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    Prior to privatisation in China, business only existed in the form of State Owned Enterprise (SOE). These were (and still are) run by people with strong political backgrounds and relationships, usually connected by family ties to someone in the government. This sort of closed organisational structure gave no
    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
    opportunity for its employees to be involved in any decision-making processes. Often, principle-based leadership was substantial to motivate staff to be productive, although the extent of government financial support available meant that SOEs frequently didn’t need much in the way of business knowledge or und
    ; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

    Examples of combination products may in
    rstanding of the market. Success was based rather on good relationship building – which effectively meant getting government financial support.

    With the boom of joint venture in the late 80s and early 90s, foreign investors started sending their own managers to interact with the SOE business culture. They we
    lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

    e given great packages as incentives to compensate for hard local living conditions. In the 13 years I have been living in China, I have heard stories, too numerous to mention, of foreign managers attending hundreds of banquets and getting drunk with government officials, while the translators took over the c
    here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
    mmunication channels. Most of the time they would have no idea of what was going on, other than that they were expected to drink vast quantities of alcohol, which somehow or other bridged the gap between the two cultures. The main criteria for foreigners to be successful in this business arena were knowledge
    d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

    Combination pro
    f the following:

    1. How to recognise who is a decision maker
    2. How to impress Chinese counterparts by speaking a few Chinese phrases
    3. How to use chopsticks and understand meal etiquette
    4. How to ‘fake’ drinking

    How to recognise who is a decision maker
    All banquets are served o
    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
    round tables and there is no obvious distinguishing mark, to indicate where the main guest is seated. However there are a few give-aways. Look out for these clues:
    - The guest of honour is most likely to be facing the door (so they can see when the new dishes are brought in).
    - Fish is the sign of
    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
    prosperity and a banquet is likely to include a fish dish. The head of the fish will be placed facing the person of highest status.
    - The counterpart will be seated directly opposite.
    - The people seated at the right and left hand of the person of highest status are the two next most important decis
    nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
    on makers.

    How to impress Chinese counterparts by speaking a few Chinese phrases
    The Chinese language consists of phrases that are called ‘chengyu’, the nearest interpretation of which, would be – proverbs. They usually have four characters and have a whole story behind them to support the meanin
    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
    that you want to express. There are dictionaries with a selection of the most frequently used chengyu, an essential part of your library. Make sure you use a chengyu at the appropriate time and you will grab everybody’s attention and gain substantial respect.

    How to use chopsticks and understand meal eti
    ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
    uette
    This involves practice beforehand. Using chopsticks is the first step of eating etiquette and conveys the message to the Chinese that you are willing to learn and accept their way of living. There are two kinds of chopsticks – disposable (wooden) and those used at banquets (made of plastic, jad
    ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

    Following aspects would a
    or polished wood). The latter are quite difficult to use to eat the peanuts and small bits, so common in Chinese cuisine, so make sure you practise with these.

    When dishes are brought to the table, wait for your counterpart to start eating or at least invite you to help yourself. Fish is always taken by the
    dd to the challenges in developing combination products:

    Which markets to tap where the combination products can do fairly well?
    Which combination prod
    highest ranking person seated at the table. They usually get the fish cheeks too – the best part of the fish.

    When drinking toasts, your cup should be held at a lower level than your counterpart’s. That way you show respect. If they attempt to say cheers with their glasses held lower than yours, don’t fall f
    cts are meaningful and rational?
    Which therapeutic categories to select?
    Which Combinations can address unmet needs of the patients?
    Do combin
    r it, it is just a test.

    Waitresses will keep refilling your glass while you are talking. While conversation continues, tap your index and middle finger twice on the table, which simply means ‘Thank you’. This custom is explained by the legend of an emperor, who decided to mingle with his people in disguise.
    tions increase the patient compliance?
    What would be the developing cost?
    How to tackle the risks encountered during combination product developmen
    He swapped clothes with his servant and watched as officials focussed all their attention on his servant, believing him to be the emperor. When the servant, dressed as emperor, was offered tea the true emperor in servant’s clothes had to serve him. To preserve the disguise, without compromising the respect d
    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
    e to his emperor, the servant, dressed as emperor, tapped two fingers on the table to denote bowing with respect to the real emperor.

    How to ‘fake’ drinking (and not get drunk)
    The easiest way is secretly to pour water into your cup, since you will be challenged to drink baijiu (white spirit). Th
    ping new procedures for reviewing their safety, efficacy and quality.

    Professional from academic institutions, pharmaceutical industries, health care indust
    s lethal spirit has a strong taste and is 50%-70% alcohol. While nobody is watching fill your cup with water and make sure it is always full. Initiate constant refills of everybody’s drinks and you will soon gain the title of ‘Lao Han’ (honourable Chinese). An alternative is quickly to dispose of the contents
    y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
    of your cup over your shoulder as you bring it close to your mouth. Make sure there is nobody watching and that there is nobody standing behind you! Baiju is always drunk down in one go unless it is mentioned otherwise. It is a good idea to fake being slightly drunk too, in order to avoid arousing any suspici
    .

    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
    ns.

    And remember, enjoy the meal, be prepared to eat intestines, turtles, snakes and drink snake blood and bile without showing any disgust – these delicacies are believed to improve your manhood. If you are a woman, you are more likely to be forgiven the odd lapse and at least won’t be under so much pressur
    elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

    Companies that provide selfless information through particip
    to drink heavily. In this case, you should make sure that you are accompanied by a Chinese person of higher position in your company, who is prepared to take over the drinking part of the evening, which is so crucial in establishing good business relationships.

    Copyright 2006 Dalida Turkovic


    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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