global and local pharma distribution - trends and · pdf file2 total global pharmaceutical...

Copyright © 2016 QuintilesIMS. All rights reserved.

Global and local Pharma distribution - trends and

challenges

Klaus Perera, Senior Principal, Global Supply

QuintilesIMS

1

Topics

Global forecasts and regional growth trends

The payers response to innovation

“The wholesaler dilemma”

Conclusions

2

Total global pharmaceutical market will reach $1.4 trillion by 2020

Source: IMS Market Prognosis May 2016; (*) at ex-manufacturer price levels, not including rebates and discounts. Contains Audited + Unaudited data. $US used for Argentina, Venezuela, Nigeria & Ukraine due to hyperinflation

Global Sales and Growth, 2011-2020

0%

2%

4%

6%

8%

10%

0

200

400

600

800

1.000

1.200

1.400

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Gro

wth

, LC$ (

%)

Sale

s (U

S$ B

n)

Global sales Global growth

5% 3% 5% 9% 9% 7% 5% 5% 6% 6%

The forecast suggests that 2015 growth will not be sustained

3

US illustrates that net price growth is much lower

Source: IMS Health, National Sales Perspectives, IMS Institute for Healthcare Informatics, Mar 2016; IMS Health

MIDAS MAT Dec 2015 (Protected brands only)

8,7% 9,1%

4,9% 5,1%

2,8%

9,3% 10,0%

11,5%

14,3%

12,4%

-15%

-10%

-5%

0%

5%

10%

15%

20%

0%

2%

4%

6%

8%

10%

12%

14%

16%

2011 2012 2013 2014 2015

Sale

s (

LC$)

Gro

wth

%

Price G

row

th %

Título do Eixo

Estimated Net Price Growth Ex-Man price growth Protected Brand sales ($LC) growth

Ex-Man list price growth vs net price growth 2011-2015

Invoice price

growth

Estimated net

price growth

4

Rebates/discounts continue to grow for both large and

small molecules

Source: IMS Institute for Healthcare Informatics, MIDAS Dec 2015, annual company reports.

Lower biologic average discount/rebate at 29%

0

5

10

15

20

25

30

35

40

45

50

55

20

06

20

05

20

09

20

07

20

08

20

12

20

11

20

10

20

15

20

14

20

13

46%

5%

23%

40%

6%

22%

38%

5%

20%

34%

4%

18%

37%

55%

6%

30%

49%

7%

27%

7%

36%

Ne

t sa

les a

dju

stm

en

t (%

)

3%

16%

38%

3%

16%

40%

3%

16%

41%

5%

18%

45%

Lower Quartile Sales weighted average Upper Quartile

20

15

20

13

20

11

20

12

20

14

20

10

20

09

20

08

20

07

20

06

20

05

13%

21%

3%

10%

28%

3%

29%

52%

3%

24%

45%

3%

18%

40%

3%

14%

31%

1%

15%

33%

1%

15%

31%

2%

16%

30%

4%

17%

33%

1%

15%

34%

2%

Small Molecules, Net Sales Adjustment (%)

Biologics, Net Sales Adjustment (%)

5

Growth in Europe will lag behind Global growth

Source: IMS Market Prognosis May 2016; (*) at ex-manufacturer price levels, not including rebates and discounts.

Contains Audited + Unaudited data. $US used for Argentina, Venezuela, Nigeria & Ukraine due to hyperinflation

Global Sales and Growth, 2011-2020

-2%

0%

2%

4%

6%

8%

10%

12%

0

200

400

600

800

1.000

1.200

1.400

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Gro

wth

, LC$ (

%)

Sale

s (U

S$ B

n)

Rest of world Europe sales LC$ % Growth Europe LC$ % Growth, rest of world

Rest of World

Europe

6

2016 pharmaceutical spend KPIs vary across countries

Positive Growth No growth Negative Growth

Elements of Market Growth Total, Rx Pharmaceutical Market

Priced at ex-mnf level before rebates and discounts

US DE ES FR IT UK BR MX AU TR CA

Value growth % (US$)

