Purpose of the article:
 

1.To review specific to Georgia diseases;
2. To show specific to Georgia organizational forms of treatment ;
3. To make  brief description of the Georgian pharmaceutical market;
4.To review forms of promotion of pharmaceutical productions used on the  Georgian pharmaceutical market today
5.  To offer pharmaceutical companies competitive forms of promotion of their new pharmaceutical production on the Georgian market based on analysis of  existed situation.
 

The author thanks Medical Faculty of Tbilisi State University and Professor Teimuraz Chigogidze, deputy of dean of the faculty, for consultation.
The author thanks the specialized medical marketing company "Shenco-group LTD". The author was allowed  to use its database, the statistic facts and the results of sociological researches.
There have been used materials prepared by the State Department for Statistics of Georgia in scopes of the TACIS project.
Readers interested in detail concerning the article should ask by e-mail
 

1.Specific character of diseases in Georgia
 

In order to study a pharmaceutical market it is valuable to know specific character of diseases existed in a region. Bellow it is shown the specific character of diseases for Georgia, based on the official statistic information. Because of some reasons this information needs to be defined more precisely. These reasons are:
 

Method of the sociological research
 It have been carried out the sociologic research in different sociological groups to study diseases frequency. Today in Georgia there is no objective serviceable criteria   to distinguish  the population with a social mark The real situation is that a professor sells hamburgers, a physician manufactures beer and etc. It have not been managed to identify population according to their income, because most of the population tend to avoid taxes. In such situation it has been distinguished social groups indirectly.
 

There have been selected following groups:
1. Tradesmen (250 persons);
2. Farmers from villages of  the middle level (140 persons);
3. Intelligentsia having appropriate work  places (universities, institutes) (140 persons);
4. The unemployed  (illegal market of the unemployed) (300 persons);
5. The employed  involved in legal business (140 persons).
It turned out that the character of dissemination of diseases, in the above mentioned groups, is quite different. On  the left it is shown the total frequency of dissemination of diseases classified basically by the organ pathologies  (without a social group gradation). The research was carried out in scope  the planning  project works  of Caucasus Medical Server
(http://www.caumedserv.com.ge/)
 

According to the information of the State Statistic Department, bellow it is shown  the statistic of the treatment ways. The information needs to be made more precisely from the pharmaceutical market point of view:
A). Ambulance services. The population uses this way in urgent situation. Ambulance

services in 4% end by transportation   to hospitals. In other cases, as a matter of fact, a physician diagnosis without any  laboratory tests, gives recommendations and after that most part of such patients continues treatment her/himself, without a physician supervision.

B). It is interesting last 4 items of the diagram:
"Paid treatment under supervision of a private physician", "Free of charge treatment under supervision of a familiar physician", "Self-treatment without any consultation", "Treatment with unconventional methods". They amounted to over 70% of all treatment ways. It may be incomprehensible for colleagues from developed countries meaning of the "private physician", "familiar physician". Sometimes it means to get consultations from an unemployed physician, without any laboratory tests (because of inaccessible cost). From the pharmaceutical market point of view, this means getting of consultation from a physician who is  isolated from the medical informational environment and does not receive information about new medical preparations from  the first sources.
Thus,  we would like to say that the conventional "physician-patient” scheme of distribution of information about  medicinal preparations to a patient, is broken. We consider this fact as a significant peculiarity. But the Georgian market has also other peculiarities.
 

Using a simple scheme, most of pharmaceutical companies successfully manage to promote their production on the Georgian market . A company tries to give information about a medicinal preparation to famous physicians, make close informative  contact with them.  Ordinary physicians, who are not involved in this informational space, get the secondary information from the famous physicians. The total result of working of  this scheme (in both cases) is 30% segment of all market. Actually, this is the segment, when a patient gets a medicinal preparation, as a result of a physician consultation. Other 70% is the segment isolated from the first source of the information. The result of this is that there are many good and accessible medicinal preparations on the Georgian market, but they do not manage to be promoted.

