side effects

Penicillins are among the least toxic drugs known. The most common side effect of
penicillin is diarrhea. Nausea, vomiting, and upset stomach are also common. In rare
cases penicillins can cause immediate and delayed allergic reactions specifically, skin
rashes, fever, and anaphylactic shock. Penicillins are classed as category B during
pregnancy.
3.1.2 Cephalosporin
Cephalosporin has a mechanism of action identical to that of the penicillins. However, the
basic chemical structure of the penicillins and Cephalosporins differs in other respects,
resulting in some difference in the spectrum of antibacterial activity. Like the penicillins,
Cephalosporins have a beta-lactam ring structure that interferes with synthesis of the
bacterial cell wall and so are bactericidal. Cephalosporins are derived from cephalosporin
C which is produced from Cephalosporium Acremonium.
Cephalosporins are used to treat pneumonia, strep throat, staph infections, tonsillitis,
bronchitis, otitis media, various types of skin infections, gonorrhea, urinary tract
infections Cephalosporin antibiotics are also commonly used for surgical prophylaxis.
Cephalexin can also be used to treat bone infections.
Cephalosporins are among the most diverse classes of antibiotics, they are grouped into
"generations" by their antimicrobial properties. Each newer generation has a broader
spectrum of activity than the one before.
The first generation Cephalosporins include: Their spectrums of activity are quite similar.
They possess generally excellent coverage against most gram-positive pathogens and
variable to poor coverage against most gram negative pathogens.
The first generation Cephalosporins include:
cephalothin
cefazolin
cephapirin
cephradine
cephalexin
cefadroxil

Second generation Cephalosporins In addition to the gram positive spectrum of the first
generation Cephalosporins, these agents have expanded gram negative spectrum.
Cefoxitin and cefotetan also have good activity against Bacteroides fragilis. Enough
variation exists between the second generation cephalosporins in regard to their
spectrums of activity against most species of gram negative bacteria, that susceptibility
testing is generally required to determine sensitivity.
The second generation Cephalosporins include:
cefaclor
cefamandole
cefonicid
ceforanide
cefuroxime
Third generation Cephalosporins have much expanded gram negative activity. However,
some members of this group have decreased activity against gram-positive organisms.
They have the advantage of convenient dosing schedules, but they are expensive.
The third generation Cephalosporins include:
cefcapene
cefdaloxime
cefditoren
cefetamet
cefixime
cefmenoxime
cefodizime
cefoperazone
cefotaxime
cefpimizole
cefpodoxime
ceftibuten

ceftriaxone
The fourth generation Cephalosporins are extended-spectrum agents with similar

activity against gram-positive organisms as first-generation cephalosporins. They also
have a greater resistance to beta-lactamases than the third generation cephalosporins.
Many fourth generation cephalosporins can cross blood brain barrier and are effective in
meningitis.
The fourth generation Cephalosporins include:
cefclidine
cefepime
cefluprenam
cefozopran
cefpirome
cefquinome
Cephalosporins side effects - Cephalosporins generally cause few side effects.
Common side effects associated these drugs include: diarrhea, nausea, mild stomach
cramps or upset. Approximately 510% of patients with allergic hypersensitivity to
penicillins will also have cross-reactivity with cephalosporins. Thus, cephalosporin
antibiotics are contraindicated in people with a history of allergic reactions (urticaria,
anaphylaxis, interstitial nephritis, etc) to penicillins or cephalosporins. Cephalosporin
antibiotics are classed as pregnancy category B.
3.1.3 Fluoroquinolones
Fluoroquinolones (fluoridated quinolones) are the newest class of antibiotics. Their

generic name often contains the root "floxacin". They are synthetic antibiotics, and not
derived from bacteria. Fluoroquinolones belong to the family of antibiotics called
quinolones. The older quinolones are not well absorbed and are used to treat mostly
urinary tract infections. The newer fluroquinolones are broad-spectrum bacteriocidal
drugs that are chemically unrelated to the penicillins or the cephaloprosins. Because of
their excellent absorption fluroquinolones can be administered not only by intravenous
but orally as well.