2015/2016 10.6 4.1 16.0 1.1 16.0 10.5 11.2 5.3 2.3 19.0 7.2


2012/2016 7.2 4.6 4.1 0.5 5.6 7.3 13.1 2.2 -0.4 8.7 3.5

GDP growth 2015 2.4 1.7 3.2 1.2 0.8 2.3 -3.8 2.5 2.3 4.0 1.1

SOURCE: IMS HEALTH MIDAS MAT March 2016; Growth in LC US$; Growth 2012-2016 CAGR;

GDP growth from World bank

SE DK NO FI PL CZ PT AT IE BE SA


2015/2016 5.4 2.5 8.0 4.0 4.4 3.6 15.9 3.3 6.1 3.3 10.7


2012/2016 3.6 2.6 6.7 3.3 3.5 -1.2 1.3 3.2 1.5 0.8 8.3

GDP growth 2015 4.1 1.2 1.6 0.5 3.6 4.2 1.5 0.9 7.8 1.4 1.3

7

2016 Sell in & Sell out market in Portugal (Retail only)

Total Pharmaceutical Market (Channel: Pharmacies)

SOURCE: IMS HEALTH Dataview IFP (Sell in Market) and ICH (Sell out Market) MAT September 2016.

PT

UN EUR

Value Growth % MAT/9/2016

of Sell in Market 0.6 2.4

Value Growth % MAT/9/2016 of Sell out Market

0.1 1.1

Year

Volume (Standard Units*) Average Price per Standard Unit Sales

SU (million) Annual Growth

(%)

€ Annual Growth

(%)

€ (million) Annual Growth

(%)

2017 10571 0.4 0.181 0.2 1916 0.6

2018 10611 0.4 0.182 0.2 1927 0.5

2019 10641 0.3 0.182 0.2 1936 0.5

2020 10667 0.2 0.182 0.1 1943 0.4

Forecast Retail Sector (2015-2020)

Notes: *Standard Units equate the number of milliliters of liquid preparations to the standard solid dosage of one tablet, therefore making solid and

liquid preparations comparable.

SOURCE: IMS HEALTH Market Prognosis Q3 2016

8

Agenda



The wholesaler dilemma

Conclusions

9

2016-2020 will set a record for launches when the

current innovation rich pipeline approved

Source: IMS Health, IMS Institute for Healthcare Informatics, October 2015

22% increase from the previous 5 years

Number of New Active Substances (NAS) launches 1996-2020

225

184

146

165

223

2006-2010 2001-2005 1996-2000 2016-2020

26%

22%

2011-2015

10

Hep C only the first of several potential tsunamis

Source: IMS Health Analytics Link consensus analyst forecast; Drug analyst consensus; IMS Health

MIDAS Q4 2015;

Are these innovations sustainable?

10

0

40

30

20

20

20

20

18

20

16

20

14

An

aly

st fo

reca

st (B

n U

S$

) $18-22 Bn

40

30

20

10

0

An

aly

st fo

reca

st (B

n U

S$

)

2020

20

18

20

16

20

14

$5-7 Bn

30

40

20

10

0

20

20

20

18

20

16

20

14

$6-8 Bn

Immuno-Oncology Respiratory

biologics

PCSK9 inhibitors?

