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When in Egypt, you had better negotiate like an Egyptian. Be sure to leave your cowboy hat at home since the rules are very different in the Middle East.

Egyptian culture has five thousand years of recorded history, so I won’t be giving a history lesson today. Let’s just say that eve

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

ry aspect of life in Egypt has a special meaning and a reason why they do things as they do. If asked why something is done a certain way, they will likely recite history from thousands of years ago.

Egypt is a high context culture which means that a lot what is communicated is trans

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

ferred implicitly with body language, silence, eye contact, and oblique words or phrases. For example, it is considered impolite to deny a wish to someone. Instead of saying “no”, other phrases are used to describe an inconvenience, which implies that the answer is no. When an Egyptia

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

n says “yes”, he or she may actually mean “possibly”. Communication can include intense eye contact and frequent gestures for emphasis.

The official language of Egypt is Standard Arabic and is used in most written communications. Egyptians tend to speak at a much closer distance than

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

Americans. This close contact can be awkward for Americans, but don’t back away. Moving away could make you seem cold or disinterested. Egyptians tend to be emotional and tend to use emphatic language; they also tend to exaggerate. When making a point they will speak loudly and repea

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

themselves for emphasis. They frequently will interrupt each other and will speak over other speakers.

Egyptians touch when speaking with good friends and established business associates, but until they know you well they usually confine physical contact to handshakes. However, afte

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

r they trust you, expect close contact including hugging and kissing. It’s good thing. You made the team.

Non-verbal communication is huge in Egypt. Never point since it is rude. A “thumbs up” gesture is very insulting similar to our middle finger salute. They remove their shoes ofte

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

n in meetings, but never show the bottoms of their feet.

Relationships are very important and gifts are often given. When a gift is needed you might want to consider an exquisitely made compass; this enables a devout Muslim to always know where Mecca is (even when traveling). When of

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

fered coffee always accept it, since it is considered very rude to do otherwise.

The Islamic religion dominates Egyptian life. They believe that many solutions to current problems are to be found in the orthodox practice of an Islamic life. Egypt is a fatalistic culture which believe

and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ

s that the hands of God will define their destiny. There is a pervasive collectivist thinking because of the centuries old battle with the harsh climate and deprivation; to survice they have had to share with others. The individual is always subordinate to the family, the tribe, or th

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

collective. It is a male dominated society.

Business meetings tend to be very formal affairs. They usually begin with coffee and conversation even in situations when the issues are important or time is limited. The business day is similar to American business, but with longer lunche

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

s and frequent breaks for coffee. The pace of business is much slower in Egypt than it is in the West, so you will need to be very patient.

Time is relative in the Egyptian culture and punctuality is not important, although they expect you to be on time. It is common for visitors to

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

be kept waiting; for example, if your meeting is scheduled at 10 am it may not start until 11 am. Once started, expect interruptions such as phone calls, memo signings, and, yes, blackberry messages. There is no need to rush in Egypt.

Decisions will seem to take forever and will almo

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

st never happen in the meeting. They also don’t understand the American need to close the deal on the spot and will resist it. When negotiating, you can expect raised voices and arm waiving; this is normal even when they agree with you. Egyptians negotiate as teams and it may not be c

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

lear in the meeting who is in charge. Often the most powerful Egyptian in the meeting will just listen. They like to stall and tease the other side; since time is one their side, they figure that they can wear you down and get what they want. They often do.

Relationships are more imp

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

rtant than contracts or signed documents. In Egyptian culture, “Kalima”, the verbal pledge to carry out what has been agreed upon, is more binding than a contract; this commitment is a matter of honor. Yet, it remains very important to agree on the next steps, along with the time tabl

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

e to meet again.

A few more things: – Business cards should be printed in English on one side and in Arabic on the reverse. When presented a card, pause and reflect upon it.
– Orthodox Muslims won’t drink alcohol or eat pork.
– Adding salt to your food is rude.
– Most

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

eating is done without utensils. Get used to it.
– When in meetings, sit with both feet on the floor; don’t cross your legs.
– Expect heavy and prolonged eye contact. This can feel a little creepy by American standards, but this is the behavior of an honest man in Egypt.

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

> – Avoid eye contact, speaking with, or touching Egyptian women at all costs. You will find few women in positions of authority in Egypt. The Islamic culture has very strict rules about women and morality. Avoidance is key.
– Dress formally in western attire at all times; don’t

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

even try to look like a local.

Special thanks to Chuong Thai-Lazaro, Veronica Tsang, and Brian Weiss of California State University, Long Beach, for assisting me with this research.

John Bradley Jackson © Copyright 2006 Please visit my website at www.firstbestordifferent.co

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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