Fluoroquinolones are used to treat most common urinary tract infections, skin infections,
and respiratory infections (such as sinusitis, pneumonia, bronchitis).
Fluoroquinolones inhibit bacteria by interfering with their ability to make DNA. This
activity makes it difficult for bacteria to multiply. This effect is bacteriocidal.
Commonly used fluoroquinolones include
ciprofloxacin
levofloxacin
lomefloxacin
norfloxacin
sparfloxacin
clinafloxacin
gatifloxacin
ofloxacin
trovafloxacin
Fluoroquinolones side effects - Fluoroquinolones are well tolerated and relatively safe.
The most common side effects include nausea, vomiting, diarrhea, abdominal pain. Other
more serious but less common side effects are central nervous system effects (headache,
confusion and dizziness), phototoxicity (more common with lomefloxacin and
sparfloxacin). All drugs in this class have been associated with convulsions.
Fluoroquinolones are classed as pregnancy category C.
3.1.4 Tetracycline
Tetracyclines got their name because they share a chemical structure that has four rings.
They are derived from a species of Streptomyces bacteria. Tetracycline antibiotics are
broad-spectrum bacteriostatic agents, that inhibit bacterial protein synthesis.
Tetracyclines may be effective against a wide variety of microorganisms, including
rickettsia and amebic parasites.
Tetracyclines are used in the treatment of infections of the respiratory tract, sinuses,
middle ear, urinary tract, skin, intestines. Tetracyclines also are used to treat Gonorrhoea,

Rocky Mountain spotted fever, Lyme disease, typhus. Their most common current use is
in the treatment of moderately severe acne and rosacea.
The most commonly prescribed tetracycline antibiotics are:
tetracycline
doxycycline
minocycline
oxytetracycline
Tetracycline side effects - Drugs in the tetracycline class become toxic over time. Expired
drugs can cause a dangerous syndrome resulting in damage to the kidneys.
Common side effects associated with tetracycline include cramps or burning of the
stomach, diarrhea, sore mouth or tongue. Tetracycline can cause skin photosensitivity,
which increases the risk of sunburn under exposure to UV light. This may be of particular
importance for those intending to take on holidays long-term doxycyline as a malaria
prophylaxis. Rarely, tetracycline may cause allergic reactions. Very rarely severe
headache and vision problems may be signs of dangerous secondary intracranial
hypertension.
Tetracycline antibiotics should not be used in children under the age of 8, and specifically
during periods of tooth development. Tetracyclines are classed as pregnancy category D.
Use during pregnancy may cause alterations in bone developmentt.
3.1.5 Macrolides
The macrolide antibiotics are derived from Streptomyces bacteria, and got their name
because they all have a macrocyclic lactone chemical structure. The macrolides are
bacteriostatic, binding with bacterial ribosomes to inhibit protein synthesis.
Erythromycin, the prototype of this class, has a spectrum and use similar to penicillin.
Newer members of the group, azithromycin and clarithyromycin, are particularly useful
for their high level of lung penetration. Macrolide antibiotics are used to treat respiratory
tract infections (such as pharyngitis, sinusitis, and bronchitis), genital, gastrointestinal
tract, and skin infections.
The most commonly prescribed macrolide antibiotics are:
erythromycin
clarithromycin
azithromycin
dirithromycin
roxithromycin
troleandomycin
Macrolides side effects - Side effects associated with macrolides include nausea,
vomiting, and diarrhea; infrequently, there may be temporary auditory impairment.
Azithromycin has been rarely associated with allergic reactions, including angioedema,
anaphylaxis, and dermatologic reactions. Oral erythromycin may be highly irritating to
the stomach and when given by injection may cause severe phlebitis. Macrolide
antibiotics should be used with caution in patients with liver dysfunction. Pregnancy
category B: Azithromycin, erythromycin. Pregnancy category C: Clarithromycin,
dirithromycin, troleandomycin.
3.1.6 Aminoglycosides
Aminoglycoside antibiotics are used to treat infections caused by gram-negative bacteria.

Aminoglycosides may be used along with penicillins or cephalosporins to give a two-
pronged attack on the bacteria. Aminoglycosides work quite well, but bacteria can
become resistant to them. Since aminoglycosides are broken down easily in the stomach,
they can't be given by mouth and must be injected. Generally, aminoglycosides are given
for short time periods. The aminoglycosides are drugs which stop bacteria from making
proteins. This effect is bacteriocidal.
The most commonly-prescribed aminoglycosides:
amikacin
gentamicin
kanamycin
neomycin
streptomycin
tobramycin

