Syndisciplinary approaches to pharmaceutical and healthcare research

Citation

Mukherjee, A. (2013), "Syndisciplinary approaches to pharmaceutical and healthcare research", International Journal of Pharmaceutical and Healthcare Marketing, Vol. 7 No. 2. https://doi.org/10.1108/ijphm.2013.32407baa.001

Syndisciplinary approaches to pharmaceutical and healthcare research

Article Type: Editorial From: International Journal of Pharmaceutical and Healthcare Marketing, Volume 7, Issue 2

The mission of the International Journal of Pharmaceutical and Healthcare Marketing is to encourage, invite, evaluate and disseminate research that spans across disciplines. The journal regularly receives submissions from scholars in schools/departments of business, management, marketing, health administration, pharmacy, medicine, dentistry, health economics, public health, health education, health communication, healthcare law, and healthcare technology. Interestingly, eclectic research paradigms in pharmaceutical and healthcare are evolving rapidly from a multidisciplinary orientation to an interdisciplinary orientation to a trans-disciplinary orientation and eventually to a syndisciplinary orientation.

Thus, the evolution is along the following continuum of synthesis/integration:

So, what exactly is the difference between these orientations towards research?

“Multidisciplinary research” involves a set of researchers working in a team, where each person brings separate theories, skills, data and ideas and puts them to use to address a common problem. The next level is “interdisciplinary research”, where researchers not only come together with their own paradigms but also jointly frame the problem, agree on a common method and jointly analyse the data. On an even higher level of integration, “transdisciplinary research” transcends disciplinary boundaries, and develops a unique collective approach to solving the research question. Such approaches frequently lead to new disciplines such as environmental management or healthcare management. The ultimate level of eclecticism is a “syndisciplinary orientation”, which is ideally suited to address real-life problems that are so complex that no one discipline can explain or resolve. Syndisciplinary research strives to offer a holistic, contextual and systemic understanding of an unresolved problem by synchronizing diverse insights, triangulating multiple evidences, and creating common ground. Such approaches are frequently non-reductionist, iterative, and problem-oriented.

It is interesting to note that the most pressing problems in healthcare today such as the implications of the Affordable Care Act, including healthcare efficiency, access, equity, outcomes, quality and performance are inherently complex demanding holistic solutions. Such problems are ideally suited for syndisciplinary research that fosters creating common ground, reconciling conflicting methodologies, finding an intellectual community with shared interests, and identifying sources of funding and grants.

There are several challenges to syndisciplinary orientation. Such challenges stem from the need to redefine disciplinary boundaries, extend theories, reorganize extant literature, and transform dominant paradigms. A frequent solution to such problems is the promotion of research clusters, matrix organization for research, team-taught courses, research centers, and most importantly, growth of syndisciplinary journals. IJPHM strives to offer syndisciplinarity in its mission and objectives, editorial board and reviewer composition, and call for papers for special issues. A sample of such an orientation can be seen in this current issue.

The first article of this issue is a research paper by Jhandré Bredenkamp and Eon van der Merwe Smit titled “Originator and generic medicine: pricing and market share.” The aim of this study was to examine the effects of generic medicine competition on the market share growth and pricing of originator brand medicine in the South African private pharmaceutical market. The authors applied regression analysis to market share data of originator brand drugs that have been exposed to competition from generic substitutes based on an agency model of the prescribing physician, the pharmacist or the medical scheme. The results of the study indicate that the price of an originator brand medicine relative to the weighted average price of its generics has a significant negative impact on the change of its market share. Investigations into the prices of the originator brands in relation to the number of generic equivalents in the market, indicate that the number of generics available in a specific market has a significant positive impact on the relative price of originators, thereby making originators relatively more expensive compared to their generic competitors. At the same time the results of the study show that the absolute price of the originator brand medicines declines as the number of generic equivalents in the market increases. Furthermore, the results of this study indicate that, for all modules pooled together, the relative price of the originator product to that of the generic equivalent is responsible for a significant reduction in the relative change in the market share of the originator medicine. When analysed on the level of anatomical class or the individual molecule, results are not consistent. For affordable healthcare, the results support the reduction in barriers to entry for generic medicine. Furthermore, the results support education and incentives for doctors, pharmacists and end-users to develop generic alternatives as trusted brands in their own right.

The second article of this issue, authored by Mellina da Silva Terres and Cristiane Pizzutti dos Santos, focuses on consumer trust in medical services. Titled “Consumer trust in high-consequence decisions: a study of medical services,” the purpose of this research paper is to address the impact of affect (as opposed to cognition) on patient trust in high-consequence exchanges. The authors also investigate the mediator’s role of trust in the relationship between affect and cognition, and behavioural intentions. For these purposes, the authors performed three between-subjects experiments using undergraduate students from a large North American university. The analyses showed interesting results. Study 1 findings demonstrated that affect and cognition elements equally influence trust in high-consequence decisions. Also, trust is an important mediator between affect and cognition and the intention to continue the relationship and to seek a second opinion. Study 2 reinforced the importance of trust for the patient’s evaluations, showing that when trust is low, the second opinion influences patient satisfaction. However, when patient trust is high, the second opinion (the same or different, compared with the first diagnosis) does not affect patient satisfaction. Study 3 showed that, in low-consequence choices, cognition is a more relevant antecedent of trust than affect. Affect is important when cognition aspects (e.g. the competence of the doctor) are perceived as low. As an original contribution, this study addresses the different impacts of affect and cognition aspects on patient trust, in high- and low-consequence exchanges. Also, it highlights the importance of patient trust in the doctor when a second opinion is sought: a different diagnosis depletes patient satisfaction only for patients with low levels of trust in the doctor.

