pharmaceutical and homeopathic markets of israel · israel’s pharma market will grow to over $2.3...

Pharmaceutical and Homeopathic Markets of Israel


Prepared by Cobi Bitton

INTEGRITAS PEOPLE & BUSINESS

JUNE 2017


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ABSTRACT

The Israeli pharmaceutical market is set to rise from $1.75 billion in 2015 to around $2.12 billion by 2020,

representing a compound annual growth rate of 3.9%, according to research and consulting firm GlobalData.

Israel borders Lebanon, Syria, Jordan, Egypt and the Mediterranean Sea. Lying within its borders are areas that

the Palestinians claim as their own; the threat of hostile actions dominates the political landscape.

Israel has the largest medical device market in the Middle East region and this is set to grow at an attractive rate

of 6.1% in the medium term. Much of the market, at over 80%, is supplied by imports, and a significant portion

of these in value terms are dominated by "high-end" products falling under the diagnostic imaging apparatus

category.

In terms of expenditure, Israel spends around 8.0% of total GDP on healthcare, and per capita spending rates are

considered high by regional and world standards. Much of spending is in the public sector and the government

has made allowances in recent years to expand the number of services and treatment offered by public health

insurance programs. The country also has a rapidly growing elderly demographic that is contributing to rising

healthcare costs.

Below are the 15 countries that exported the highest dollar value worth of drugs and medicines during 2016:

Germany: US$48.6 billion (15.3% of total exported drugs and medicines)

Switzerland: $39.9 billion (12.5%)

Belgium: $26.5 billion (8.3%)

France: $22.8 billion (7.1%)

United States: $22.5 billion (7.1%)

United Kingdom: $22 billion (6.9%)

Ireland: $19.8 billion (6.2%)

Italy: $16.6 billion (5.2%)

Netherlands: $15.5 billion (4.9%)

India: $11.6 billion (3.6%)

http://www.centerwatch.com/news-online/tag/globaldata


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Spain: $7.5 billion (2.3%)

Canada: $7.4 billion (2.3%)

Sweden: $5.6 billion (1.8%)

Austria: $5.3 billion (1.7%)

Israel: $3.9 billion (1.2%)

The listed 15 countries shipped 86.5% of all drugs and medicine exports in 2016 (by value). Among the above countries, the fastest-growing drugs and medicine exporters since 2012 were: Canada (up 84.5%), India (up 38.2%), Switzerland (up 27%) and the Netherlands (up 17.5%). Those countries that posted declines in their exported drugs and medicine sales were led by: France (down -17.1%), Spain (down -16.2%), Israel (down -11.8%), Belgium (down -10.9%) and Sweden (down -10.5%).

Israel has the highest concentration of engineers and PhDs per capita in the world, laying the

foundation for influential research and innovation.

Israel is an R&D and technology leader.

No.1 in the world R&D investment as a percentage of GDP, with more than 5,000 high-tech companies

and start-ups (the highest concentration in the world after the Silicon Valley). Israel also has the largest

number of NASDAQ listed companies outside North America.

Pharma in Israel: building a global industry


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Israel's pharmaceutical and biotechnology market has a reputation for high R&D spending and an impressive

international reach, with world-class export numbers and a growing market value. Pharma Technology Focus

profiles this innovative market to find out the secret of its success, and challenges for the future.

For many years, Israel's pharmaceutical and biotechnology sectors have been used to punching above their

weight. Despite the country's relative youth as an independent state and a history of geopolitical tension, its

health and life sciences industries have emerged as a jewel of the Middle East, with rapid expansion in many

fields driven by a strong academic underpinning, world-class research facilities and high spending in research

and development (R&D).

The Israeli pharma market, which is broadly composed of generics giant Teva Pharmaceutical Industries and a

host of smaller, R&D-driven biotech companies, is healthy and growing for a number of reasons. The country's

high population density and relatively youthful demographics provide plenty of young talent, meaning Israel

hosts one of the highest rates of high-tech start-ups per capita in the world.

But the story of Israel's pharmaceutical industry undoubtedly starts with Teva, the undisputed colossus of the

industry, which has developed into one of the largest pharma companies in the world today, one that is

expected to achieve sales worth $23.8 - 24.5 billion in 2017.