Aminoglycosides side effects - When injected, their side effects include possible damage
to the ears and to the kidneys. This can be minimized by checking the amount of the drug
in the blood and adjusting the dose so that there is enough drug to kill bacteria but not
too much of it. References & Resources
1. The Merck Manual of Medical Information. Mark H. Beers et al., eds. 2nd Home
Edition. Whitehouse Station, NJ: Merck; 2003.
2. Antibiotics: MedlinePlus. U.S. National Library of Medicine
3. Physicians' Desk Reference. 59th ed. Montvale, N.J.: Thomson PDR, 2005.
Published: May 05, 2007

last updated: December 07, 2009
3.2 Motivation
This theory which suggests five interdependent levels of basic human needs (motivators)
that must be satisfied in a strict sequence starting with the lowest level. Physiological
needs for survival (to stay alive and reproduce) and security (to feel safe) are the most
fundamental and most pressing needs. They are followed by social needs (for love and
belonging) and self-esteem needs (to feel worthy, respected, and have status). The final
and highest level needs are self-actualization needs (self-fulfillment and achievement). Its
underlying theme is that human beings want' beings: as they satisfy one need the next
emerges on its own and demands satisfaction and so on until the need for self-
actualization that, by its very nature, cannot be fully satisfied and thus does not generate
more needs. This theory states that once a need is satisfied, it stops being a motivator of
human beings. In personnel management, it is used in design of incentive schemes. In
marketing, it is used in design of promotional campaigns based on the perceived needs of
a market segment a product satisfies.(www.businessdictionary.com/definition/Maslow-s-
hierarchy-

3.2.1 Motivation Process
Learning
Goal or Need
Unfulfilled
fulfillment
needs, wants Tension Drive Behavior
and desires
Cognitive
Process
Tension
Reduction
Figure 3.2.1 Motivation Process
3.3 Brand
A brand is a name, term, design, symbol, or a combination of them intended to identify

the goods or services of one seller or group of sellers, and to differentiate them from
those of competitors (Principals of Marketing - Philip Kotler 13th edition)

4 RESEARCH METHODOLOGY
The independent and dependent variables will be operated and hypotheses will be
developed. In order to test the hypotheses quantitative data will be collected from a
purposive sample for the research.
The system of collecting data for research projects is known as research methodology.
The data may be collected for either theoretical or practical research for example
management research may be strategically conceptualized along with operational
planning methods and change management.
Some important factors in research methodology include validity of research data,

Ethics and the reliability of measures most of your work is finished by the time you finish
the analysis of your data.
Formulating of research questions along with sampling weather probable or non

probable is followed by measurement that includes surveys and scaling. This is followed
by research design, which may be either experimental or quasi-experimental. The last
two stages are data analysis and finally writing the research paper, which is organized
carefully into graphs and tables so that only important relevant data is shown.

4.1 Theoretical framework
To identify the research requirements we need to test those depended variables as

well as independent variables which can motivate doctors to prescribe original brand
comparison to Generic brands. Following will explain on depended variables and
independent variables.
Independent Variable Depended Variables
1. Level of practice 1. Most prescribing antibiotics
2. Number of patients treat 2. Co-amoxiclav brand

preference
3. Geographical location 3.Indications
4. Doctor qualification 4.Doctor category (Surgeon,

VP)
5. Antibiotics usage 5.Dosage recommend
6. Classes of antibiotic using 6.Resason to Rx a brand.
7. Diagnosis of disease
8. Level of kwoledge
9. Co-amoxiclav usage
Figure 4.1 Theoretical Framework

4.2 Data collection
Figure 4.2 Data collection
The methodology that will be followed includes both collections of primary & secondary data.
This dissertation will collect the said secondary data & primary data from the following sources.
Questionnaire needs to be distributed among General practitioners and among other Consultants
(Physicians, Visiting Surgeons etc) and product manager of the organization, also to leading
chemists. Data Collection is an important aspect of any type of research study.
Inaccurate data collection can impact the results of a study and ultimately lead to invalid results.
Data collection methods for impact evaluation vary along a continuum. At the one end of this
continuum are quantitative methods and at the other end of the continuum are Qualitative
methods for data collection.
4.2.1 Quantitative and Qualitative Data collection methods
The Quantitative data collection methods rely on random sampling and structured data collection
instruments that fit diverse experiences into predetermined response categories. They produce
results that are easy to summarize, compare, and generalize.
Quantitative research is concerned with testing hypotheses derived from theory and/or
being able to estimate the size of a phenomenon of interest. Depending on the research
question, participants may be randomly assigned to different treatments. If this is not
feasible, the researcher may collect data on participant and situational characteristics in
order to statistically control for their influence on the dependent, or outcome, variable. If

the intent is to generalize from the research participants to a larger population, the
researcher will employ probability sampling to select participants.
Typical quantitative data gathering strategies include:
Experiments /clinical trials
Observing and recording well-defined events (e.g., counting the number of patients
waiting in emergency at specified times of the day).
Obtaining relevant data from management information systems
Administering surveys with closed-ended questions (e.g., face-to face and telephone
interviews, questionnaires etc).
4.2.2 Sample Plan.
The primary data will be mainly collected through questionnaires the sample plan
used for this purpose will be as follows.
Category Description of category Sample size
Doctors GPs 75
Doctors Consultants 25
Chemists Leading Pharmacy 50
Total 150
4.2.3 The Questionnaire
I have attached my questionnaire to Annexure

