RESEARCH PROPOSAL

Nguyen Van Khoa – Intake 12 A

“PHARMACY GENERATED RECOMMENDATIONS” – IMPACT ON THE

BUSINESS OF OTC AND ETHICAL PRODUCTS IN VIETNAM
PHARMACEUTICAL INDUSTRY

I. Background

According to the regulation of Ministry of Health (MOH), all the pharmacies in Vietnam
have to implement the Good Pharmacy Practice (GPP), the latest deadline is January
2011. There is important process to upgrade the quality of the pharmacy practice and
improve partially the healthcare system. As the report of MOH, there are 9,000 private
pharmacies, 17,000 governmental pharmacies and 15,000 retail agencies nationwide
(http://www.sggp.org.vn/ytesuckhoe/2008/3/144955/).

In Ho Chi Minh City, there are only 1,500 pharmacies in 3,667 pharmacies in total can
achieve GPP at the end of September, 2010. http://www.baomoi.com/Info/Chi-27-nha-
thuoc-TP-HCM-dat-chuan-GPP/82/4940078.epi

In Hanoi, there are 1,100 GPP pharmacies/2,000 total pharmacies can achieve the GPP
certification at the deadline.

http://www.baomoi.com/Info/Bai-2-Gan-50-nha-thuoc-phai-dong-cua/82/5104630.epi

All drugs are selling in pharmacies can be classified two group: Ethical products – Rx
(only can be sell with prescription as the regulation) and Over The Counter products
(OTC) that can be sell without a prescription. The classification is based on the efficacy
and safety profiles of each molecule and managed by the different regulations. The
regulation is to protect the patients from side effects from the Ethical products that the
recommendation from physicians is necessary. The good efficacy and safety profile can
be allowed the OTCs can be sold without prescription.

Pharmaceutical industry in Vietnam is growing about 14% with the size $1,141 million
and pharmacy channel contribution about $584 millions and growth 9% (IMS report
Q3/2010). The total size of pharmacy business is more than a half of total business of
pharmaceutical industry in both Ethical and OTC products. In the developed countries,
the selling of Ethical products with prescription is very strictly implemented and the
pharmacy generated recommendation only can be valuable with OTC business. This
regulation is not strictly followed up in developing countries, for examples in Indochina
and Vietnam, where the patients can buy the Ethical products without prescription.

The evaluation of the pharmacy generated recommendations in the pharmacy channel in

Vietnam can helps the government officers and pharmaceutical industry to take
appropriate action to cover the gap. For government perspective, this aim to evaluate the
value of GPP program, identify the gap and can take the appropriate action to improve
the quality of the medicine distribution system. For pharmaceutical industries, the results
can be used to measure the role of pharmacists or pharmacy assistants in promoting of
OTC and ethical products.

II. Research objectives:

To evaluate the role of pharmacy generated recommendation in promoting OTC and

Ethical products in the pharmaceutical industry

Gain an understanding of c of pharmacists or pharmacy assistants in terms of their

behaviors and attitudes when recommend a Ethical and OTC products for consumers.

III. Research scope:

This research is conducted in retail pharmacies in two biggest city, Hanoi and Ho Chi
Minh City.

IV. Literature review

The requirements of GPP: Beside of the requirements of infrastructure and equipments,

people is the one of the important requirement – the pharmacists must be at the
pharmacies and directly advise and consult for consumers/patients and only sell the drugs
for patients with a legal prescription. The implementation of GPP will stop the current
situation that was commonly practiced in Vietnam for a long time: The pharmacists and
pharmacy assistants in can diagnose, recommend and sell drugs in pharmacy even for
Ethical products. Another big concern of pharmacies when upgrade to GPP is the current
medicine purchasing behaviors and attitudes of patients and consumers – buy drugs
without physician consultant. “If the patients/consumers can buy drugs even Ethical
products in non- GPP pharmacies without the prescription, the story of implementation of
GPP will come to an end” (http://www.khamchuabenh.com/read.php?1280&page=1).

Online pharmacy

Online pharmacy started in 1960s and had strongly developed in 1980s with the
exploitation of private computer and internet. The benefits of online pharmacy are the
conveniences, time saving, transportation limitation, and cost saving due to management
cost reduction. The 10 essential notes for patients when using online pharmacy can be
revealed in the link:
http://www.ykhoanet.com/binhluan/nguyenyduc/100530_nguyenyduc_muaduocphamqua
internet.htm

07 rights of patients or consumers at pharmacy

To increase the 2-ways communication of pharmacy - patient and patients can be the
center of any services in pharmacies; the patients should understand 07 rights when
buying drugs from pharmacies as following:
1. Right to be provided information

Patients or member of family have right to approach the full, appropriate, clear and
accurate related to the patients’ health status. Pharmacies should provide information
including the usage of appropriate materials to guide. The consultant desk in pharmacy is
the appropriate place for information transaction. All related information should be
considered as private and confidential and only used for the improvement the treatment
quality.

