I awoke today to the news that a big piece of Ranbaxy, the Indian generics drugs giant, will be acquired by Daiichi Sankyo, the Japanese pharmaceutical company. This merger of giants is a reminder that, while the mantra of “health care is local” holds true most of the time these days, the times they are a’changing.

Pharma, of course, has been a global industry for a long time. But bringing generics into a novel pharma company is a newer phenomenon. We know that in a BRICs (Brazil-Russia-India-China) and clicks world, drug pricing transparency and heath cost management are radically changing health markets under our feet. Andrew Witty, newly-crowned CEO of GlaxoSmithKline, said earlier this week that GSK’s major growth opportunities will be outside of the U.S. The Economist reported on the growth of emerging markets in pharma here in the May 15, 2008 issue.

Whither the health consumer in these changing times? A new survey from Synovate, the Patient Power survey, provides a global snapshot into health consumers in Brazil, Bulgaria, Canada, Germany, India, Malaysia, Netherlands, Russia, Serbia, Slovakia, Turkey and the US. The profile is fascinating.

The top-line: culture drives health behaviors. While that’s an obvious general statement, how this translates into personal health decisions is the “god-in-the-details” knowledge.

Surprisingly to me, it’s the Canadians who are the most questioning of doctors — not the Americans. I am half-Canadian by blood line, and so have an opinion on this based on personal experience with those neighbors to the north. 3 in 5 Canadians were most likely to believe that the doctor is ‘just one of several sources who influence my healthcare decisions.’ This, versus an average of 24% (1 in 4 people) for all countries surveyed. Virtually no Canadian agreed with the statement that the doctor is ‘a person whose directions I follow without question.’ An observation from Synovate’s representative in Canada: “This result reflects the increasing role other healthcare providers play in how Canadians manage their health and select treatment options. Many Canadians rely on their pharmacist to explain physician recommendations. As the physician shortage continues and healthcare legislation in several provinces gives pharmacists increased authority to provide healthcare consultation and write prescriptions (and in some cases bill the government in a similar manner as doctors), we can expect this number to increase.”

eHealth and peoples’ use of the Internet in health is a global phenomenon. 18% of the overall global sample agreed that they see their doctor less than they once did as they can often find out what they need to know on the Internet.

On the alternative medicine front, Synovate says, “Pharmaceuticals easily beat ‘alternative medicines’ in the global popularity stakes. A large majority (83%) of respondents had not visited any alternative medicine practitioners in the last year.” The most common alternative health approaches are herbal remedies (garnering 24%) and massage (with 21% of respondents using this modality).

Note that Americans are keenest on meditation: 1 in 10 has meditated in the past year, the largest percentage by nation in the survey.

Health Populi’s Hot Points: I would turn Synovate’s finding on alternative medicine use on its head and say that 17% of respondents visited alternative medicine practitioners in the last year. While India, with its tradition of ayurvedic medicines, will skew this proportion upward, it’s still a big number overall. Not only does the Synovate finding show that physician visits are getting supplanted, in part, by “Paging Dr. Google,” but that globally, health consumers are also choosing to add alternative medicine to their personal health toolkits.

Globalization hasn’t only affected consumers around the world when it comes to gas and food prices; we’re morphing into global health consumers, as well. Telehealth, medical tourism, medical knowledge, products…it’s getting to be a small world in health.

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