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  • Advice You - Fear of Being Outsourced? Fight Back

    Me, outsourced? Impossible. How could they replace a business-humor columnist? But my brother-in-law, the radiologist, told me his hospital was threatening to cut his position because they had found a medical group
    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
    out of India that would read MRIs at half the cost.

    He warned me, “Hesh, don’t be so smug. No one is indispensable in today’s world economy.”

    He was right. I had become blas?. I needed to diversify and find read
    ; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

    Examples of combination products may in
    ers outside the USA, especially in the booming call-centers of India.

    Do Indians find our business customs humorous? I decided to do some research. I called the IBM help desk. I asked the technician where he was l
    lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

    ocated. He said “Birmingham, Alabama,” and he said it with pride.

    I asked for his boss. I told her that I wanted to be helped by someone in Bombay. “What? I usually get the opposite requests,” she blurted out.

    I
    here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
    told her that I found their staff people in India to be more helpful and courteous. And I found their English easier to comprehend compared to the southern accents from Birmingham.

    Within seconds, I was talking to
    d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

    Combination pro
    Bombay. After spending a few minutes on a fictitious problem, I asked my help-support person what he found humorous about working with Americans.

    He said, “Sir, it would be inappropriate for me to comment on you A
    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
    mericans and your business practices.”

    I kept on digging. “You must be frustrated spending eight hours a day listening to us Americans. How do you blow off steam?

    He suggested I call a business radio talk show in
    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
    Bombay where the locals call in with their problems of working with westerners. It was called “Can I Speak to your Supervisor, Please.”

    Using my computer I was able to find a real cheap Internet-phone line to Bom
    nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
    bay, and I called. The radio show’s producer doubted my veracity when I told him I was calling from the USA. He thought it was a crank call. But when he listened to my accent — half Pittsburgh and the other half Br
    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
    ooklyn — he knew no Indian could impersonate that dialect.

    He reminded me to use only my first name, when being interviewed. The talk show host began, “Our next caller is a Mister Hesh from the USA. We are very lu
    ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
    ky to have an overseas caller. Welcome to our show.”

    “What is it about doing business with Americans that you find most intriguing or disconcerting?” I asked.

    “A great question,” the talk show host realized he ha
    ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

    Following aspects would a
    d an issue that could generate some controversy. “Mr. Hesh, why not hold on as we let our callers respond.”

    The first caller began, “Mr. Hesh, you Americans have such a childish belief system. You expect every pro
    dd to the challenges in developing combination products:

    Which markets to tap where the combination products can do fairly well?
    Which combination prod
    blem to be solvable. Our culture has taught us the inevitability of misfortune. I want to say to callers, ‘Sorry, Mrs. Grady, your hard drive is forever broken and can never be repaired. Please unplug it and grieve
    cts are meaningful and rational?
    Which therapeutic categories to select?
    Which Combinations can address unmet needs of the patients?
    Do combin
    for the next 10 minutes.’ But, I am not allowed.”

    The second caller said. “We are obligated to try to sell you a software upgrade with each call. We think that this is very inhospitable. In our culture when someo
    tions increase the patient compliance?
    What would be the developing cost?
    How to tackle the risks encountered during combination product developmen
    ne calls for help, one must never try to gain an advantage from another’s adversity. But we are taught that this is what makes you Americans so wealthy.”

    The producer asked me to call again. He had dozens of local
    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
    callers waiting to talk to me. Before I knew it I was a radio personality in India with my own morning business call-in show.

    Now, I visit India almost twice a month. I am a regular commentator on their TV morning
    ping new procedures for reviewing their safety, efficacy and quality.

    Professional from academic institutions, pharmaceutical industries, health care indust
    shows and a sought-after lecturer at business conferences.

    The travel back and forth is brutal even in first class. Plus, because of the time difference I have to be wide awake from 2 a.m to 5 a.m to take the cal
    y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
    ls from my audience. Why I am actually considering moving to India permanently.

    Somehow the governor found out about my impending move (I bet it was from my mother) and he called asking that I not take my business
    .

    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
    overseas. It would be a terrible loss to our region’s image.

    He had funds to help businesses keep jobs here. I would qualify for an economic-development grant if I did not relocate. I guess it is like paying farm
    elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

    Companies that provide selfless information through particip
    ers not to plant corn. (Do they still do that?)

    I called my brother-in-law with my good news, and said, “I told you going to medical school was a poor career choice. You should have majored in English, like I did.


    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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