So bellow it is  presented the following scheme expressing  the situation
 

Famous physicians
 

We use this term as a conditional and it means group of physicians which are preferable for represenatatives of pharmaceutical companies  and as a rule they are always invited at the well organized expensive presentations arranged by pharmaceutical companies. There are no precise facts but "Shenco-group" has studied, that such group of physicians serves up to 40% of patients.
Due to distribution of appropriate leaflets and arrangement of  presentations of medicinal preparations, some medical circles get  valuable information, but it is not enough for making a successful choice before prescription of a medicinal preparation. Today there are numerous parameters which must be foreseen before making a choice  and therefore,  the leaflets do not provide a physician with complete informative environment. Thus, most of the physicians get the large information though they have no means of making comparative analysis. The way out of the situation is following: to provide the physicians with tools (mechanisms), which will give them opportunity for  multiparameter comparing.
We consider that such mechanisms can be:
1. computerized system of encyclopedia of   medicinal preparation   (see bellow)
 2. Textbook "Modern medicines" (see bellow)

Physicians being under informative influence of the famous physicians
 

The reality of Georgia is that around the famous physicians is a category of physicians which are under informative influence of the famous. This is expressed when such influenced physician sends a patient to a famous one or in some cases uses his/her treatment method. We really have distinguished such category of physicians. They slow react on new preparations.  It is likely to be about 60% of the patients under consultation of such physicians.
 

Physicians which have not close contacts  with the medicinal informative space

Information of this group relies on knowledge gained from conventional textbooks and their  reaction  on new preparations is passive. Basically, they use preparation by principle of analogies. Such physicians often use the term of "substitute”. The best and conventional way to inform the physicians of this group is a modern textbook (not a directory).
 

Population using self-treatment
 

Most of the population tends to self-treatment (the reason is inaccessibility) .  In this case the source of  information is a patient with similar pathologies, having some experience of treatment; familiars, drugstores, advertisements.
 We have elaborated several projects to improve access of the useful information for this group.
1.Online and mass-media consultation (popular education, warning about danger of self-treatment  etc.);
2. Creation of the informative system consisting of physicians and medical organizations dates.
 

Today in Georgia there are registered about 20 000 web-sites. This means that on  average each web-site corresponds  on 200 persons. This calculation excepts web-sites and servers which providers are registered in other countries.  So it is likely that in Georgia every 101st person has his/her private information in the Internet. It is registered more then 100 000 e-mails, so one person in every 40 persons  uses e-mail.
 

In regard of the economic situation,  the result of these compares are quite different and has peculiar expression. Here we do not explain reasons of this (this is not purpose of the article), but the state has strong logical and numerical explanation.  To the right of the column it is shown the dynamics of "Caucasus Medical Server" readers (rates of visitors by months). It is clear that number of readers is not high, but there is not made serious advertisement of the server yet and actually it is in the trial exploitation. In spite of this, number of readers increases quickly.

According to our consideration it is significant to use these resources in the pharmaceutical business. Today  two servers work  owning to the author's projects: "Georgian pharmaceutical site" and "Caucasus Medical Server". The owner of the Georgian Pharmaceutical Site is NGO the Association of Pharmacists, Producers of Medicinal Plants and Ecologists "Institute of Medicinal Plants", the owner of the Caucasus Medical Server is company "Shenco-group LTD" specialized on medical marketing. Both the web-sites directly or indirectly serve the pharmaceutical business. We do not detail them here. Though we emphasize on parts of the web-sites which are directly expressed on the market. Generally, there are placed quite large information having  capacious contents. Some of them are shown in the table:
 

Encyclopedia of  preparations

It is considered as a source of complete information about preparations. The main module of the encyclopedia is "Advisor", which gives opportunity of multifactor comparing and helps a physician to select more effective preparation to a patient.
The main users of the encyclopedia are considered physicians. Today it is likely to work 400 computers under the advisory regime. There is a plan of organization of the special services.
 

Georgian electronic medical encyclopedia

There is created no Georgian electronic encyclopedia yet. In scopes of "Shenco-group LTD" young scientists have been  preparing individual articles for the encyclopedia. The materials are Georgian and have academic style. From the pharmaceutical marketing point of view, pharmaceutical companies should be interested in preparations advertisement here and publication of information describing their preparations along an appropriate article. For instance, on the Georgian Pharmaceutical Site it was set the article Hepatic Cirrhosis by Koba Kupreishvili. In case of wishes from pharmaceutical companies along the article can be set description of preparation indicated for treatment of hepatic cirrhosis.

Discussion

New preparations

On the one hand representatives of pharmaceutical companies try to inform physicians about  new preparation and distribute leaflets; on the other hand, basically, education system is based on old information. There is created no Georgian complete textbook 'Modern pharmacotherapy". Some Russian directories can't substitute the textbook.  On the base of medical faculty of Tbilisi State University it has been carrying out works for preparing such textbook. According to the authors' project it can be used for distant education.
 

The aim of the article is to acquaint English speaking readers with some trends of the Georgian pharmaceutical market and local works. Additional information concerning the article is available upon request by e-mail.