5 DATA ANALYSIS, HYPOTHESIS TESTING AND RESULTS
After the impressive collection, data analysis was done and completed by suing MS Excel.
Data was collected according to the research proposal. Finally the entire research based
on the answer which I have collected information by using 3 questionnaires for the target
groups. They are Doctors, Patients and Chemists (Pharmacy).
5.1 Data Analysis and Hypothesis testing
5.1.1 Doctor Sample.
This consists of 75 GPs and 25 Consultants.
Question no. 1 Statistics shows that the usages of Co-amoxiclav are more comparing to
other Antibiotic available in market. What is your opinion?
60
50
40
30 Opinion
20
10
0
Strongly Agree Agree Neutral Disagree Strongly
Disagree
Figure 5.1.1.1
With the findings it is confirmed that in total Antibiotic market use of Co-amoxiclav are
very high. Therefore Co-amoxiclav has a high potential in antibiotic market. It is evident
that Co-amoxiclav as a molecule it has a clear positive impact in the total antibiotic
market, nearly 80% of the sample doctor population confirmed it.

Question no. 2 What would be the first line Antibiotic used to treat common infections?
Tetracyclines
Aminoglycosides
Fluroquinolones
Macrolides First line
Cephalosporin
Pencillin
0 10 20 30 40 50
Figure 5.1.1.2
Presently for the treatment of infection widely used first line antibiotic is Penicillin.
Trend towards Cephalosporins and Macrolides are lesser than the trend towards
Penicillin. With these findings its clear that Penicillin class antibiotic having an upward
trend in total Antibiotic drug market.
Question no.3 Reasons of selecting the drug class
Inhibition of resistant
Strong clinical triials
Better compliance
Drug Class
Less side effects
Cost effective
0 10 20 30 40 50
Figure 5.1.1.3

According to above chart doctors concern was mainly on the fact of better compliance to
patients because when doctors empirically treat patients they starts with a mild antibiotic
for many reasons, at certain times if that antibiotic shows resistance to inhibit the
bacterial growth then they prefer to use an advanced antibiotic like Co-amoxiclav to
Inhibition of resistance (Beta lactamase inhibitor) and protect patients. Sometimes they
consider the cost variable due to patients buying power because Sri Lanka is a 3rd world
country. Most of the time doctors decide to treat with penicillin drugs as first line
therapy.
Question no. 4 Co-Amoxiclav is using widely in managing infections caused by bacteria
13% 1%
16%
27% Strongly agree
Agree
Neutral
Disagree
Strongly disagree
43%
Figure 5.1.1.4
Co-amoxiclav is a drug that it is picking up a positive sign in doctors mind as a good

option to prevent bacterial infection. So definitely there is good impact on the molecule.
Therefore this information laid strong foundation for Co-amoxiclav future.
70% of the sample population agreed to say that co-amoxiclav is a leading antibiotic in
managing common infections when they empirically treat a patient.

Question no. 5 The original brand of Co-amoxiclav (Augmentin) is very frequently

prescribed to patients in my practice
Strongly disagree
Disagree
Neutral Agumentin
Agree
Strongly agree
0 10 20 30 40 50
Figure 5.1.1.5
According to the above chart that it is evident and shows most of the doctors, when they
get an opportunity to prescribe a brand of co-amoxiclav they prefer the original brand of
Co-amoxiclav (Augmentin) and the number of doctors who confirmed it closer to 60% of
the total sample population which is significantly a high number. Reason to prescribe
Augmentin can identify by next question.
Question no. 6 Reason to prescribe Augmentin in your practice may be due to
60
50
40
30 Augmentin
20
10
0
Product Good Input First Brand Regular Company None
quality Visit by
MPD
Figure 5.1.1.6

The doctors first choice to prescribe Augmentin, because that they feel Augmentin is a
high quality product. GSK have done a good job in terms of positioning and retaining the
position of originality in the doctors mind for many years.
And another strong reason to prescribe this brand is, Augmentin is the first brand of
antibiotic name comes to their mind when prescribing a Co-amoxiclav to a patient. This
may be because of first launched brand and several years of clinical success in the
market.
Also a significant number of doctors said about the regular medical reps visits and the
input they give during the sales promotional call.
Question no. 7 What are the key factors you consider in prescribing a Co-Amoxiclav drug
for your patients?
Figure 5.1.1.7
Prescribing a drug clearly depends on better compliance, quality, and the brand name.
Augmentin holds all the above benefits. This is a good example to prove that in
pharmaceutical business product quality and consumer compliance matters more than
any other factors.