The third article is a research paper by Sameer Deshpande, Samia Chreim, Roberto Bello, and Terry Ross Evashkevich with the title “An exploration of seniors’ relationships with prescription pharmaceutical brands: an application of ‘arranged marriage’ metaphor framework.” In this article, the authors explore relationships that seniors (aged 55 and above) experience with prescription pharmaceutical brands, thus attending to situations where consumers have limited control over brand choice. With this purpose, the authors conducted a phenomenological study involving interviews with seniors in two Canadian cities. Phenomenology relies on a small number of interviews that are analyzed in depth and describes the lived consumer experience. Data analysis focused on types of relationships participants had experienced with brands and factors that influenced relationships. Analysis revealed four types of relationships that seniors hold with prescription pharmaceutical brands. The interpersonal relationship metaphor of arranged marriages can be used to describe relationship forms that seniors develop with brands. The quality of relationship seniors have with prescribing physician, who acts as marriage broker, and brand attributes influence relationships with prescription pharmaceutical brands. Consumer’s ethos and nature of illness also influence brand relationships. This study provides insights into brand choice situations where consumers have low control and addresses impact of intermediaries on consumer experiences. It opens the way for further research on mediated brand relationships. The study has important implications because marketing managers need to understand the role of intermediaries, where applicable, in influencing consumer relationships with brands. Most importantly, the study closes a gap in academic research on relationships with prescription pharmaceutical brands held by consumers, specifically older consumers, which is sparse. It also encourages a critical view of the arranged marriage metaphor as a means of understanding consumer-brand interactions.

The next article by Julie M. Coe and Fang Qian is a research paper with the title “Consumers’ choice of dentist by self-perceived need.” In this article, the authors describe consumers’ choice of dentist by self-perceived need: comprehensive dental care patients and limited care patients in terms of patient characteristics and information sources used and preferred attributes during the dentist selection process. The authors surveyed 1,150 dental school faculty private practice patients who recently chose their dentist and collected 221 responses. The respondents were divided to comprehensive care patients (n=120) and limited care patients (n=90) by self-perceived need. The results showed that the comprehensive care patients were younger and more likely to be highly educated, have healthcare related profession, and have private dental insurance (p<0.001). The comprehensive care patients were more likely to use information sources such as clinic web site, the internet, and the insurance directory (p<0.05) while the limited care patients were more likely to use other dentist. Comprehensive care patients put more value on attributes such as the dentist is in my insurance network and convenient physical location (p<0.05). In conclusion, comprehensive care patients and limited care patients differed significantly in characteristics and how and why they chose their dentist. The authors conclude that healthcare marketers can use this study’s findings to better promote their practice by selecting appropriate communication channels and focus on attributes that consumers value the most. It is important to apply different strategies to different consumer groups.

The following article of this issue is authored by Shamindra Nath Sanyal, Saroj Kumar Datta and Asok Kumar Banerjee and titled “Conceptualisation of branding: strategy based on Indian pharma sector.” In this conceptual paper, the authors address how the concept of branding exists in the pharmaceutical sector and the Indian market in particular and tries to identify how branding techniques might be modified to optimize the benefit the marketing of branded generics in India. The study was conducted using qualitative interviews with two sets of respondents in Kolkata, India – first, 20 senior managers of five renowned Indian pharmaceutical companies, and second, 20 physicians of two categories. Patterns of concordance for the author-coder pairs were tested by using Cohen’s kappa. Investigation of the relationships between five different parameters deemed responsible for enhancing the brand awareness in pharmaceuticals showed that out of five parameters, “importance of customer’s perceptions and need achievement” leads to the development of positioning statement to communicate the brand’s functional values and brand personality, while “importance of pharma brand age in brand awareness” establishes the relationship of brand age with brand recall and communication in emphasising the brand recall. A high value of Cohen’s kappa helped the authors to establish the qualitative inquiry of the research. As a practical implication, the authors have proposed that through the studied five parameters, the pharmaceutical branding technique might be modified to optimise the benefit the marketing of branded generics in India. A strategic comprehensive model that has been constructed in the study would give a direction of branding in pharmaceutical industry.

The last article in this issue is a conceptual paper by Beth Ann Fiedler and Lieutenant Robert J. Bebber, titled “An international regulatory clinical trial comparative.” In this article, the authors aim to establish historic regulatory conditions and priority national characteristics eliciting outstanding best practices in clinical trial regulatory systems towards global health objectives through targeted economic development. For this purpose, the authors conducted an exploratory review of clinical trial processes of three industrialized nations with similar democratic processes – Japan, the UK, and the USA, in order to determine the efficacy of international clinical trials. In conclusion, the authors suggest that outstanding best practices in national vaccine clinical trials can guide the international economic development, manufacturing, and distribution policy strategies necessary to form the basis of a cross-cultural global delivery system. This study contributes to the academic literature threefold:

1. 1.

   it reviews established fundamental clinical trial processes for Japan, the UK and the USA;

2. 2.

   it distinguishes similarities and differences to determine best practices; and

3. 3.

   it suggests changes in regulatory vaccine clinical trials towards achieving global health objectives.

Hope you will enjoy reading the issue and thinking of new research ideas.

Avinandan MukherjeeEditor