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ReportsandReports – Philippines Pharmaceuticals and Healthcare Report Q4 2010

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The Philippines remains ranked 11th in our Asia Pacific Business Environment Ratings (BER) table for Q410. Globally, the country places 49th of the 83 markets now surveyed in our pharmaceutical universe, held back primarily by a range of price-control measures and the government’s lacking stance on intellectual property (IP) regulations. Nevertheless, the market is maturing and there are calls to expand the socialised healthcare system to serve the entire nation, which would boost volume consumption in particular. Generics makers are, however, expected to be the primary beneficiaries of this trend, as patent expirations also increase pressure on the research-based pharmaceutical industry.

However, the practice of lowering the cost of life-saving drugs has led to problems, including restricting the supply of inexpensive generic drugs. According to Edward Isaac of the Philippine Chamber of the Pharmaceutical Industry, generic drug companies have also had to lower their prices after former President Gloria Macapagal Arroyo’s regulations led to cuts in the prices of branded medicines. Some drug retailers have reportedly put their expansion plans on hold due to a decline in their profits. Additionally, the non-government Center for Legislative Development (CLD) conducted a study in 2009 which concluded that the enforcement of drug price cuts by 50-70% had benefited only the middle class. Over the 2009-2014 forecast period, we expect the value of the Philippines’ drug market to increase by a compound annual growth rate (CAGR) of 4.94% in local currency terms, reaching PHP151.3bn (US$3.69bn). While we expect the new administration (led by President Aquino) to continue some of the Arroyo administration’s programme to reduce prices in order to increase access to medicines, it seems market forces are also likely to play a larger role. President Aquino’s appointment of Enrique Ona as secretary of the Philippines' Department of Health has already been criticised, given Ona’s position as an advocate for the corporatisation of government hospitals and medical tourism - despite the country's healthcare system's inability to cater to all of the Philippines’ population.

Still, we have recently upgraded our 2010 real GDP growth forecast for the Philippines, from 4.4% to 4.9%, mainly on the back of firmer private consumption as well as capital formation growth. Moreover, heavy government spending due to the May 2010 general elections will also serve as a major boost in the short term. The positive outturn reaffirms our view that the Philippines economy will stage a V-shaped rebound in 2010, which should also bode well for the performance of the pharmaceutical market. However, we have also revised our 2011 economic growth forecast downwards to 4.0% (from 4.4%), due to concerns for a Chinese double-dip slowdown, which will have an impact on fiscal revenues available for public sector expenditure. In the meantime, despite substantial improvements in its investment climate in recent years, the Philippines still has a lot to do if it is to continue to attract foreign direct investment (FDI), which will play into the hands of domestic and overseas generics players.
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ReportsandReports – Nigeria Pharmaceuticals and Healthcare Report Q4 2010

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Pharmaceutical firms have long regarded Nigeria with interest, chiefly because of its massive middleclass population and rising GDP, although we caution that much of that GDP depends on oil revenues. Current plans for 10% of oil revenues to be directed at developing the Niger Delta region could be revised downwards if the president calls for electoral reform and remains the incumbent. This could escalate tensions between the north and south of the country - with the north wanting a larger share of the revenues - and raise risks for pharmaceutical firms looking for a Nigerian base.

BMI identifies a number of key risks for pharmaceutical sector development in Nigeria: the weak regulatory environment; large numbers of counterfeit drugs; sporadic law enforcement for shutting down illegal pharmacies; low per-capita spending on medicines (although this is to be expected); supply chain issues; power generation and supply; and high unemployment and therefore a limited skilled workforce, among others. Infrastructure is also a key shortcoming in the Nigerian market. Most infrastructure investments have focused on transport and power generation, as when power stations are operating, there are frequent outages. For pharmaceutical firms with heavy energy demands, this means investment in separate generators to prevent losses during production. In its Q410 Business Environment Ratings, BMI gives Nigeria a total score of 35.8 out of 100. Against a selection of regional peers, it ranks below Ghana, but otherwise is generally in line with expectations.

The population is expected to reach 166mn by 2014, while real GDP growth will continue just above 7% for the next five years. Unemployment is set to remain high, and will be 14.6% of the total labour force by 2014, although this is on a slow downward trend. High unemployment points to lower purchasing power, which means that we estimate per-capita spending on pharmaceuticals at a meagre US$4 in 2009, rising to US$8.3 by 2014. This is a marginal improvement, but indicates serious underlying irregularities in income distribution, particularly from the key oil sector.

On the upside, low drug spending by a large population is still attractive to drugmakers, particularly those with generic medicines and essential over-the-counter (OTC) drugs. The latter is significant - analgesic OTC drugs feature heavily in terms of sales volumes and BMI believes spending in this segment will continue to be just under one-fifth of total pharmaceutical spending in Nigeria over the medium term. We also consider Nigeria to be very much in the stages of high essential medicine demand, which is a key reason for the OTC market comprising a generous proportion of all medicine expenditure.