Question no. 8 Whenever you decided to prescribe Co-Amoxiclav to your patient, first
brand name comes to mind as:
Figure 5.1.1.8
When we analyze the figures of findings, the interesting factor to identify was that still
there are 60% of doctors reminds a branded generic when they write a prescription and
40% of them confirmed that their trusted brand of co-amoxiclav is Augmentin. Whenever
they get opportunity to prescribe Co-amoxiclav, more than 40% of the doctors they will
prescribe this brand. Because Augmentin is the first brand comes in to their mind.
When we look at the previous question, question no 07; that it will show the reason to
motivate doctors mind set to prescribe Augmentin compare to Generic Brand. That is due
to quality of the product, better patient compliance and brand name easy to remember.
By using of this valuable information that we can identify what are main reasons to
motivate doctors in prescribing Co-amoxiclav particular brand, In this case original brand.
Even though certain Generic Brand has some of these same benefits still they couldnt
reach doctors mind to motivate them and influence them towards prescribing generic
brands. Main target will be positioning in doctors mind and motivate them to prescribe.

Question no. 9 The answer for question no 08. Because of
Figure 5.1.1.9
Doctors are highly motivated to prescribe Augmentin because they feel that it is the
quality and confident product compare to others. This mentality created by GSK to
motivate them towards that brand by using their promotional capability.
Question no. 10 Have you ever prescribe Generic as Co-amoxiclav to your patients in practice?
Figure 5.1.1.10

When we see the above question most of the doctors comment as didnt prescribe
Generic Brand at least once. When we see the Generic Brand promoting team they have
to focus on other products Co-amoxiclav. Generic brands need more focus. But GSK have
a separate team to promote Augmentin as the flagship product. So they get more time to
focus on the brand compare to generic companies. Augmentin needs to reach more
number of doctors to sustain and grow over market share.
Even in some rural inertial areas doctors think Augmentin is the generic name. That much
there minds has been registered with this brand.
Question no. 11 According to question no. 10 if your answer Yes, reason may be..
Well Known brand 4
Regular visit of Medical rep 12
Another Doctor is prescribing 2
Reasonable price 3
Good quality 10
Good inputs to promote 1
Total 32
12
10
Well known brand
8 Regular visit of Medical rep
Another doctor is prescribing
6
Reasonable price
4 Good quality
Good inputs to promote
2
Figure 5.1.1.11
Most of the Generic brand prescribers are prescribing, because of regular visits of the
medical rep and in other words the medical reps rapport and reasonable price compared
to Original.
Question no. 12 According to question no. 10 if your answer No, reason may be...
Never heard 6
Not interested 20
Cheap brands available 7
No interest on Co-amoxiclav 7
Company support not enough 13
Medical rep not visit 2
No confident on quality 13
Total 68
Never heard
Not interested
Cheap Brands
No interest on Co-Amoxiclav
Company support not enough
Medical rep not visit
No confidence on quality
Figure 5.1.1.12
The doctors who said No, in the question no. 10 They comment that because of they
were not interested in prescribing a generic brand also there were few doctors, who said
they have not heard of any generic brands most of them were newly appointed doctors.

5.1.2 Chemists samples 50
Question no 01. Among Co-Amoxiclav market Augmentin is a well known famous Brand
Figure 5.1.2.1
In Antibiotic market Augmentin is a well known brand among chemists and

pharmaceuticals industry, mainly because Augment is the most dispensed brand of Co-
amoxiclav and also effective chemist level promotion and information shared by sales
representatives on their sales visits. So brand is well aware among chemist level.
Question no 02. What is the most dispensing Brand among Co-Amoxiclav?
Augmentin 26
Enhancin 5
Novaclav 13
Clavamox 3
Myclav 3
Total 50

Figure 5.1.2.2
According to the above question most of the pharmacist gave there comment as Most
dispensing brand as Augmentin, and others are less compare to Augmentin. That because
of the prescription flow. Most of the doctors prescribe as Original brand.
And information we could found another brand is moving because of less price that is
Novaclav marketed by Cipla city health. Even some pharmacy they use to substitute
prescription when they dont have the prescribed brand. Pharmacy people they get more
bonus on this product.
Question no 03. What is your perception about Generic Brands compare to Augmentin?
Excellent Good Bad
Quality 9 39 2
Supplier Service 5 33 12
Availability 4 42 4
Compliance 8 40 2
Affordability 2 43 5
Prescription flow 6 24 20