A generic power house

Of course, the manufacture and export of generic drugs is still of prime importance to Teva and the wider

Israeli industry, which includes smaller generic manufacturers such as Taro Pharmaceutical Industries and

Dexcel Pharma. A strong focus on generics - and the growth of Israeli generic drug companies - drives much of

the disproportionate export volumes that the country achieves every year to markets around the world.

The biotech base : building strength in depth


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The wider base of Israel's biotech sector, which is mainly comprised of small-scale companies that generally

rely on outlicencing their products to larger pharma companies for commercialization, is a healthy eco-system

of innovation that is fed by a strong underlying academia. Research centres such as the Weizmann Institute,

the Hebrew University of Jerusalem, Tel Aviv University and the Technion - Israel Institute of Technology

provide the starting point for many of the country's most significant medical discoveries.

Perhaps the largest impediment to further growth in the industry - and the possibility of any other biotech

firms following Teva's lead and blossoming into fully-integrated pharma companies - is the issue of financing.

Israel's Office of the Chief Scientist provides matching money in some cases, but external investors, from

venture capital firms to angel investors, are still essential to get innovative biotech off the ground, and few

and far between in Israel.

Israel’s pharma market will grow to over $2.3 billion by 2020

Israel’s pharmaceutical market value will increase from around $1.9 billion in 2013 to $2.34 billion by 2020,

driven by medical technology advances, high R&D expenditure and a robust economy, according to new

research.

The latest report from research and consulting firm GlobalData states that this rise, which represents a modest

compound annual growth rate (CAGR) of 2.8%, will occur in a country with high levels of generic production and

pharmaceutical exports.


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Major Middle East health care market

Israel is one of the major health care markets in the Middle East. Pharmaceuticals represent the largest and

most established sector of the Israeli life science industry, with a total of 76 companies, of which 22% are

involved in drug discovery and 17% in drug delivery.”

This commitment to scientific development is fortified by a highly skilled population, with Invest in Israel

highlighting that the country is ranked second in the world for percentage of engineers and scientists in the

workforce, he noted. Approximately 24% of Israel’s workers hold university degrees, placing it third among the

industrialized countries, after the US and Netherlands. Israel’s pharmaceutical sector is supported by a network

of recognized academic and research institutes, R&D facilities, and well-developed medical centers.

Indeed, Israeli research expertise and clinical advances have led to the development of blockbuster drugs and

promising treatments.

Regulation:

Israeli Regulatory Affairs

In the dynamic, complex Israeli regulatory environment and registration process, Pharmaceuticals affairs

Services helps obtain swift marketing authorization for newly launched products in Israel.

From large multinationals to small biotech firms, regulatory affairs solutions offered by top Israeli consultancy

services are tailored to meet exact requirements, from full regulatory affairs department outsourcing to filling

appointed pharmacist or regulatory affairs functions to project management. Such services should ensuring legal

compliance, resolving issues with the Israeli Ministry of Health and keeping current with industry trends to

advise on regulatory aspects affecting your objectives.

Regulatory affairs services include:

Regulatory affairs department outsourcing

Qualified Person (QP) outsourcing,

Appointed pharmacist / regulatory affairs manager outsourcing/insourcing

New product approvals, dossiers, submission and follow-up for innovations or generics


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Post-approval support (renewals, variations, import issues, etc.)

Line extensions

Labeling and Packaging with localization (patient leaflets, labels, packages, etc.)

Management consulting

Regulatory second opinions

Israeli license holder for your product registration

Prospects of the OTC Market in Israel

Traditionally, the over-the-counter medicines market in Israel has not been of any significant size, but there

have in recent times been signs that things are changing. Companies already present in this market, and those

which are now entering it, are allocating more resources and efforts than they have in the past, and the market

as a whole is receiving increased levels of attention, according to Ben-Ami Rosenfeld, executive vice president

and chief operating officer of Teva Pharmaceutical Industries Ltd.

He told the self-medication conference organized in London by OTC News last month (Marketletter May 18) that

in 1990, OTCs accounted for only about 14% of the total Israeli pharmaceutical market, which was worth about

$300 million during that year. Most OTC sales are made via private pharmacies, and they account for about 28%

of the private market. The biggest-selling OTC products in Israel are vitamins, pain-relievers, gastrointestinal

products, cough/cold preparations and dermatological, a pattern which is very similar to that in other western

markets, and no significant change in this mix is expected, said Mr Rosenfeld.

