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SYNOPISIS
M/s. Alfa Corpuscle Ltd, Delhi , wanting to expand their product line in India approached
Our Institution Garden City College, Bangalore. They conducted an interview for MBA-
Marketing Students offering an internship programme on market research on Hernia Mesh.
Having got shortlisted for the internship programme, we had a training at their Delhi Office
briefing us about the Hernia Surgeries and their product range, The objective of the internship
Programme was to understand the current market of hernia mesh in Karnataka, and to get the
opinions of the General surgeons on the current available meshes in Karnataka Region, and to
know the market potential for the new product in the Karnataka Region.
To achieve this purpose, Karnataka region was divided into two geographic zone- Bangalore
Zone and Rest of Karnataka Zone. The target was to meet 150 Surgeons in a span of 15 days
in both the Zones. The Bangalore Zone was assigned to Jobin Babu Varghese and the other
being the rest of Karnataka assigned to Athar Amin.
We had planned to meet the General surgeon of both the Zone, based on reputed hospitals
and reputed surgeons. Some of the well know hospitals in Bangalore Zone like Columbia
Asia, MS Ramaiah, CMH Hospital, Baptist Hospital and Reputed Surgeons like Dr.
Anjanappa of General Surgeon Association. In Rest of Karnataka Zone, Famous Hospitals
Bapuji Hospital Davangere, SS Hospital Davangere, VIMS Bellary, Sidhartha Medical
College Tumkur, and reputed surgeons like Dr. Arun S K of Bellary were visisted and data
was collected based on the sample questionnaire(attached in Annexure). We were able to
cover about 100 hospitals and 121 surgeons. The said data is as summarised in the report in
detail below.
1
TABLE OF CONTENTS
2
SL.NO INDEX PAGE
NO
1 OBJECTIVE 3
2 MARKET RESEARCH
FACTS & FIGURES
MESH USAGE
IPOM MESH
SURGEONS ON MESH
PRIORTIES ON DECIDING
THE MESH
BUYING PATTERN
REASONS FOR NOT USING
THE MESH
COSTING
4
5
10
11
12
15
18
19
20
3 DISTRIBUTOR’S
INFORMATION
23
4 FACTS & FINDINGS 25
5 SUGGESTIONS &
RECOMMENDATIONS
26
6 ANNEXURE 27
OBJECTIVES OF THE MARKET SURVEY ON HERNIA MESH
To understand the current market situation of Hernia Mesh in Karnataka .
To know the surgeons opinion of the Mesh that is currently available in the market.
To analyse the present useage of the Mesh.
To understand the market potential for a new product (mesh) in the Market.
To Understand the patients decision criteria for hernia surgery .
To know the distribution channel design of Hernia mesh in the Market
3
MARKET RESEARCH ON HERNIA MESH
We conducted a market research on hernia mesh in Bangalore and other parts of Karnataka to
understand the views and opinions of the surgeons on the hernia mesh.
We surveyed 121 doctors in Karnataka (68 in Bangalore and 53 in cities of Karnataka).
During the 15 days of our survey we found many doctors who were really willing to share
with us their experiences and their valuable suggestions, but at the same time some were
reluctant to give us their suggestions. Based on their responses we summarise our findings as
below .
During the survey we found that at an average a surgeon performs 10 hernia surgeries in a
month.
The surgeons have started performing the laproscopic surgeries recently as it reduces the pain
for the patients and they feel more comfortable but the common man cannot afford the
laproscopic surgery as the cost of the surgery and the cost of the mesh is really high. Because
of this most of the surgeons prefer open surgery over laproscopic one as it costs much lesser.
Since the last five years the surgeons have started using the mesh more frequently in the
hernia surgeries.
The surgeons have the opinion that they require the best quality mesh at a very reasonable
price which meets the general specifications and standards.
Based on the cost of the surgeries we have categorized the surgeons into three groups such as
1. tier I Surgeons- high cost, 2. tier II Surgeons- medium cost 3. tier III Surgeons-low cost.