40

30

20

10

0 His

toric s

ale

s (

Bn

US

$)

20

15

20

14

20

13

20

12

Hepatitis-C market

2012-2015

$32 Bn

11

Price challenges in Europe are numerous

Price negotiation collaboration • Netherlands and Belgium announced pilot

joint price negotiations for orphan drugs

• Greek and Portuguese health ministers call

for increasing payer collaborations

• Increased transparency of net price

Post launch payer led RWE scrutiny • France NOAC re-assessment based in part

on own RWE

Italy and France Avastin reimbursement for

use in AMD

• SiNATS ex & post launch evaluation

• Infliximab switching NOR-SWITCH

Budget caps and pharma

payback schemes

• Portugal and Italy reviewing payback

mechanisms for budget overspend

• French HCV spending cap

• UK PPRS scheme

Increasing emphasis

on drug cost-value

• NHS England Cancer Drugs Fund being

taken in under NICE QALY assessment &

threshold being reviewed

• 2015 HCV negotiation

• French and Italian MoH reviewing current

drug reimbursement system

“P” MA

uncertainty

12

Many key biologics losing protection by 2020

Source: IMS Health MIDAS MAT Q4 2015

Top 10 biologics total $79Bn sales globally

20 15 10 5 0

Sales 2015 US$

84% 16%

84% 16%

78% 22%

41% 59%

48% 52%

55% 45%

57% 43%

66% 34%

77% 23%

66% 34%

Global Top 10 Biologics sales by region US expiry date EU expiry date

Adalimumab (Humira) 2016 2018

Insulin Glargine (Lantus) Expired Expired

Etanercept (Enbrel) 2028 (extended) Expired

Infliximab (Remicade) 2018 Expired

Rituximab (Mabthera) 2018 Expired

Bevacizumab (Avastin) 2020 2019

Trastuzumab (Herceptin) 2019 Expired

Insulin Aspart (Novorapid) Expired Expired

Glatiramer Acetate (Copaxone) Expired 2017

Pegfilgrastim (Neulasta) 2015 2017

Non US US Sales

13

Therapy classes exposed to biosimilar competition

in Europe Size of classes in 2015 sales versus total European Biologics market

Oncology

Fertility

Anti –TNF

EPO

G-CSF

HGH (Human Growth

Hormones) 0

0,1

0,2

0,3

0,4

0,5

0,6

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Market Share based on MAT 09 2015 sales values

14

In Europe, there is a large variation in the uptake of

infliximab

Source: IMS MIDAS monthly Dec 2015 ; Denmark data from MIDAS Monthly Restricted database; Bulgaria, Latvia

excluded because only biosimilar manufacturers present in market

EU5 penetration 10-24% in under a year

Europe: Infliximab biosimilar market share

0%

20%

40%

60%

80%

100%

M0 M2 M4 M6 M8 M10 M12 M14 M16 M18 M20 M22 M24

In

flix

imab

bio

sim

ilar u

pta

ke

Denmark Poland Norway

Italy UK Spain

Germany France Portugal

Europe

98%

94%

86%

24%

23%

20%

10% 15%

EU5 +

Portugal

Tender

system

markets

Other European

countries

21%

15

Agenda




Conclusions

16


The Wholesaler

Dilemma

The economic

situation

Channel shifts

Polarization

– growth of

specialty

Competition

around

retail

17


The Wholesaler

Dilemma

The economic

situation

Polarization

– growth of

specialty

18

Pharmaceutical spend closely linked to GDP

AT BE

CZ

DK

EE

FI

FR DE IE IT

LV

LT

NL

NO

PT

RU

SL

ES

SE

CH

US

BR CH

MX IN

0

200

400

600

800

1.000

1.200

1.400

1.600

0 20.000 40.000 60.000 80.000 100.000

LC

€/

CA

PITA

GDP/CAPITA

TOTAL MARKET SALES AT EX-MNF PRICE BEFORE REBATES AND DISCOUNTS

VS. GDP/CAPITA (2015)

• The amount spent on pharmaceuticals is linked to the GDP per capita

• Very low GDP

countries spend also a very low share

• As GDP growth, pharmaceutical spend growth faster

• At a certain level, the rate of increasing need declines (ie when all drugs are funded)