The size of the Israeli OTC market contracted in 1988 and 1989, he told the meeting, and only in 1990 was there

a significant increase in market size. His estimate for 1991 is an increase of 12% compared with 1990, but he

pointed out that overall, the market has been growing by less than 10% a year in the past four years, which is

less than the growth of the total pharmaceutical market. This again is a similar trend to that experienced by

other western markets.

No dramatic changes are expected in market size over the next year or two, but by the middle of the 1990s

greater year-on-year growth is expected, Mr Rosenfeld told the meeting, although he added that this growth is

dependent on:

Government activities, including the easing of prescription to OTC switches;

Company activities, in terms of the introduction of new products and levels of advertising spending;

The success of the players in the market in accessing the true decision-makers - the consumer and the

pharmacist - and in convincing them of the safety and efficacy of self-medication.


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The major companies in this sector are first and foremost pharmaceutical companies, and not consumer-

oriented organizations. They generally have contacts with multinational companies, primarily for prescription

products, and secondarily for OTCs. They license these products either as manufactured in Israel under license,

or under importation.

Leading OTC Companies The two leading companies in the Israeli OTC sector, Teva and ABIC, are both

wholly-owned subsidiaries of the Teva Corporation, which accounts for 35% of both the prescription and OTC

markets. ABIC has more external licensing relationships for OTCs than Teva, and thus expects to expand this

business to a significant degree in the coming years. ABIC's licensing agreements include tie-ups with ICI,

Boehringer Mannheim, Janssen, Boots, Farmitalia and Angelini.

Another important company in the OTC market is Neopharm, which is particularly prominent in sales of

vitamins, and operates a licensing agreement with Lederle.

A list of the top ten OTCs in Israel shows that sales volumes are not great, at $2.4 million annually for the leading

product, Teva's Acamol, dropping to $600,000 for the tenth product, Norcliff/Mediline's Tums. Therefore,

advertising budgets are not high, with most OTC firms preferring to promote their products to pharmacists via

bonus goods incentives.

Mr Rosenfeld told the meeting that he expects the OTC sector to show growth of 10% per annum in the latter

half of the 1990s, largely as a result of:

Prescription to OTC switching;

Withdrawal of mandatory government price checks;

An increase in the number of points of purchase, both in the number of pharmacies (chains and

independents) and through supermarkets;

Pharmacists' changing attitudes, largely because of the OTC sales impact on their businesses, and

their acceptance of these changes;

Greater focus and professionalism by the dominant players in the market;

Increased consumer awareness of self-medication, prevention and therapy.

Potential For Growth in Israel's OTC Market

The growth rate of Israel's over-the-counter medicines market can match that of the emerging markets of

Southeast Asia, Latin America and Eastern Europe, according to Peter Glynn Jones, chairman of the World

Federation of Proprietary Medicines Manufacturers, speaking at the annual meeting of Telem, the Israeli OTC

industry association, in Tel-Aviv last month.


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The meeting also heard from Telem's chairman, Zeev Biber, that the average annual growth rate of the Israeli

OTC market has been 5% during the last five years, and that the national market value is currently estimated to

be $70 million at manufacturers' selling prices. The OTC market represents 12% of Israel's total national drug

market, compared with 17% in the UK, 20% in the USA, and 28% each in France and Germany. Mr Biber added

that annual OTC consumption in Israel averages $12 per capita, compared to WFPMM estimates of $19 for the

UK, $40 in France and $57 in the USA. These comparisons suggest considerable growth potential, given that

Israeli patterns of consumption usually follow those of the USA and other western markets, he said.

Changing Market Structure Local IMS data shows that semi-ethicals now account for only 22% of the market and

are declining, while the share of non-prescription-bound OTCs is up, growing 15% in the year to June.

The leading OTC therapeutic classes are pain relief, at 23% of the total, vitamins/minerals/supplements at 17%,

and skin products at 15%. Leading OTC brands are American Home Products' multivitamin product Centrum,

Teva's paracetamol Acamol and Ciba's Voltaren Emulgel (diclofenac). The leading local OTC marketing groups

are Teva, Promedico and Neopharm.

Mr Biber also revealed new findings gathered through two surveys conducted by Telem recently, which included

claims made by 85% of adults polled that they read the product leaflet (65% saying that they always do so and

20% saying they do so sometimes). Also, community practitioners were found to express positive attitudes

towards self-medication, with 69% approving the use of self-medication products for minor ailments and 84%

claiming that switching will not change their prescription habits; if they have recommended a specific

prescription brand they will keep on recommending it if and when it is switched to OTC status.

