For years, advisers have told pharma clients that it is hard to find an example of reputation problems affecting the bottom line: the purchasing process is so complex (doctor – pharmacist – patient with insurers and wholesalers in the mix) that reputation worries don’t seem to hit sales. Ranbaxy might be disproving all the articles and lectures on the subject. A few weeks ago, they had to pay the US government over $500 million in fines over a series of frauds and data fabrications (the full story is here Ranbaxy got a fairly soft ride in the Indian press (as Health Issues India noted here but apparently patients in India are demanding that they be shifted to medicines from other producers — at least, according to Fierce Pharma. It may be yet another example of growing patient power amongst Indian consumers. It may also suggest that patients are getting their information from social media (or more likely that their children are) and that gentle treatment from the press no longer insulates a company from nasty consequences.