Economic growth

important driver

for healthcare &

pharma spend

19

Growth of Specialty outpaces the total market

Specialty: Region Market Share 2015

7,2%

6,5%

11,3%

21,0%

54,0%

Japan

Pharmerging

ROW

Top 5 Europe

US

Source: IMS Health MIDAS MAT March 2016

0%

5%

10%

15%

20%

25%

-

50

100

150

200

250

300

2010 2011 2012 2013 2014 2015 2016

Gro

wth

, L

CU

S$

Sale

s,

US

$ b

illio

ns

Specialty sales Specialty Growth

Total Pharma growth

Global market trends

Sales and Growth

20

Europe and US illustrate growing importance of

specialty therapies

Source: IMS Health, MIDAS, MAT Dec 2015. Rx only

Europe Top 10 products 2011-15 US Top 10 products 2011-15

2011 2012 2013 2014 2015

1 HUMIRA HUMIRA HUMIRA HUMIRA HUMIRA

2 SERETIDE SERETIDE ENBREL ENBREL HARVONI

3 LIPITOR HERCEPTIN HERCEPTIN HERCEPTIN SOVALDI

4 HERCEPTIN ENBREL SERETIDE MABTHERA ENBREL

5 ENBREL MABTHERA MABTHERA SERETIDE HERCEPTIN

6 MABTHERA REMICADE REMICADE REMICADE AVASTIN

7 LOVENOX LOVENOX AVASTIN AVASTIN MABTHERA

8 REMICADE AVASTIN LOVENOX LOVENOX REMICADE

9 GLIVEC SPIRIVA LYRICA LYRICA SERETIDE

10 AVASTIN GLIVEC LUCENTIS LUCENTIS LOVENOX

2011 2012 2013 2014 2015

1 LIPITOR NEXIUM ABILIFY LANTUS HARVONI

2 PLAVIX ABILIFY NEXIUM SOVALDI HUMIRA

3 NEXIUM SERETIDE LANTUS HUMIRA LANTUS

4 SEROQUEL CRESTOR HUMIRA ABILIFY ENBREL

5 ABILIFY HUMIRA SERETIDE ENBREL CRESTOR

6 SINGULAIR LANTUS CRESTOR NEXIUM SERETIDE

7 SERETIDE CYMBALTA CYMBALTA CRESTOR REMICADE

8 CRESTOR ENBREL ENBREL SERETIDE ABILIFY

9 ENBREL REMICADE REMICADE REMICADE NOVORAPID

10 HUMIRA COPAXONE COPAXONE COPAXONE COPAXONE

Traditional Specialty

21

Top products vary in Developed and Pharmerging

markets

Source: IMS Health, MIDAS, MAT Dec 2015. Rx only

Specialty

Top products 2015

KR JP BR MX CN

1 BARACLUDE HARVONI HERCEPTIN HERCEPTIN PLAVIX

2 LIPITOR AVASTIN CIT

SILDENAFILA MG

HUMIRA SHEN JIE

3 HERCEPTIN PLAVIX HUMIRA CELEBREX LIPITOR

4 VIREAD SOVALDI LOSARTAN

HYPM AVASTIN

XUE SHUAN TONG

5 JANUMET CRESTOR SYNFLORIX DOLO

NEUROBION BEI TONG

6 TWYNSTA NEXIUM AVASTIN LANTUS SOD

CHLORIDE KELU

7 PROGRAF BENICAR LOVENOX CIALIS SODIUM

CHLORIDE

8 PREVNAR REMICADE TORSILAX NEXIUM ADEGOLD

9 VARIVAX LYRICA ENBREL CELESTONE DANSHEN

DUOFENSUAN

10 ARICEPT SECTOR MABTHERA KALETRA

LANSOPRAZOLE

Traditional

22

High specialty growth is a long term trend

SOURCE: IMS HEALTH MIDAS 2015;

0%

20%

40%

60%

80%

100%

US DE ES FR IT UK SE NO FI DK* BE AT NL* CH CZ PL BU HR HU SK PT*

Va

lue

ma

rke

t s

ha

re

Traditional (retail) Traditional (hospital) Specialty (retail) Specialty (hospital)