Figure 5.1.2.3
According to above information most of the pharmacy comment good on Augmentin

quality.
And when we see the supplier service that is also good, few number of pharmacy
comment as poor or bad supplier service.
Availability in some case it is always a Question mark due to out of stock situations.
Compliance is all most everybody comment as superb.
Price wise everybody cannot afford compare to generics.
When we analyze the flow of prescription, there is a huge gap between Augmentin and
generic brand.

Question no.04 What is the first brand name that comes to your mind having seen a
prescription with a generic name Co-Amoxiclav?
Augmentin 21
Myclav 4
Enhancin 5
Clavamox 2
Novaclav 16
None of the above 2
Total 50
Figure 5.1.2.4
Most of the pharmacist said that first brand name comes to their mind as Augmentin.
After that some pharmacy said Novaclav is the first brand name comes to the mind. That
is because of less in price, more bonuses and willing to substitute.

Question no.05 What would be your favorite Brand when you need any Co-Amoxiclav use
for yourself/ Patients?
Figure 5.1.2.5
According to the above chart Augmentin is the most favorite brand of the pharmacist in
their personal use. Another few pharmacist said Enhancin, Myclav that because they
concern about the quality.
Question no.06 Do your patients buy the whole course of medicine when the doctor
prescribed Augmentin?
Figure 5.1.2.6

Almost most number of patients they buy the whole course. There some patients who
cannot afford they will not buy the entire course they may buy for 3 days or 2 days at that
time. This may be a good point to position in doctors mind to convert to Generic brands.
Question no. 07 Do your patients complains about the price of Augmentin saying that it is
expensive
Figure 5.1.2.7
Sometimes some patients complain to pharmacy that it is expensive.

5.2 Objectives and research model testing through findings and the out
come
As the main objective in this research to identify the factors motivating doctors to
prescribe Original brand with Special preference to Augmentin, is factoring with the
Brand image, quality, Efficacy, Safety, Better tolerability and patient compliance. These
factors have influenced positively and which resulted Augmentin to be the number one
pharmaceutical brand in the island.
We identified some specific reason, why a doctor is to prescribe Generic Brand over the
original brand and key influencing factors were Medical reps rapport, trust that have
towards the company.
To examine whether there is a correlation between willingness to prescribe Myclav and

the inputs been provided. Sure there is an impact on that but that is not the major
problem. Providing of inputs will help to create a rapport with the doctor but wont talk
about the quality of the product. In this situation its little bit risk to provide inputs and
create a positive image towards the product, because this will build the relationship with
the representative once they leave the company some times that can have a negative
impact on sales.

6 CONCLUSION AND RECOMMENDATIONS
6.1 Conclusion
I have conducted this practical research in order to Identify The factors motivating
doctors to prescribe original brand with Special Preference to Augmentin among the Co-
amoxiclav brands in Antibiotics market and the reasons for huge market share that own
by Original brand whilst others owns a small share. I also wanted to identify the reason
why it is only Augmentin, that has a constant positive growth in the category, whilst all
the other have a negligible growth.
According to the analysis and the findings Augmentin as a brand it is highly motivating
doctors to prescribe as a quality product and message is strongly positioned in their mind.
Even though Generic brands also own the same feature, was unable to reach as it is a
quality brand with unique features and reasonable price. That may be because of too
many Co-amoxiclav plays in the market. Augmentin has its unique advantageous in the
market place by being the only brand of co-amoxiclav to be imported from the United
Kingdom and also Augmentin has a dedicated and very well trained team of medical
representatives across the country to promote the brand effectively.
Today Augmentin is 30 plus years old as an antibiotic and still records positive growth.
Augmentin was the first brand of co-amoxiclav to be launched in the local market and
been in the market nearly 30 years and day by day the trust towards Augmentin increases
number of new doctors in climbing towards Augmentin is increasing and Augmentin
enjoys being the number one pharmaceutical brand (source- IMS quarter4 2015)
At the same time few generic brands also available in the market with reasonable years
of market history. Findings show that Augmentin has correctly taken the advantage of
being the original brand and clinical experiences of doctors have motivated and
influenced them to be held strongly with the brand. That is a prime reason why
Augmentin has a constant positive growth in the category, whilst all the other Co-
amoxiclav owns a small market share.
Finally I would like to elaborate Augmentin must increase in focus to position strongly
against the indications that are indicated by having effective & scientific promotions also
engaging in professional activities and professional bodies will help to retain the number
one position and to grow further.

