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Out of a maximum of 100, Belgium scored 65.1 in BMI’s Q410 Pharmaceuticals & Healthcare Business Environment Ratings (BERs), placing it joint fifth in the Western Europe matrix, on a par with the UK and below Germany, Switzerland, France and Sweden. Although growth in medicine sales is low, the country has a very large market in absolute terms. Furthermore, per-capita spending is high, there is a sizeable pensionable population and regulations are transparent. Emphasising its attractiveness as a pharmaceutical market globally, Belgium is placed joint 11th of the 77 markets surveyed by BMI’s everexpanding pharmaceutical universe.
As of April 2010, pharmacists in Belgium receive a fixed reimbursement amount of EUR3.88 plus VAT for every pack of medicines sold. This new system replaces the old proportional reimbursement rate of 31%, with an absolute limit of EUR7.44. Despite the new model taking away revenue-earning opportunities from the sale of high-value patented medicines, BMI believes the fixed reimbursement rate will provide significant revenues from the sale of lower-value generic medicines. BMI believes the additional reimbursement fees are one way in which the government is encouraging the consumption of lower-value generic medicines – generic substitution by pharmacists is permitted in Belgium. BMI notes that Belgium is behind markets such as Germany in terms of generic penetration and is among the lowest in Europe by volume and value. Medical traditions and the generic market share in Belgium more closely resemble those of France, with both markets characterised by a strong preference for branded prescription drugs. However, BMI believes the patent cliff and the consequent availability of low-value generic medicines will work towards pushing drug sales in the sector.
Despite a compound annual growth rate (CAGR) of 3.38% in local currency terms and 5.86% in US dollar terms from 2004-2009, BMI’s outlook for the Belgian drug market is less optimistic over the subsequent five years. From 2009-2014, a CAGR of 0.56% is projected in local currency terms (-1.69% in US dollar terms), largely as a result of the impending patent cliff and the consequent consumption of lower-value generic drugs in place of the high-value patented drugs, in addition to increasing government efforts to promote the consumption of generic medicines. By 2014, pharmaceutical expenditure in Belgium is expected to reach a value of EUR4.72bn (US$5.90bn), up from the calculated EUR4.59bn (US$6.43bn) in 2009.
Over a longer 10-year period, the growing use of high-value biologics, in particular personalised medicines, will spur a return to growth in Belgium, with a CAGR of 1.25% in local currency terms and 0.11% in US dollar terms through to 2019. As a result, BMI calculates that drug sales in Belgium will reach a value of EUR5.20bn (US$6.50bn) by 2019.

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