2. Rights to approach the services

The price should be reasonable and the. All the discriminations related to religion,
gender, age, social position…etc are strictly prohibited.

3. Right to choose the services after consultant

The patients selection after consultant is absolutely spontaneously after understand all the
solutions and pharmacy can consult, convince patients based on the appropriate usage of
drugs but patients or member of family should be the decision makers.

4. Right to receive the safe services

Safety services require the fluent knowledge and skills. This right is also requires the
appropriate usage the guide dance for service provided.

5. Right to keep the confidential information

Patients or family members have right to keep all the related information in privacy and
confidential. The private consultant desk is a requirement a separation from the trade
areas.

6. Right to be respect and provide the feedbacks

All patients and/or members in family have right to be treated respectfully. Pharmacies
have to make sure that to provide the most convenient for patients. Patients should be
encouraged to provide the feedbacks, even when the feedbacks are contradiction with
sellers.

7. Right to being provided continuously

Every patient has rights to use the services, equipment and follow up continuously. In
treatment courses, the pharmacies are responsible to follow up the patient condition and
should introduce and recommend the patients to move to the specialists or other service
providers with higher service level.

(Source: http://www.vho.vn/bv-13669-7-quyen-cua-benh-nhan-tai-noi-mua-thuoc-dieu-
tri)

V. Conceptual framework:

Medicine purchasing process (MPP):

This process describes the way the patients or consumers when they purchase a medicine
from a pharmacy in Vietnam.
Normally, the consumers or patients come to pharmacy to buy medicine with or without
the prescription for OTC products. For the Rx products, the prescription is compulsory
as the governmental regulation. But in Vietnam, Rx products can be sold without
prescription practically so the MPP can be applied for both OTC and Rx products in this
research.

Pharmacy generated recommendations:

In developed countries, only pharmacists can allow to provide the consultants for patients but in
Vietnam this task is often done by pharmacy assistants. For example, in Ho Chi Minh City, there
are 4,568 pharmacists but very few pharmacies have the pharmacist for consulting practically
(http://www.baomoi.com/Info/TPHCM-Nha-thuoc-dat-chuan-GPP-chay-dua-voi-thoi-
han/82/5157316.epi).

The pharmacy recommendations are very important for patients and consumers to selects a right
drugs, use as the right way with appropriate dosage, control the advert events and side effect if
any. Pharmacist also can contact with doctor to adjust the prescription if found the inappropriate
in prescription.

In the commercial view, the pharmacy generated recommendations contribute an important role
in OTC products when the pharmacist or pharmacy assistant recommends a drug for patients.
The pharmaceutical companies have to provide the information for pharmacists to position
brands in this segment.

The factors that may influence the pharmacy generated recommendations are: the “top of mind”
brands in appropriate indication, quality of drugs, profit, suitable price, easy to use, drug
information, drug availability, post sale services…etc.

VI. Research design

Data needs
The qualitative data to identify and evaluate the key factors that influenced the pharmacy
generated recommendations and,

the quantitative data to evaluate the ratio of each step in the medicine purchasing process
(MPP), as following:

The behavior of consumers purchase medicine with and without prescription for OTC or
Rx products

The current patient compliance (follows or not follows up the prescription).

The behaviors of asking consultants in pharmacy

The ratio of patients will follow up the consults of pharmacists/pharmacy assistants.

Data sources & Measurement scales

A field work research with questionnaire for the target respondents.

Part 1: Identify the key factors that influenced the pharmacy generated
recommendation:

Base on the top distribution of the answers of 02 the questions. Top 5 highest frequency
answers will be reported as the key influenced factors.

What is the most important factor that influences or decides your recommendation when
you select an OTC product?

What is the most important factor that influences or decides your recommendation when
you select an Rx product?

Part 2: Evaluate the ratio of each step in medicine purchasing process:

The average value of ratios based on total answers will be calculated and reported as the
value of each step in MPP. The ratio for each respondent will based on following
questions:
Note: A same questions will applied for OTC products.

How many percent of your customer bring the prescription when buying a Ethical
products?

For who not bring the prescription, how many percent of them will ask for your
consultant?

How many percent of them will follow up the bring prescription?

If not follow up the bring prescription, how many percent of them will ask for your
consultant?

After asking for your consultant, how many of your patients will follow your
recommendation?