6.2 Recommendations
Augmentin is a good quality and a timely trusted product so I strongly recommend

followings to maintain the market position and to grow further
1. Detail more science to doctors to convince and emphasize the reason why they
need to prescribe Augmentin over a cheap generic
2. Expand the operation and reach maximum doctor universe, Augmenting being a
first line antibiotic any doctor get an opportunity to prescribe
3. To partner with colleges, Eg:- College of Surgeons, College of Pediatricians etc..

and sponsor their events and increase the noise level of brand among the decision
makers and most influencing people in the country
4. In rural areas can help hospitals to conduct their monthly clinical meetings and
make Augmentin brand available and visible
5. Look in to government tender opportunities as many antibiotics MSD purchased

have fail to do the job and many complains came out in resent past
6. Dentist are sector for Augmentin reps to consider, who have high potential to
prescribe the brand and patients willing to pay the price to end the tooth
infections. Brand team can focus their promotions and material towards this
7. Help professional bodies to identify antibiotic resistance patterns
8. Get in to digital marketing and have an mobile based app for doctors to write
their concerns and get answers (work like a blog)

7 References
Kotler Philip, Keller KL, Marketing Management 12th edition, 274
http://www.s-m-a-r-t.com/index.htm, Strategic Marketing and Research Technique
IMS, Retail pharmacy Market Audit, ( 2008) Antibiotic Drugs Market data
Brand Management book (SLIM), Chapter 01, Branding and its diverse interpretation,
page no, 03
British Medical Association,( March 2006) British National Formulary
http://www.gsk.com/products/prescription-medicines/augmentin.htm to get information

about Augmentin brand.
www.businessdictionary.com to get motivation information
The Merck Manual of Medical Information. Mark H. Beers et al., eds. 2nd Home Edition.
Whitehouse Station, NJ: Merck; 2003.
2. Antibiotics: MedlinePlus. U.S. National Library of Medicine
3. Physicians' Desk Reference. 59th ed. Montvale, N.J.: Thomson PDR, 2005.Published:
May 05, 2007
Last updated: December 07, 2009

8 Appendices
Questionnaire No
Project Name
Assessing the factors motivating doctors to prescribe original brands with Special Preference to
Augmentin
Respondents Report:
Date of Interview: Year: Month:.. Date: ..
1. Statistics shows that the usages of Co-amoxiclav are more comparing to other Antibiotic
available in market. What is your opinion?
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
2. What would be the first line Antibiotic used to treat infections?
Penicilin Cephalosporins
Macrolides Fluroquinolones
Aminoglycosides Tetracyclines

3. Reasons of selecting the drug class
It is cost effective
Less side effects
Better Compliance
Strong clinical trials
Inhibition of resistant (betalactumase)
4. Co-Amoxiclav is using widely in managing infections caused by bacteria
Strongly Disagree Strongly Agree
Disagree Neutral
Agree
5. The original brand of Co-amoxiclav (Augmentin) is very frequently prescribed to patients

in my practice
Strongly Disagree Strongly Agree
Disagree Neutral
Agree
6. Reason to prescribe Augmentin in your practice may be due to
Product Quality
Good Inputs used to promote
First brand comes to mind
Regular visits of Medical delegates
Because of the company
None of the above

7. What are the key factors you consider in prescribing a Co-Amoxiclav drug for your
patients?
The Brand Name
The Price
Better Compliance
Quality
Service
Organization
8. Whenever you decided to prescribe Co-Amoxiclav to your patient first brand name comes
as,
Augmentin Novaclav
Myclav Moxiclav
Enhancin Generic Name
Clavamox
9. The answer for question- 8 is because of
Popularity of the brand Name Confidence
Price Quality
Person represents the brand None of the above

10. Have you ever prescribe generic brands as Co-amoxiclav to your patients in practice
Yes No
11. According to question no. 10 if your answer Yes, reason may be.
Well known brand
Regular visit of Medical Rep
Another doctor is prescribing
Reasonable price
Good quality
Good promotional materials used to promote
12. According to question no. 10 if your answer No, reason may be..
Never heard about this brand
Not interested to prescribe
Cheaper brands available
Not interested to prescribe Co-amoxiclav
Company support is not enough
Medical rep not visits regularly