Specialty versus traditional medicine market value dynamics (2015 value market share vs. 10 year value growth (2006-2015)

10 yr value CAGR %

Traditional Specialty

1% 11%

0% 10%

2% 15%

1% 13%

-1% 7%

2% 12%

1% 9%

2% 9%

1% 10%

2% 10%

0% 9%

- -

1% 7%

0% 11%

0% 10%

4% 14%

7% 20%

2% 13%

0% 10%

-2% 2%

3% 11%

* NL CAGR n/a, PT CAGR for retail only,

23


The Wholesaler

Dilemma

The economic

situation

Polarization

– growth of

specialty

Channel shifts

24

Channel shifts express differently by market Shifts contains threat and opportunities for wholesalers

• US;

> Growth of specialty distribution, pharmacy,

specialty mail

• Europe;

> Significant shift to hospital

> Homecare in UK, NL

• China;

> Shift from hospital to retail

25

There is longer term shift to hospital in many markets

1%

4% 6% 4%

5%

12% 3% 10% 13%

3% 1% 0% 5% -1% -3% 0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

AUSTRIA BELGIUM FRANCE GERMANY ITALY PORTUGAL SPAIN UK

Va

lue

ma

rke

t s

ha

re

Evolution of hospital share of Rx Pharmaceutical Value Sales

(2015 value market share vs. 10 year value growth (2006-2015)

Typical reasons for hospital based dispensing (distribution often direct):

Medical need, controlling prescribing, avoiding wholesaler & pharmacy margins and the

ability to negotiate discounts

Hospital Retail % represents 10 year CAGR

(2006-15)

9-year CAGR

Source: IMS Health, at ex-manufacturer price levels, not including discounts and

rebates, MAT Dec 2015; *5 year CAGR

26


The Wholesaler

Dilemma

The economic

situation

Channel shifts

Polarization

– growth of

specialty

Competition

around

retail

27

Competition around retail

• Retail focus becomes “traditional” (versus Specialty) medicine.

• The majority of dispensed packs have very low cost

• Most products are generic/ multisource products

• OTC has increased importance in many countries

28

The case for retail dispensing of speciality drugs

Patient

• Integration of medicine care

• Patient convenience

• (driving adherence and compliance)

Payer versus the provider

• Who will benefit from potential rebates?

29

The loss of the “market” continues for wholesalers

Hospital

Q4 2015

Direct retail

Q4 2015

Traditional

FLW

Q4 2015

Delta

WHS

2015 vs

2011

Italy 58.5% 16.5% 34.7% -11.2%

Spain 50.3% 4.7% 47.4% -9.2%

Portugal 43.4% 56.6% -8.4%

Netherlands 41.0% 59.0% -7.7%

Czech Republic 35.5% 11.0% 57.4% -5.3%

Croatia 35.2% 4.2% 62.0% -7.1%

Denmark 57.5% 0.0% 42.5% -6.5%

Ireland 23.8% 11.2% 67.7% -5.4%

UK 45.4% 2.6% 53.2% -5.0%

France 33.4% 25.0% 49.9% -3.6%

Poland 18.8% 4.2% 77.8% -3.5%

Belgium 36.4% 7.2% 59.1% -3.7%

Hungary 26.2% 0.8% 73.2% -2.4%

Norway 32.0% 0.0% 68.0% -2.3%

Slovakia 13.6% 1.2% 85.3% -2.1%

Bulgaria 19.7% 1.5% 79.1% -1.7%

Switzerland 22.2% 12.9% 67.8% -1.0%

Austria 32.7% 8.5% 61.6% -0.7%

Romania 19.0% 0.1% 80.9% -0.8%

Finland 26.5% 0.1% 73.4% 0.3%

Sweden 23.1% 0.0% 76.9% 1.2%

Germany 12.7% 13.4% 75.6% 2.6%

Traditional Full

Line Wholesalers

Direct sales to retail

Direct

sales to

hospitals

30

Issues that needs to be addressed to “win”