Overall we visited 121 surgeons in Karnataka out of which 19 % falls into tier I Surgeons
Category, 55 % falls into tier II Surgeons Category and 26% falls into tier III Surgeons
Category
4
FACT AND FIGURES ON HERNIA SURGERIES
Surgeries PercentagesTier Type
Inguinal 80% I, II, IIIVentral 20% I, II, III
Hernia Surgeries
InguinalVentral
5
I- Inguinal Hernia
Surgeries PercentagesTier Type
Open 70% I, II, IIILaproscopi
c 30% I, II, III
Open70%
Laproscopic30%
Ingunial Hernia surgeries
Open Laproscopic
6
7
A) OPEN SURGERIES DETAILS IN INGUINAL
70% are done through Open surgeries
Tier Type Tier I Tier II Tier III
Percentages 10% 20% 70%
Tier I13%
Tier II39%
Tier III18%
Laproscopic30%
Open surgeries with Tier dataTier ITier IITier IIILaproscopic
B) LAP SURGERIES DETAILS IN INGUINAL
30% are done through Laparoscopic surgeries
Tier Type Tier I Tier II Tier IIIPercentage
s 10% 75% 15%
Tier I6%
Tier II17%
Tier III8%open
70%
Laproscopic SurgeriesTier ITier IITier IIIopen
8
II Ventral Hernia
Surgeries Percentages Tier TypeOpen 70% I, II, III
Laproscopic 30% I, II, III
Open
70%
Laproscopic
30%
Ventral Hernia surgeries
Open Laproscopic
9
A) OPEN SURGERIES DETAILS IN VENTRAL
70% are done through Open surgeries
Tier Type Tier I Tier II Tier III
Percentages 10% 20% 70%
Tier I13%
Tier II39%
Tier III18%
Laproscopic30%
Open surgeries with Tier dataTier ITier IITier IIILaproscopic
B) LAP SURGERIES DETAILS IN VENTRAL
30% are done through Laparoscopic surgeries
Tier Type Tier I Tier II Tier III
Percentages 10% 75% 15%
Tier I6%
Tier II17%
Tier III8%open
70%
Laproscopic SurgeriesTier ITier IITier IIIopen
10
MESH USAGE IN HERINA SURGERIES
A) In Inguinal Hernia
At an average 85% of the surgeons use the Mesh
Tier Type Tier I Tier II Tier IIIPercentages 100% 95% 95%
With Mesh85%
Without Mesh15%
Usage of MESH
With MeshWithout Mesh
B) In Ventral Hernia
At an average 98% of the surgeons use the Mesh
Tier Type Tier I Tier II Tier IIIPercentages 100% 95% 95%
With Mesh
98%
without Mesh2%
Useage of mesh in Ventral Herina
With Meshwithout Mesh
11
IPOM MESH
Only 10% of the surgeons use the Composite Meshes in Laparoscopic surgeries
Tier Type Tier I Tier II Tier IIIPercentages 10% 5% 2%
Tier 1 Tier 2 Tier 30%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
10 5 2
Column2Not using the Mesh
Reason for not using the composite mesh is that the price of the mesh is very high therefore
the common man is not able to afford so much for the composite mesh for a Laparoscopic
surgery. The surgeons have suggested that the price of composite mesh has to be brought
down so that the common man can afford it but without compromising with the quality of the
mesh
12
SURGEONS OPINIONS ON THE PRESENT MESH
A) Tier I Surgeons opinion on the Present Mesh
MESH WEIGHT (9)
PORE SIZE (9)
ELASTICITY (9)
MEMORY (9)
COST (8)
Of the current mesh that they are using .The Surgeons don’t have an issue with
the cost of the Mesh as most of the patients are coming from a high class
family background or they are coming through an insurance company. For
these patients the quality of the product and the service of the hospital is more
important than the cost. The surgeons are bothered about the properties and the
features of the mesh rather than the price of the mesh.
13
B) Tier II Surgeons Take on the Present Mesh
MESH WEIGHT (7)
PORE SIZE (7)
ELASTICITY (9)
MEMORY (9)
COST (6)
Of the current mesh that they are using, the Surgeons concentrate more on the
features, the cost and the technical specifications of the Mesh. They want the
Best Mesh at the Best Price.
The Patients are concerned about the cost of the mesh and the surgery as well as
the Quality of the Service. The Cost is the main factor for the patients while
deciding on the Mesh and the hospital for a surgery.