Questionnaire No
Project Name
Assessing the factors motivating doctors to prescribe original brands with Special Preference
to Augmentin
Respondents Report:
Date of Interview: Year: Month:.. Date: ..
1. Among Co-Amoxiclav market Augmentin is a well known famous Brand
Agree Strongly disagree
Strongly agree Neutral
Disagree
2. What is the most dispensing Brand among Co-Amoxiclav?
Augmentin Clavamox
Enhancin Myclav
Novaclav

3. What is your perception about Generic brands compare to other Augmentin? (Put a tick )
Excellent Good Bad
Quality
Supplier
Service
Availability
Compliance
Affordability
Prescription
flow
4. What is the first brand name that comes to your mind having seen a prescription with a
generic name Co-Amoxiclav?
Augmentin Clavamox
Myclav Novaclav
Enhancin None of the above
5. What would be your favorite Brand when you need any Co-Amoxiclav use for yourself/
Patients?
Augmentin Enhancin
Myclav Clavamox
Novaclav Generic

6. Do your patients buy the whole course of medicine when the doctor prescribed
Augmentin?
Not at all
Perhaps
Sometimes
Always
7. Do your patients complains about the price of Augmentin saying that it is expensive
Always yes
Not at all
Sometimes
Most of the times
Rarely


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FINAL RESEARCH MGU MBA

ASSESING THE FACTORS MOTIVATING DOCTORS TO

ABDUL GHANY WAZEER KHAN

Mahatma Gandhi University

1 Executive Summary ......................................................................................................................... 3

2.2 Research Problem ................................................................................................................... 5

2.2.1 What are Antibiotics? ...................................................................................................... 8

2.2.2 Antibiotic resistance ........................................................................................................ 8

2.2.3 Antibiotics classification .................................................................................................. 9

2.2.4 AUGMENTIN* .................................................................................................................. 9

2.3 The Significance ..................................................................................................................... 11

2.4 The Objectives ....................................................................................................................... 12

3 LITERATURE REVIEW ..................................................................................................................... 13

3.1 Antibiotics classification ........................................................................................................ 14

3.1.1 Penicillins ....................................................................................................................... 14

3.1.2 Cephalosporin ............................................................................................................... 15

3.1.3 Fluroquinolones ............................................................................................................ 17

3.1.4 Tetracycline ................................................................................................................... 18

3.1.5 Macrolides ..................................................................................................................... 19

3.1.6 Aminoglycosides ............................................................................................................ 20

3.2 Motivation ............................................................................................................................. 21

3.2.1 Motivation Process........................................................................................................ 22

3.3 Brand ..................................................................................................................................... 22

4.1 Theoretical framework .......................................................................................................... 24

4.2 Data collection....................................................................................................................... 25

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4.2.1 Quantitative and Qualitative Data collection methods ................................................ 25

4.2.2 Sample Plan. .................................................................................................................. 26

4.2.3 The Questionnaire ......................................................................................................... 26

5 DATA ANALYSIS, HYPOTHESIS TESTING AND RESULTS.................................................................. 27

5.1 Data Analysis and Hypothesis testing ................................................................................... 27

5.1.1 Doctor Samples ............................................................................................................. 27

5.1.2 Chemists samples .......................................................................................................... 36

6 CONCLUSION AND RECOMMENDATIONS ..................................................................................... 43

6.1 Conclusion ............................................................................................................................. 43

6.2 Recommendations ................................................................................................................ 44

Mahatma Gandhi University

Co-amoxiclav is a widely using antibiotic also it is famous as a beta lactumase inhibitor.

After inventing and introducing Co-amoxiclav, many pharmaceutical research based

Mahatma Gandhi University

Co-amoxiclav was invented around 1977/78 by British scientists working at Beecham,

Mahatma Gandhi University

2.2 Research Problem

Augmentin Glaxso Smith Kline

Enhancin Ranbaxy (Hemas)

Novaclav Cipla City Health

Clavamox Kalbe (Hemas)

Myclav Unichem Baurs

Brand Name Strength Each tablet/bottle price Rs.

Enhancin 625mg tab 60.00

Enhancin 375mg tab 36.60

Enhancin 156mg syrup 288.00

Clavemox 625mg tab 67.00

Clavemox 375mg tab 42.00

Clavemox 156mg Syrup 252.00

Mahatma Gandhi University

Novaclav 625mg tab 49.00

Novaclav 375mg tab 29.00

Novaclav 156mg Syrup 233.00

Myclav 625mg tab 55.25

Myclav 375mgtab Not Available

Myclav 156mg Syrup Not Available

Mahatma Gandhi University