Data collection method

Currently, GlaxoSmithKline Vietnam has set up a dedicated team for pharmacy in Hanoi
and Ho Chi Minh City with the coverage around top 2,000 pharmacies with highest
potential. Every month, each sales representative is being asked for conducting 400 calls
visit the customers in their districts. This team will be asked for conducting this research
as a part of their roles and responsibilities.

For the pharmacies within the coverage scope of team: The data will be collected with the
current sale representative in team when they visit the customers as working plan.

For the pharmacies out of the scope of the team: This will be considered as an additional
job with assigned respondents will base on the allocated districts.

Sampling design

The randomized selection of 100 pharmacies in Ho Chi Minh and Hanoi will based on
the list of total private pharmacy in Hanoi and Ho Chi Minh (5,667 pharmacies):
 Ho Chi Minh City: 65 pharmacies

Hanoi: 35 pharmacies.

There are no excluding criteria for the selection.

Plan for analysis

The questionnaires will be collected from the team after fieldwork and the results will be
analyzed to identify the distribution of responds of the factors influenced the pharmacy
generated recommendations and average of ratios of each step in the MPP.

Resources, organization and timeframe

Resources:

Research proposal: 01 person from MSM (project owner)

Fieldwork: 12 sales representatives in Hanoi and Ho Chi Minh team.

Analysis & Report: 01 person from MSM (project owner)

Budget: To be calculated for overhead cost of the team.

Time frame:

Time Job description People in Note

charge
th th
20 – 25 , Dec, 2010 Research proposal Khoa Nguyen
25th – 30th, Dec, 2010 In deep interview and Khoa Nguyen
questionnaire testing
th th
15 – 30 , Jan, 2011 Field work GSK exclusive 65 pharmacies in
team HCM an 35 in Hanoi
st th
1 -4 , Jan, 2011 Analysis & Report Khoa Nguyen

VII. Appendices
Key words: GPP – Good Pharmacy Practice, Ethical Products – Rx, Over The Counter –
OTC products, Medicine Purchasing Process – MPP.

Articles reviewed:

1. http://www.james-king.net/projects/pharmacy The potential pharmacies in the future -

2. http://baohatinh.vn/home/y-te-suc-khoe/nha-thuoc-dat-tieu-chuan-gpp-bao-gio-thuc-
hien-duoc/1k53984.aspx: GPP and deadline of regualtion

3. http://www.sggp.org.vn/ytesuckhoe/2008/3/144955/: Total retails pharmacy in

nationwide.

4. http://www.hanoimoi.com.vn/newsdetail/suc_khoe/391782/moi-co-11-nha-thuoc-dat-
tieu-chuan-thuc-hanh-tot.htm. Current situation of GPP implementation.

5. http://www.baomoi.com/Info/TPHCM-Nha-thuoc-dat-chuan-GPP-chay-dua-voi-thoi-
han/82/5157316.epi. Insufficient of pharmacist in pharmacy.

6.http://yduc.com.vn/default.php?
go=newsdetail&ndid=65&PHPSESSID=07b6bb32f721486df04a1fe1b7ef45aa. The role
of patient loyalty in pharmacy

7.http://tintuc.xalo.vn/001026150627/Mo_nha_thuoc_bao_gio_giau.html?
id=11a61d4&o=0 – How to get more profit in pharmacy?

8. http://www.baomoi.com/Info/Bai-1-Mo-nha-thuoc-chi-can-200-trieu-
dong/82/5098488.epi -Requirements of doing pharmacy business

9. http://www.baomoi.com/Info/Bai-2-Gan-50-nha-thuoc-phai-dong-cua/82/5104630.epi
- What are the requirements of GPP?

10. http://www.khamchuabenh.com/read.php?1280&page=1 – Doctors are doing like

pharmacist and vice versa.
11.http://www.ykhoanet.com/binhluan/nguyenyduc/100530_nguyenyduc_muaduocpham
quainternet.htm – Online pharmacy – Future opportunity?

12. http://www.vho.vn/bv-13669-7-quyen-cua-benh-nhan-tai-noi-mua-thuoc-dieu-tri - 7
rights of patients in pharmacy.

13.http://yduc.com.vn/default.php?
go=newsdetail&ndid=67&PHPSESSID=4b533fbbc150ef6953c0eeb6d0ba100e – The
strategy of the biggest pharmacy chain in Vietnam.

14. http://www.doanhnhan360.com/Desktop.aspx/Thi-truong-360/Hang-hoa-Dich-vu-
360/Kinh_doanh_chuoi_nha_thuoc_kho_noi_truoc/ - The experiences of opening a
pharmacy chain in Vietnam.