Batia Haran, head of the pharmaceutical department at the Israeli Ministry of Health, told the meeting that the

national authorities acknowledge the role and importance of OTC medicines, and will assist in the development

of self-medication in Israel.

Israeli Life Science Industry

Following a decade of significant growth, the Israeli Life Science Industry continues to go strong, and improve its

position in the global healthcare market. The industry is demonstrating encouraging signs of maturity, with more

companies reaching the revenue stages. This is an innovative industry, which takes advantage of Israel's

excellence in academic research as well as deep government support. Beyond that, its commercial success lays

with a combination of highly educated professionals entrepreneurial culture, innovative spirit and great

technologies. In the two years since our last report, the Healthcare IT and Digital Health sub sectors have surged

both in terms of the sheer number of companies and the funding they raised. For other sub-sectors, it's a mixed


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story. The amounts raised by Israeli life sciences companies, both in the public and private markets, have

declined in step with global trends. However, the average dollar amount per deal went up, mainly thanks to the

higher maturity level of many companies.

Global healthcare service providers worldwide are facing many challenges. Shrinking budgets force a shift to

value-based care, forcing organizations to adapt, and prompting a wave of fine-tuning across the industry to

allow doing more with less. Meanwhile, the demand for healthcare is ever-increasing, mainly from growing

populations in emerging markets and ageing populations in the developed world. Innovative technologies are

ranked high among the solutions to address those challenges, which is an opportunity for the Israeli life science

industry. Additionally, governments try to streamline regulatory environment to nurture innovation, and bring

more technologies earlier to market, by accelerating approval processes. A notable example is the 21st Century

Cures Act that was enacted in late, giving US patients early access to regenerative medicine technologies (under

certain circumstances). This can also be supportive for the innovative Israeli life science industry and will allow

medium size companies to move quicker to regulatory approval. Substantial demand is coming from China,

where authorities are reforming public health services to better care for the massive number of elderly people

and booming urban populations. Chinese authorities are spending more, and particularly look for innovative

technology solutions. In turn, Israeli life science companies are attracting larger investments from China.

According to multiple different databases and our own estimates, about 1,350 life science companies are active

in Israel (Figure 1). As many as 1,234 life sciences companies were established in Israel in the last decade (2007-

2016), or 123 companies every year in average (Figure 2), and 612 of them are still active.


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HOMEOPHATY

Homeopathy is a form of medicine which views and treats the body as a whole entity and helps it heal itself.

It can be used for acute or chronic illnesses. The treatment is based on the principle that substances which are

poisonous in large doses can be very beneficial in small doses. Homeopathy uses animal, vegetable and mineral

preparations to cure a person's illness and prevent them from recurring. Millions of people in Britain, Europe

and America are treated homeopathically.

Homeopathy regards each patient individually; practitioners then develop a personal remedy or treatment plan

strictly for that patient. Homeopathy relies upon a person's inherent powers of healing - the immune system - to

develop a successful therapy.

There are significant differences between the concepts used in Western medicine and those of homeopathy.

In conventional medicine, symptoms are seen as a manifestation of the disease. Drugs are given to kill the

bacteria or to relieve the symptom of the condition. Homeopaths, on the other hand, see the symptoms as the

body's attempt to heal itself. They regard the symptom as a positive sign that the body's defense mechanism is

trying to fight the underlying cause. By this reasoning, they insist that the symptoms should not be suppressed

as we are working against the body's attempt to cure it. In conventional treatment, there is a minimum dosage

that must be given before the medication becomes effective in treating the underlying problem.

Vaccines are not rendered more potent when they are diluted like homeopathic preparations.

Homeopaths believe that the energy of the remedy rather than the chemical content stimulates the healing by

activating the "vital force" that keeps us healthy and balanced. Vital force, which is called chi by Chinese, is the

healing power or energy that exists within us all and fuels the mind, body, emotions and mind.

Homeopathic remedies, which are made from natural substances, are recognized and regulated by the Food and

Drug Administration (FDA) and are manufactured by established pharmaceutical companies under strict

guidelines, There are over 2,000 homeopathic remedies. Taken in this ultra-diluted form they have no side

effects and are perfectly safe, non-toxic and non-addictive.

