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In a competitive marketplace where businesses compete for acquiring and retaining customers, customer satisfaction is seen as a key differentiator. With rapid development of mobile technology and remarkable growth in customer adoption to mobile telephony, mobile communication services have been achieving faster growth in Indian market. At the same time, fast-paced competition with the entry of new players as well as with the advent of new technologies make the industry more competition intensive. As the competition becomes very tight, each company tries to provide high-quality services to satisfy their customers. Ultimately, the levels of customer satisfaction and resultant loyalty will be the determinants of success for any operator in the mobile service industry. The main objective of this paper is to explore the relationship of customer satisfaction with with reference to eight demographic parameters of customers towards different brands operating in mobile network industry. A sample of 200 customers using different mobile network services in Warangal district of the state of Andhra Pradesh was sampled through a self-designed questionnaire. The responses were analysed through Chi-square test for consistency.
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Each medicine surveyed had a specific strength, dosage form, standard pack size of 10 if capsule/tablet and three medicine versions: (1) originator brand, also known as the innovator brand that was the first to receive market authorisation, (2) most-sold generic brands and (3) lowest-priced generic brands. Since there is no publicly available list of originator brands used in childhood cancer treatment, an attempt was made at identifying them prior to the survey through online searches, contacting experts in the pharmaceutical field and checking the US Food and Drug Administration website for any records. See online supplementary table 1A for the list of originator brands identified.
As government hospitals provide free medicines to patients, data regarding price were only collected from private retail pharmacies (n=32) and private hospital pharmacies (n=2). Prices paid by the consumer at private retail pharmacies (which may be maximum retail price or discounted price) were obtained through available price lists. Prices were recorded for each version (originator brand, most-sold generic and lowest-priced generic) for each medicine in Indian rupees (INR). For solid oral dosage medicines, price was adjusted to a pack size of 10 capsules/tablets, and for injectables we collected price per vial/ampoule. The median price ratio (MPR) was calculated to evaluate the consumer price in Delhi compared with international reference prices. WHO set a benchmark that no patient purchasing medicines in the private sector should pay more than four times the international reference price.19 MPR was calculated using the following formula:
The mean availability of anti-neoplastic medicines across seven survey anchor areas (hospital and retail pharmacies combined) was 70% (table 1). Strength-specific medicines which were unavailable in any pharmacy were available in alternative doses and strengths, which were not on the EMLc (eg, daunorubicin is available in alternative strength of 20 mg). Mean availability of anti-neoplastic medicines was 43% and 71%, respectively, in the public-sector and private-sector hospital pharmacies. In private-sector retail pharmacies, mean availability of anti-neoplastic medicines in either generic or originator brand version was 38%. See table 1 for mean availability of non-cancer medicines.
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Originator brands were available for five anti-neoplastic medicines and none of the non-cancer medicines. The percentage availability in retail pharmacies was cyclophosphamide, powder inj, 500 mg in vial (25%); cytarabine, powder inj, 100 mg in vial (3%); doxorubicin, powder inj, 10 mg in vial (6%); doxorubicin, powder inj, 50 mg in vial (9%); and ifosfamide, powder inj, 2 g in vial (16%).
Similar to previous studies,28 29 our study shows there is little relevance in surveying originator brands. Generic brand versions are now more available than originator brand versions25 28 29 and governments have recognised brand substitution in favour of lowering public health expenditure in hospitals.29 Moreover, most originator brands were developed more than three decades ago for childhood cancer treatment and are phased out with the increasing generic competition.