14
C) Tier III Surgeons Take on the Present Mesh
MESH WEIGHT (7)
PORE SIZE (7)
ELASTICITY (9)
MEMORY (9)
COST (5)
Of the current mesh that they are using. These Surgeons concentrate more on
the cost and the technical specifications of the Mesh. They want the Mesh at the
most reasonable Price. Their Patients are bothered about the cost of the mesh
and the surgery. The Cost is the main factor for the patients while deciding on
the Mesh for a surgery. Their patients will not be bothered about anything else
other than the cost. These surgeons sometimes does surgeries at a very low cost
as the patient is not able to afford it and sometime at free of cost too in
government hospitals. Special consideration should be given to these hospitals
when the Mesh is sold to them
15
PRIORITES OF DECIDING THE MESH
A) Tier I Surgeons Priorities while deciding on the Mesh
PRIORTIES PERCENTAGESTechnical 50%
Cost 15%Brand Name 30%Availability 5%
Technical Specifica-
tion50%
Cost15%
Brand Name30%
Availability5%
Priorities of Tier I surgeons
Technical SpecificationCostBrand NameAvailability
These surgeons concentrate on the technical specification and the Brand
name of the Mesh rather than the cost and the availability of the Mesh. As
mentioned in the previous page , the patients are not worried about the
cost because it is covered through insurance companies
16
B) Tier II Surgeons Priorities while deciding on the Mesh
PRIORTIES PERCENTAGESTechnical 40%
Cost 50%Brand Name 5%Availability 5%
Technical Spe-cifications
40%
Cost50%
Brand Name5%
Availability5%
Priorities of Tier II surgeons
Technical SpecificationsCostBrand NameAvailability
These surgeons concentrate on the cost of the mesh and then the technical specifications as
their patients are from middle class families.
For these patients the surgery has to be done with a good quality mesh & without any
defects. The brand name and the availability of the Mesh are not given much importance.
They want good quality product and service.
17
C) Tier III Surgeons Priorities while deciding on the Mesh
PRIORTIES PERCENTAGESTechnical 30%
Cost 60%Brand Name 5%Availability 5%
Technical Spe-cification
30%
Cost60%
Brand Name5%
Availability5%
Priorities of Tier III surgeons
Technical SpecificationCostBrand NameAvailability
These surgeons concentrate on the cost of the mesh and then the technical
specifications as their patients are from middle class or Lower class families.
For these patients the surgery has to be done with a good quality mesh without any
defects. The brand name and the availability of the Mesh is not given much
importance. They want good quality product and service. They t want the surgery to be
done. In some cases the surgeon waives off the cost of the surgery of cost as the
patient is not able to afford it by themselves.
These surgeons should be given special considerations on the cost of the mesh.
18
PURCHASE PATTERN OF MESH
PURCHASE PATTERN IN BANGALORE
In 80% of the hospitals, Pharmacy deals with the purchase of the Mesh,
the Medical officer decides on the purchase of the Mesh(examples: Multi
specialist Hospitals)
20% of the hospitals ,the Surgeons take the final decision on the Mesh
(examples: Nursing homes, Clinics, etc)
PURCHASE PATTERN IN OTHER PLACES IN KARNATAKA
In 70% of the hospitals, Pharmacy deals with the purchase of the Mesh,
but the surgeons decide on the brand and type of the mesh
30% of the hospitals, the Surgeons take the final decision on the Mesh
and deals with the purchase of the Mesh..
19
REASONS FOR NON-USAGE OF MESH
WHEN MEDICALLY PRESCRIBED(Only in other parts of Karnataka other than Bangalore)
Financial Condition of the Patients: the surgeons prefer not to use the
mesh in an Hernia Repair Surgery as the patients are not able to afford
the cost of the surgery.
Strong Muscle tone: Sometimes in some Patients the muscle tone would
be very strong. In these cases the surgeons do not use the Mesh as it is not
required in the Patients
Old aged patients with Diabetes, BP: Because of the presence of
Diabetes and BP in the Old aged patients the surgeons do not use the
meshes as the body might not accept the foreign body and might cause
infections leading to complications.
In case of small Hernial Defects: in cases of small hernia defects the
surgeons do not prefer to use the mesh in the surgeries as it is not
required and can be repaired without a mesh.