Scientists who accept the potential benefits of homeopathic theory suggest several theories to explain how

highly diluted homeopathic medicines may act. Using recent developments in quantum physics, they have


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proposed that electromagnetic energy in the medicines may interact with the body on some level. Researchers

in physical chemistry have proposed the "memory of water" theory, whereby the structure of the water-alcohol

solution is altered by the medicine during the process of dilution and retains this structure even after none of

the actual substance remains.

Ailments such as colds, constipation, vomiting and diarrhea respond well to homeopathic treatment.

They can also help conditions such as rheumatoid arthritis, fibrositis, psoriasis, acne, allergies, back and neck

problems, headaches, asthma, colds and sinus problems. Homeopathy is also effective in the treating emotional,

mental or physical complaints such as irritability, anxiety, fear, smoking and others.

Several clinical studies have demonstrated the effectiveness of homeopathic remedies, especially with

conditions that conventional medicine has not had much of success in treating - infectious diseases such as flu

and colds; chronic conditions such as allergies, asthma, migraines, and PMS. Many of these studies employed

double blind studies, accepted by scientists. Recent clinical trials suggest that homeopathic medicines have a

positive effect on allergic rhinitis, asthma, treatment of dermatological complaints, fibrositis, influenza, and for

the treatment of migraine. (Data from holistic-online.com)

In 1994, a study involved homeopathy was published in a peer-reviewed American Scientific Journal

(Jacobs J, M.D.). The study included 81 children with acute diarrhea. All the children received standard

anti-dehydration treatment. In addition, half the children received homeopathic treatment and half received a

placebo. The recovery time for children receiving homeopathic treatment was 20 percent faster than those

receiving the placebo, reducing the bout of diarrhea by one day.

In 1991, the British Medical Journal published an analysis of 107 clinical studies published between 1966 and

1990. The authors found that in 81 of the experiments, the homeopathic treatments were successful: 13 out of

the 19 trials of respiratory infection treatment were effective; 6 out of 7 were positive for other infections;

5 out of 7 were positive for digestive system treatment; 5 out of 5 were successful for hay fever, 5 out of 7

showed accelerated recovery after surgery, 4 out of 6 helped in rheumatologicall disease, 18 of 20 were

beneficial for pain or traumatic injury; and 8 out of 10 worked for mental or psychological problems.

The results of a double-blind, controlled trial (crossed over) published in the British Medical Journal in 1989

were evaluated by a rheumatology professional that was not a homeopath. The study found that the

homeopathic remedy provided highly statistically significant improvement in both subjective and objective

symptoms.


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Code of Ethics

1. Homeopaths shall be of good character and practice their profession with integrity and dignity in all

circumstances. The highest standard must be maintained in conduct and professional ethics.

2. Homeopaths shall recognize an obligation towards clients and must act in their best interests at all times.

They must be honest with the client and shall have regard to their wishes. The client’s safety and welfare shall

have priority.

3. The information acquired from a client during consultation or in the course of professional treatment shall not

be divulged to anyone without the client’s / their legal guardian’s / representative’s written consent except

where required by law or where failure to take action would constitute harm to the client or another member of

the community.

4. Homeopaths shall not give guarantees regarding the results of treatment and shall not misuse their position to

exploit clients in any way being mindful of their professional responsibility towards the client.

5. Homeopaths shall not exploit their professional relationships with clients sexually or otherwise.

6. It is advisable that a chaperone be present when conducting a physical examination on a client. Children under

the age of 16 yrs, must be examined in the presence of a parent / authorized caregiver / legal guardian

Bridges – Homeopathy in Israel

With the inception of the Bridges segment, The American Homeopath began a tradition of exploring

Professional Homeopathic Societies around the globe. With each issue, a different national association is

profiled, revealing the history, standards of operation, and services the organization provides to its members.

Our world tour started with one of the "oldtimers" of homeopathy, Great Britain, and proceeds now to our next

destination...Israel. Homeopathy has quite recently taken root and been blossoming here at record pace.

In September, while visiting Israel, I had the great pleasure of meeting and interviewing Yair Shemmer, who is a

prominent homeopath and teacher in Tel Aviv and the current Chairperson for the Israeli Association of Classical

Homeopaths (IACH).