Traditional Full

Line Wholesalers

Direct sales to retail

Direct

sales to

hospitals

1. Handling of Rebates • Sales to hospitals frequently require rebates to be handled as pass-

through

• Example in the Nordics

• Selected situations require that also rebates to retail can be tracked

• Increased transparancy as for virtual chains

• DTP eg UK

2. Increased Service offerings • Better logistics:

• Orphan drugs handling

• Solutions for click and collect” of specialty

• Just in time delivery etc

• Supporting better care:

• Support systems for dispenser

• Data collection

• Data exchange

3. Smart Remuneration Model • Need to cover both direct cost, capital, and risk

• Value of services needs to be rewarded

31

The progressive dominance in retail of low cost packs

80%

82%

84%

86%

88%

90%

92%

94%

96%

2010 2011 2012 2013 2014 2015

% Products which cost <$5 per pack (Retail only)

Ireland Greece UK Germany Italy Spain France

32

Global generics market is growing in volume and value

0%

5%

10%

15%

20%

25%

0

200

400

600

800

1000

1200

1400

1600

2009 2010 2011 2012 2013 2014 2015

SU

Billio

ns CAGR

+6.2%

0%

5%

10%

15%

20%

25%

0

50

100

150

200

250

300

2009 2010 2011 2012 2013 2014 2015

US

$ B

illio

ns

Japan Pharmerging ROW Top 5 Europe

US Pharma growth Generics growth

CAGR +10.5%

Global Generic Rx market, Value, US$ at ex-mnf price

before rebates and discounts

Global Generic Rx market, Volume, SU

Source: IMS Health MIDAS 2015, TLP groupings

33

In developed markets the most evident shift is to

unbranded generics While the focus in pharmerging markets remains branded GX

Source: IMS Health MIDAS 2015, TLP groupings, China includes Traditional Chinese Medicines;

*CAGR available for retail only

Generic sales 2015 Value MS *CAGR 2009-15

2015 Branded Unbranded Branded Unbranded

($ bn) generics generics generics generics

US 95.6 33% 67% 9% 13%

Canada 4.5 23% 77% 5% 1%

China 40.5 70% 30% 15% 21%

Japan 13.5 54% 46% -1% 17%

Korea 4.7 89% 11% 3% 1%

Germany 9.8 43% 57% 3% 5%

Spain 4.3 45% 55% 0% 10%

France 8.1 34% 66% 3% 6%

UK 7.3 30% 70% 8% 9%

Italy 6.3 63% 37% 4% 12%

Portugal* 0.9 53% 47% 0% 1%

Brazil* 8.3 50% 50% 15% 28%

Mexico* 2.5 84% 16% 6% 17%

Sales

US$

34

In developed markets the most evident shift is to

unbranded generics While the focus in pharmerging markets remains branded GX

Source: IMS Health MIDAS 2015, TLP groupings, China includes Traditional Chinese Medicines;

*CAGR available for retail only



(SU bn) generics generics generics generics

US 196.6 7% 93% -3% 4%

Canada 20.0 19% 81% 2% 4%

China 120.6 45% 55% 20% 22%

Japan 103.9 62% 38% 0% 20%

Korea 23.3 88% 12% -1% 2%

Germany 45.4 18% 82% 0% 4%

Spain 24.5 35% 65% -3% 11%

France 31.7 29% 71% -2% 6%

UK 45.3 19% 81% 3% 6%

Italy 21.7 58% 42% 1% 12%

Portugal* 5.4 44% 56% 0% 12%

Brazil* 58.5 65% 35% 14% 19%

Mexico* 9.4 60% 40% 0% 17%

Volume

SU (TABS)