20
SURGEON OPINION ON IDEAL COST OF MESH
FOR TIER I SURGEONS IDEAL COST OF MESHES
SIZE RANGE PERCENTAGE GRAPH
3”X6” 500 to 750 (10%) (A)
750 to 1000 (30%) (B)
>1000 (60%) (C)
4”X6” 650 to 850 (10%) (A)
850 to 1150 (30%) (B)
>1150 (60%) (C)
6”X6” 900 to 1400 (10%) (A)
1400 to 1800 (30%) (B)
>1800 (60%) (C)
3" X 6" 4" X 6" 6"X 6"0%
10%20%30%40%50%60%70%80%90%
100%
CBA
21
FOR TIER II SURGEONS IDEAL COST OF MESHES
SIZE RANGE PERCENTAGE GRAPH
3”X6” 500 to 750 (50%) (A)
750 to 1000 (40%) (B)
>1000 (10%) (C)
4”X6” 650 to 850 (50%) (A)
850 to 1150 (40%) (B)
>1150 (10%) (C)
6”X6” 900 to 1400 (50%) (A)
1400 to 1800 (40%) (B)
>1800 (10%) (C)
3" X6" 4"X6" 6"X6"
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
CBA
22
FOR TIER III SURGEONS IDEAL COST OF MESHES
SIZE RANGE PERCENTAGE GRAPH
3”X6” 500 to 750 (80%) (A)
750 to 1000 (20%) (B)
>1000 (0%) (C)
4”X6” 650 to 850 (80%) (A)
850 to 1150 (20%) (B)
>1150 (0%) (C)
6”X6” 900 to 1400 (80%) (A)
1400 to 1800 (20%) (B)
>1800 (0%) (C)
3"X6" 4"X6" 6"X6"
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
80 80 80
CBA
23
DISTRIBUTOR’S INFORMATION
During the project we also surveyed the distributiors who supply different brands of hernia
meshes to the hospitals. The objective of the distributor’s survey is to find out the distributing
channel that the distributors follow to supply the meshes to hospitals. And, also to find out
the cost of mesh at which they supply it to the hospitals and to the customers( i.e the MRP).
The details of the survey are given below.
COST DETAILS:
Brand: Ethicon (J & J)
Sl. No Mesh Type Size MRPCost to
HospitalsCost to
Distributors
1 Prolene Mesh 3"X6" Rs. 1759 Rs. 1408 12%4"X6" Rs. 2565 Rs. 2308 12%6"X6" Rs. 3934 Rs. 3147 12%
2 Ultra Pro Mesh 3"X6" Rs. 7191 Rs. 5531 12%4"X6" Rs. 7582 Rs. 5832 12%6"X6" Rs. 8105 Rs. 6234 12%
3 Vipro Mesh30cmsX30cm
sRs.
15362 Rs. 11817 12%
4 Vipro II Mesh 3"X6" Rs. 2605 Rs. 2005 12%4"X6" Rs. 3566 Rs. 2744 12%6"X6" RS. 5353 Rs. 4117 12%
5 Proceed Mesh 3"X6"Rs.
19689 Rs. 15145 12%
6"X6"Rs.
31658 Rs. 24352 12%
24
Brand: Sutures India
Sl. No Mesh Type Size MRP Cost to HospitalsCost to
Distributors
1 Trulene Mesh 3"X6"Rs.
1350 25% 33%
4"X6"Rs.
1966 25% 33%
6"X6"Rs.
2258 25% 33%
Brand: Dolphin
Sl. No Mesh Type Size MRP Cost to HospitalsCost to
Distributors
1 Dolphin Mesh 4"X6"Rs.
1600 20% 40%
From the survey we came to know that Ethicon is the major player in the Karnataka market.
The reasons for this being its quality and its availability. Ethicon (J & J) has got good
network of distributors who supply the meshes to hospitals effectively and efficiently.
DISTRIBUTION CHANNELS:
The distribution channels that the distributors (Ethicon, Sutures India etc.,) follow are
- The medical representitives get the orders from the hospitals and the distributors gives
the delivery of the meshes ordered.
- Sometimes hospitals buy the meshes on yearly or monthly basis from distributors.
- Sometimes hospitals give the order for meshes when there is need.