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IACH

The Israeli Association of Classical Homeopaths (IACH) was founded in 1993. The IACH was modeled after the

British Society of Homeopaths, adapting their by-laws, Code of Ethics, and structure. Their Board of Directors

consists of one Chairperson and nine members elected for two-year terms. The following committees run much

of the IACH activity: Ethics/By-laws, Internal Inspector, Membership/Acceptance, Education, Seminars, and a

Journal Committee, which biannually publishes, "Homeopathic Times," which circulates to over 800 people.

Membership

As the sole homeopathic professional body in Israel, the 50 professional members and 120 student members of

the IACH consists of both medical doctors and professional homeopaths from all around the country.

The National Register of Homeopaths is published yearly in Israel and distributed widely throughout Israel,

particularly to all pharmacies. The annual membership fee for a professional member of the IACH is 660 shekels,

approximately €165. Members have access to malpractice insurance by a private insurance company for an

additional €400 per year.

The first step to become qualified for membership is graduation from an accredited school. (School

accreditation is based on ICCH guidelines; currently, one Israeli school is accredited and another school is in the

process of becoming accredited.) Alternatively, one can become a member by receiving minimum training in a

school and passing the association qualifying exams. Once this basic groundwork of study is accomplished,

applicants must submit 5 case studies, each with 2-3 followups (not necessarily only 'cured' cases, but an

adequate analysis of the patient's response to the remedy is required). They are also required to have a site visit

and an interview with the Acceptance Committee in order to join the IACH.

The organization maintains high standards for its members, yet they try not to be rigid as to methodology or

personal homeopathic philosophy. "No one formula," says Yair, "can cover the life force. It is very spontaneous

and mysterious. As homeopaths, we must be open-minded, we must start with a formula and then be able to let

go of it."


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Legality

Like in the U.S. , the legal status of homeopathy in Israel remains somewhat unclear. According to formal Israeli

law (Common Law), only doctors can practice medicine. This means that only MD's can formally practice

homeopathy without any limitations. However, the medical establishment is not yet convinced that

homeopathy is anything more than the placebo effect, therefore there has been no law forbidding the practice

of homeopathy by non-doctors. Homeopathic remedies are sold over the counter in Israel.

In this uncertain state of affairs, the IACH is directing its efforts to establish clear guidelines and high standards,

in the hope of achieving the proper legislative support in the long run. As it seems now, this goal is very

attainable for a few reasons. Not only does homeopathy and alternative medicine have great support by the

general public, but it is also becoming the medicine of choice by the Orthodox Jews. Most of you reading this are

aware of the great split between the Orthodox Jews and the secular Jews of Israel and the ongoing political

clashes between them. As it stands, a number of Orthodox Religious Parties are strongly represented in the

government, particularly in the Health Ministry, which they have virtually taken over. This provides for a

favorable climate for legislation of homeopathy in Israel. The list of Israeli Homeopaths, by the way, comes from

all the full spectrum of the cultural rainbow, from Orthodox, to secular, to Kibbutznik, etc. One homeopath,

Shirley Gilad, has established a charity clinic to work with Palestinians, providing homeopathy to people in that

community.

Quite similar to what is happening in various states here in the U.S. , in 1992, homeopaths banned together

with other alternative medical professionals and formed an Umbrella Coalition. This organization includes only

those fields that have conventional medical training within their studies: acupuncture, naturopathy, reflexology,

massage, and homeopathy. Israeli homeopaths have opted for this mode of organizing for the purpose of

legislation, and in the past year the umbrella coalition has been very active. Their lawyers have already drafted a

bill for the acupuncturists to establish a national council with register, and the lawyers are now formulating a

plan for the homeopaths, based on their wishes.

Homeopathy and the public

The Israeli populace can be described as very dynamic, active and young; open to change, new ideas, and very

influenced by Europe and the U.S. A. Many young Israelis go to India to travel and study, where they become

open to Eastern philosophy and alternative thinking; they come back wanting to do something like this in Israel.


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There is a saying in Israel, "People vote with their legs." And it seems that these days, people's legs are walking

them over to the local homeopath, more and more. The public is very disillusioned with conventional treatment,

and they are seeking out less invasive methods, in general. All of this makes the public demand for homeopathy

in Israel very strong.