($ bn) generics generics generics generics

US 95.6 33% 67% 9% 13%

Canada 4.5 23% 77% 5% 1%

China 40.5 70% 30% 15% 21%

Japan 13.5 54% 46% -1% 17%

Korea 4.7 89% 11% 3% 1%

Germany 9.8 43% 57% 3% 5%

Spain 4.3 45% 55% 0% 10%

France 8.1 34% 66% 3% 6%

UK 7.3 30% 70% 8% 9%

Italy 6.3 63% 37% 4% 12%

Portugal* 0.9 53% 47% 0% 1%

Brazil* 8.3 50% 50% 15% 28%

Mexico* 2.5 84% 16% 6% 17%

35

Purchasing strategies are key in most markets

RATIONALE FOR COMPANY MERGERS/CONSOLIDATION

Walgreen’s – Alliance Boots

- AmerisourceBergen

“...streamline the distribution of pharmaceuticals to Walgreens’ stores and

leverage global supply chain efficiencies while

improving patient access to affordable pharmaceuticals to increase the efficiency of the

healthcare system.”

Source: AmerisourceBergen Press Release March 2013

McKesson – Celesio –RITE AID

“A Celesio acquisition will allow McKesson to buy as much as $10 billion a year in generic

drugs for distribution, compared with $6 billion to $7

billion on its own”

Source:

http://www.bloomberg.com January 2014

CVS – Cardinal Health

“This partnership will enable us to maintain our leadership role

in navigating the dynamic U.S. generics market. With its combined volume and capabilities, the joint venture

will develop innovative purchasing strategies with generic manufacturers and

enhance supply chain efficiencies.”

Source: Cardinal health press

release1

84% of the US generic market consolidated to 4 buying consortia 15% of Europe added to the US consortia

SOURCE: 1http://ir.cardinalhealth.com/files/doc_news/2013/CAH%20Press%20Release%2012.10.13.pdf

http://www.bloomberg.com/

36

Global generic competition more fragmented

Generic volumes 2010 1056 bn SU

Generic volumes 2015 1449 bn SU

2% 2%

SUN PHARMA 2%

MYLAN 2%

HYPERMARCAS 3%

SANOFI

3%

CIPLA

3%

GSK

3%

NOVARTIS

5%

TEVA

5%

ALLERGAN

others

71% LUPIN 67% others

TEVA

7%

6%

ABBOTT 2% PFIZER

2% SUN PHARMA 2%

ALLERGAN 3%

SANOFI 3%

CIPLA 3%

GSK 3%

MYLAN

3%

NOVARTIS

Source: IMS MIDAS 2015

Outside top 10 grows share

37

Very few generic corps have a truly global footprint

Selected top GX companies – Volume sales breakdown 2015

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

TEVA

NO

VARTIS

GSK

SAN

OFI

SU

N P

HARM

A

LU

PIN

CIP

LA

ZYD

US C

AD

ILA

ASPEN

GED

EO

N R

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Japan Pharmerging ROW Top 5 Europe US

Source: IMS Health MIDAS 2015, TLP groupings,

38

Key dynamics in global pharmaceutical market

Regional

• US innovation

• Pharmerging volume

Specialty

• Dominates launch and pipeline

• Small populations

• High per capita prices

Payers

• European payer environment hardening because of increasing demands on specialist /hospital budget

Biosimilars

• Large variation in uptake of some biosimilars

• Budget relief?

The Wholesaler Dilemma

• Economic situation

• Retail competition

• Growth of Specialty

• Increase use of hospital

39

My colleague, Hugo Mendes, asked me to also say

something innovative …

Drones Set to Deliver Medicine to Remote

Parts of the U.S. Whitehouse asks Zipline

following success in Rwanda

Why not ?

• Can travel 100km in 30 minutes

• No refrigeration necessary

• Cost effective for rural areas

(low weight / high value goods)

• Can be life saving.

Never say crazy idea !

..we used to say that about Mail

Order or internet shopping…

40

Thank you!

[email protected]

mailto:[email protected]

mailto:[email protected]

global and local pharma distribution - trends and · pdf file2 total global pharmaceutical...

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