25
FACTS & FINDINGS
1. Average surgeries performed by a surgeon in a month is 10 Cases
2. 80% of these surgeries are inguinal
3. 20% of these surgeries are Ventral
4. 70% of these are Open surgeries
5. 30% of these are Laparoscopic surgeries
6. 90% of the surgeons use Mesh in the Surgeries
7. 99% of the surgeons are of the opinion that the ideal weight of the mesh, pore size is
as it is available in the market
8. 10% of the surgeons use Composite Meshes
9. 80% of the Surgeons use the Brand ETHICON
10. 10% of the Surgeons use the Brand Lotus
11. 10% of the Surgeons use the other Brands Like Sutures India, Dolphin, Bard, etc..
12. Tier I surgeons prefer the quality and technical specification of the mesh over the Cost
13. Tier II surgeons prefer both cost and technical specification along with the quality of
the mesh
14. Tier III surgeons area concerned with the Cost of the mesh
26
SUGGESTIONS & RECOMMENDATIONS
1. Price should be competitive
2. No Compromise on Quality
3. Quality should be according to the Standards
4. Should be easily available
5. Bio acceptability of the MESH should be good
6. Pre-medicated MESH are good but should be available at cheaper price
7. Texture of the mesh should be strong
8. Mesh should be available in Flexible Sizes and Price..
27
ANNEXURE
MARKET SURVEY ON HERNIA MESH
Doctor: Hospital:
Years of practice in hernia surgery:
Phone:
Email:
Other Hospitals Visited:
Q1. How many hernia surgeries do your perform in a month?
Total: ____________________________
a) Inguinal Open _________ Percentage of usage of mesh__________
Brand _________ Size:- __________
Laparoscopic________
Brand ________________ Size:- _______
Do you prefer :Pre- shaped Mesh over Flat Mesh? Yes/No
b) Ventral: Open _________ Percentage of usage of mesh__________
Brand __________
Laparoscopic________
Brand _______________
28
When you do a Laparoscopic Ventral hernia surgery and put an IPOM do you use a composite mesh? Yes(Brand:-_____________________) / No
Q2: Are you satisfied with the Mesh that you are using currently? Yes/ No
Reasons_________________________________________________________________________________________________________________________________________
Q3: On a scale of 1 to 10 how will you rate these parameters in the Mesh that you are currently using? (10 being the best 1 being least)
a) Cost Rating out of 10 :_______________b) Availability Rating out of 10:_______________c) Mesh weight Rating out of 10 _______________
d) Pore size Rating out of 10________________
e) Elasticity Rating out of 10 _______________
f) Memory Rating out of 10 ________________
Q4: What according to you should be the ideal measures for:
a) Mesh Weight _________________b) Pore Size _________________c) Elasticity/ Memory what is more important?.
Q5:When you decide to buy a mesh how would the following four play a role: (Rank them in order of priority) (Most important being 1and 4 being least important)
a) Cost________________
b) Brand Name__________
29
c) Availability___________
d)Technical specification________
Q6: Who is the dealer for the Mesh in the Hospital?
Name_______________________________________________________________
Phone no____________________________________________________________
Q7: What is the buying process in your hospital?
________________________________________________________________________.
Q8: Who is the decision maker to buy the mesh in your hospital?
Q9:What is the reason in cases where you don’t use a mesh
(Question not applicable where use of mesh is medically not indicated)
_______________________________________________________________________
________________________________________________________________________________________________________________________________________________
Q10. How bothersome is mesh infection in your hospital setting and do you feel adding antibiotics to mesh will help in reducing infection?
________________________________________________________________________________________________________________________________________________________________________________________________________________________
30
Q 11.What should be the price to the Hospital for an Ultra Light Weight Mesh
( Monofilament Polypropylene, Macro porous Mesh) with good Elasticity and Memory in size of
3X6”: 500 to 750
750 to 1000
>1000
4X6” 650 to 850
850 to 1150
>1150
6X6” ” 900 to 1400
1400 to 1800
>1800
Q12.What is the total cost of surgery for a one sided inguinal hernia repair with mesh in your hospital:
Laparoscopy:_______________
Open:_____________________
31
Please give some suggestions to help us make a product more suited to your needs:
____________________________________________________________
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Signature :
Date:
Remarks:
32