This is not only "back room homeopathy,"- homeopaths in Israel are extremely visible. Every major hospital in

Israel has opened an outpatient department for homeopathy and other alternative disciplines. Some of these

clinics work with therapists that are not certified MD's, and others only with MD's. They offer patients a

preliminary interview with a doctor who then directs the patient to the appropriate therapy. This method also

screens for pathology, which would necessitate medical treatment. Yair heads the homeopathic department of

one of the major hospitals in Tel Aviv. They see about 20- 30 patients a week, they are separate, not integrated

into the hospital itself, but do research together. Presently they are studying homeopathy in the treatment of

digestive disease (Crohn's, UC, etc.) Other such studies, by IACH member Michal Yakir at the Hadassah Hospital

in Jerusalem, has been done about the effect of homeopathic remedies on PMS (pre-menstrual syndrome) and

another, with the cooperation of the Psychiatric department, about homeopathy and GAD (General Anxiety

Disorder). One of the aims of the IACH is to introduce association members to hospitals and health

organizations.

Apart from hospitals, there are at least four major health organizations that provide general health care, and

they have all opened various alternative health clinics around the country. The social health system of Israel is

similar to that of the U.K. They have their own clinics, in which homeopaths do work, and sometimes they even

reimburse private consultations with homeopaths. The National Health Fund has opened a large alternative

clinic in Tel Aviv, complete with homeopathic computer program.


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Accomplishments

With all the great accomplishments of IACH, including their tremendous public support, their work within the

hospital setting, and their important research, Yair declares the greatest accomplishment of IACH to be the

harmony with each other within the organization.

Yair characterizes the typical Israeli homeopath as "deep, having a sharp, quick mind, sometimes to the point of

impatience or rudeness; wanting to learn, to climb to the top the fastest way possible." With this character

sketch could easily come ego clashes, but this has not been the case. "People have really been able to put egos

aside," says Yair. "Our motivations are clear and idealistic-to work for the advantage of homeopathy." What are

the challenges that lie ahead? Yair comments, "Homeopathy is in a process of finding its identity between

spiritualism and medicalism."

Israel - Market Entry Strategy

Distribution methods vary by type of product.

Commissioned Agents: used mainly for industrial equipment, raw materials and commodities.

Non-Stocking Agents: used mainly by manufacturers.

Stocking Agents: used mainly for high volume items.

Importers/distributors: used often for consumer goods.

Franchising: since its introduction to Israel in the mid-1980s, franchises have increased in popularity.

Most of well-known global companies of services and products have their own operation or via

franchisees.

Direct marketing is fairly common.

Door-to-door salesmanship is uncommon in Israel and is considered a nuisance. Cable and satellite TV

offer shopping channels.


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Direct marketing is common through mail order booklets that are distributed monthly by credit card

companies and through the Internet. An “opt-in” spam law was introduced to Israel in late 2008.

Companies can only send individuals spam if the individual agrees in advance. Political and charity

mailings are exempt.

Mobile phone marketing through messaging is common.

Internet use in Israel is widespread and represents a good marketing avenue.

The Government of Israel encourages both joint ventures and licensing.

Joint ventures are the most popular method of cooperation for Israeli firms, especially in technology-

related industries.

Israeli businesses prefer obtaining five-year licensing agreements with automatically renewable clauses

that extend the agreement for another five years.

A Commercial Agents Law became effective in 2012. The law specifies advance notice of termination of

a relationship related to the duration of the supplier/agent contract and monetary compensation of the

agent for the loss of potential profits.

Manufacturing under licensing agreements is common in Israel. Israeli businesses prefer licensing

agreements in which the licensor takes equity with the licensee.

The norm for royalties is four to five percent of turnover. Higher rates are common for luxury articles,

authors fees and specialized machinery.

A ten to fifteen percent withholding tax on royalties and fees is often deducted at the source.

Licensees may repatriate royalties through an authorized bank, and are entitled to claim an income tax

deduction on royalties and fee payments.

Foreign companies should seek advice from a respected law firm and accounting firm when figuring tax

liabilities.


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References

http://www.businesswire.com/news/home/20091110005627/en/Research-Markets-Report-Israels-

Pharmaceutical-Market-Understand

http://www.pharmaceutical-technology.com/features/featurepharma-in-israel-building-a-global-industry-

