ADHD is typically found in children aged 6-11 years. So, we targeted their parents who could identify ADHD symptoms. To deliver the message efficiently, we utilised the waiting area of paediatricians– parents could check with their trusted paediatrician if they identified the symptoms and then be recommended to a specialist.

In India, prescription drugs can’t be promoted/advertised directly to patients/ consumers in any format/circumstances. However, unbranded disease/category awareness/education campaigns can be utilised for category building. These unbranded campaigns can carry company logos and can be linked back for doctors through branded communication, if required.

We realised that several fairytale characters show symptoms of ADHD – we just needed to point them out to parents. Did the hare lose because he lost focus? Was Cinderella forgetful? Was Pinocchio hyperactive?

So did we create new films or storybooks? No, instead, we created a cost-effective, scalable new medium: ADHD Symptom Stamps.

30 one-dollar, readily available fairytale books were selected and transformed into ADHD fairytales with simple 50-cent rubber stamps. The hare teased the tortoise? We stamped “Verbal Aggression”. He fell asleep? That’s “Lack of Focus”. Each book received 4-5 of 9 such stamps. Mini-libraries were created in paediatricians' waiting rooms where parents could entertain children during the average 1-hour waiting period. The last page of each book explained ADHD as the possible reason behind ‘your child’s naughtiness/poor academic performance’, listing 9 key symptoms of ADHD and ending with a nudge to the doctor.

Initially, the activity was planned and conducted in 100 paediatrician clinics as a pilot project from February 2016 to April 2016. However, with 1,000 likely ADHD patients being identified each month and deeply positive responses from parents and paediatricians, it was decided to scale up the activity to 10,000 clinics across the country. With the Indian Association of Paediatricians (IAP) data stating the presence of 25,000 paediatricians in the country, the intent is to ensure that the top 40% of these clinics are covered.

Through ADHD Symptom Stamps, parents realised that ADHD could be the reason behind their child’s perceived naughtiness/poor academic performance and got an opportunity to resolve any concerns on their child’s behaviour. Paediatricians became a new channel to funnel likely ADHD patients to specialists.

In the pilot, all paediatricians were excited by the activity and over 1,000 kids were identified each month, allowing us to scale-up the activity to 10,000 clinics, targeting the identification of >200,000 likely ADHD patients in the first year itself. All this at an estimated cost of <$2.5 per patient identified, or <0.5% the cost of annual treatment with Concerta.

Since ADHD patients report almost thrice as many peer problems, and poorer school performance, the treatment of these new ADHD patients has been life-changing.

In pockets where the paediatricians and specialists were well-connected, the impact on brand prescriptions was significant, making this a focus area for execution.

This activation involved the placement of mini-libraries of fairytale books specially stamped with ADHD symptoms.

ADHD symptom stamps required the following steps for a one-time activity at paediatrican clinics:

1. Discussing this activity with paediatricians and taking the permission to set-up at their clinics

2. Educating paediatricians on the diagnosis of ADHD and connecting them to specialists, if required

3. Appropriately placing the mini-libraries in the waiting room

4. Educating the nurses/assistants manning the reception area and waiting room at these clinics so they could supervise the activity and answer patient queries

5. Monitoring the activity for the first few weeks

While planning the Indian launch of Concerta, we realised that though the prevalence of ADHD in India was 11.3%, the market size was relatively negligible. Conversations with specialists that treated ADHD – developmental paediatricians/child therapists/psychiatrists demonstrated that <5-10% of ADHD patients were diagnosed. As a late but ambitious entrant in the market, we identified the opportunity to build a relationship with specialists by funneling likely ADHD patients to them.

While studying the stakeholders, it was obvious that specialists only receive patients already suspected of ADHD. In contrast, paediatricians meet children and have the capability to diagnose ADHD but do not have the time or inclination since they do not treat ADHD. Hence, the need for a mechanism to help diagnose ADHD at paediatricians’ clinics but, with minimal time involvement from the paediatrician.

1 in 10 children aged 6-11years in India have Attention Deficit Hyperactivity Disorder (ADHD) but it goes undetected since the diagnosis isn't taken up as a responsibility by parents, paediatricians or specialists:

Parents miss noticing ADHD in their children since the symptoms hide behind everyday behaviour like lack of focus, aggression, excessive talking, etc.

Paediatricians meet children regularly but don’t have the time to watch out for symptoms or educate parents.

Specialists like developmental paediatricians/child therapists that treat ADHD patients, only meet children already suspected of ADHD.

Johnson & Johnson’s Concerta – one of the world’s leading brands in ADHD– launching in India decided to plug this gap to scale up the category significantly.