4866023

https://www.thepharmaletter.com/article/israel-s-pharma-market-will-grow-to-over-2-3-billion-by-2020-report

http://www.pharmaceutical-technology.com/researchreports/researchreportreport-israeli-pharmaceutical-

market-to-grow-at-a-compound-annual-growth-rate-of-39-5685762/

http://www.israelnationalnews.com/News/News.aspx/221105

http://itrade.gov.il/us-dc/2013/10/10/israel-fourth-largest-supplier-pharmaceutical-products-u-s/

https://www.dor-ps.com/pharmaceuticals/

http://www.pwc.com/il/en/pharmaceuticals/managing-regulatory-compliance.html

http://www.science.co.il/biomedical/Companies.php?s=pharmaceuticals

http://www.prnewswire.co.uk/news-releases/otc-markets-group-to-hold-seminar-for-israeli-companies-on-

how-to-raise-capital-and-access-us-markets-621114913.html

https://www.thepharmaletter.com/article/prospects-for-the-otc-market-in-israel

https://www.thepharmaletter.com/article/potential-for-growth-in-israel-s-otc-market

http://www.hadassah-med.com/medical-care/complementary-medicine/homeopathy

http://www.wholehealthnow.com/homeopathy_pro/israel.html

https://www.reportbuyer.com/product/4415278/homeopathy-product-market-global-industry-analysis-size-

share-growth-trends-and-forecast-2016-2024.html

http://www.prnewswire.com/news-releases/homeopathy-product-market-is-expected-to-reach-us174862-

million-by-2024-exhibiting-a-cagr-of-182-over-the-period-between-2016-and-2024-600000861.html

http://homeoresearch.blogspot.com/2013/05/bridges-homeopathy-in-israel.html

http://www.homeopathy.co.nz/assets/pdf/public/nzch-rules-of-practice-and-code-of-ethics-august-2010.pdf

https://www.export.gov/article?id=Israel-Market-Entry-Strategy

http://www.businesswire.com/news/home/20091110005627/en/Research-Markets-Report-Israels-Pharmaceutical-Market-Understand

http://www.businesswire.com/news/home/20091110005627/en/Research-Markets-Report-Israels-Pharmaceutical-Market-Understand

http://www.pharmaceutical-technology.com/features/featurepharma-in-israel-building-a-global-industry-4866023

http://www.pharmaceutical-technology.com/features/featurepharma-in-israel-building-a-global-industry-4866023

https://www.thepharmaletter.com/article/israel-s-pharma-market-will-grow-to-over-2-3-billion-by-2020-report

http://www.pharmaceutical-technology.com/researchreports/researchreportreport-israeli-pharmaceutical-market-to-grow-at-a-compound-annual-growth-rate-of-39-5685762/

http://www.pharmaceutical-technology.com/researchreports/researchreportreport-israeli-pharmaceutical-market-to-grow-at-a-compound-annual-growth-rate-of-39-5685762/

http://www.israelnationalnews.com/News/News.aspx/221105

http://itrade.gov.il/us-dc/2013/10/10/israel-fourth-largest-supplier-pharmaceutical-products-u-s/

http://www.pwc.com/il/en/pharmaceuticals/managing-regulatory-compliance.html

http://www.science.co.il/biomedical/Companies.php?s=pharmaceuticals

http://www.prnewswire.co.uk/news-releases/otc-markets-group-to-hold-seminar-for-israeli-companies-on-how-to-raise-capital-and-access-us-markets-621114913.html

http://www.prnewswire.co.uk/news-releases/otc-markets-group-to-hold-seminar-for-israeli-companies-on-how-to-raise-capital-and-access-us-markets-621114913.html

https://www.thepharmaletter.com/article/prospects-for-the-otc-market-in-israel

https://www.thepharmaletter.com/article/potential-for-growth-in-israel-s-otc-market

http://www.hadassah-med.com/medical-care/complementary-medicine/homeopathy

http://www.wholehealthnow.com/homeopathy_pro/israel.html

https://www.reportbuyer.com/product/4415278/homeopathy-product-market-global-industry-analysis-size-share-growth-trends-and-forecast-2016-2024.html

https://www.reportbuyer.com/product/4415278/homeopathy-product-market-global-industry-analysis-size-share-growth-trends-and-forecast-2016-2024.html

http://www.prnewswire.com/news-releases/homeopathy-product-market-is-expected-to-reach-us174862-million-by-2024-exhibiting-a-cagr-of-182-over-the-period-between-2016-and-2024-600000861.html

http://www.prnewswire.com/news-releases/homeopathy-product-market-is-expected-to-reach-us174862-million-by-2024-exhibiting-a-cagr-of-182-over-the-period-between-2016-and-2024-600000861.html

pharmaceutical and homeopathic markets of israel · israel’s pharma market will grow to over $2.3...

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