Despite the risks, there are evidently opportunities - Canadian drugmaker Valuben Pharmaceutical has recently stated its interest in forming a public-private partnership with the Nigerian government in the Living Spring Pharmaceutical firm. Valuben's experience in establishing operations abroad has led the firm to prospect the country and the Nigerian firm, in turn, stands to benefit from knowledge transfer.
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ReportsandReports – Thailand Pharmaceuticals and Healthcare Report Q4 2010

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BMI believes the recent unrest in Thailand will not have an immediate impact on pharmaceutical sales or the revenue earning opportunities of drugmakers because the demand for healthcare is relatively independent of the trends in the economy - people get ill and need medicines despite drops in national wealth. However, note the word ‘relatively’. We believe the conflict and its effect on the country’s economy could have a longer-term impact on drugmakers’ revenues in Thailand as a result of the downward trend in consumer spending, as well as the slowdown in government contributions towards healthcare schemes. Thailand’s economy is the biggest loser of the political stalemate, which has negatively affected the country’s investment climate as well as its tourism industry, including medical tourism. The violent clashes in Thailand could cost the economy THB150bn (US$4.6bn), according to a statement by Deputy Prime Minister Trairong Suwankiri in May 2010.

Consequently, BMI expects headline real GDP expansion to average a below-potential 4.0% per annum over the next decade. The government’s budget deficit amounted to 4.0% of GDP in 2009 and we believe the cost of the violence will not ease these fiscal pressures. We calculate that fiscal expenditure will drop by 8% year-onyear (y-o-y) in 2010, having grown by 15% in 2009, which we believe will have a bearing on the government’s ability to provide adequate healthcare and pharmaceutical services.

We believe the government’s THB30 scheme may be an area of concern. Under the scheme, implemented in 2001, even uninsured patients may visit any government hospital and pay only a nominal sum per visit, with the remaining cost of the treatment paid by the government. The scheme covers most basic diseases, as well as surgery and expensive treatments such as those for HIV/AIDS and cancer. An estimated 80% of the population benefits from the plan, with the government hoping that universal health coverage can be achieved throughout the country in the long term.

Political deadlock and its effect on government finances could further delay progress on health sector reforms. HIV/AIDS is the leading cause of death in Thailand, illustrating a huge need for treatment. This therapeutic area is set to increase in value as the government has unveiled a series of new measures that make Thailand the first country in the world to guarantee antiretroviral (ARV) treatment to all patients requiring such remedies. However, as the drugs are provided free of charge, some questions remain over the viability of funding in the future.

In 2009, pharmaceutical sales reached a value of THB138.45bn (US$4.04bn) and in 2010 we calculate drug sales to reach THB150.09bn (US$4.59bn). By 2014, we expect Thailand’s pharmaceutical market to be worth THB207.60bn (US$6.81bn), equating to a compound annual growth rate (CAGR) of 8.44% in local currency terms and 11.01% in US dollar terms.
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ReportsandReports – Jordan Pharmaceuticals and Healthcare Report Q4 2010

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While we continue to see Jordan as one of the moderately attractive markets in the Middle East and North Africa (MENA) region – with the country ranked 12th of the 19 regional markets by BMI’s Business Environment Ratings Table for Q410 – this is largely due to its small population size and modest percapita spend on pharmaceuticals. Still, through to 2014, we forecast a steady 5.37% compound annual growth rate (CAGR) in Jordanian pharmaceutical spending, as measured in local currency terms, from the calculated JOD282mn (US$397mn) in 2009.
Nevertheless, specific sectors, including the fast-growing medical tourism, will continue to provide ample opportunities for commercial players. Additionally, in order to cater for the growing number of medical tourists, the Ministry of Health recently announced that it will establish a new medical tourism directorate, with the aim of regulating the sector and tackling complaints made by Arab and foreign patients receiving treatment in the Kingdom, usually over treatment costs. In the meantime, the US AID and the Jordan Economic Development Program (SABEQ) agreed to help Jordan’s Private Hospitals Association (PHA) increase the number of hospitals with Joint Commission International (JCI) accreditation, which will provide a further boost to medical tourism.
Public sector pharmaceutical volumes are also likely to be boosted by the gradual increase in the number of the insured in the country, which currently stand at 87% of the total population. In July 2010, the country’s Social Security Corporation (SSC) continued working to extend the health insurance coverage programme to also include the retired and the uninsured persons. The move would serve to facilitate small- and medium-sized enterprises (SMEs) with insurance for their workers. Similarly, access to medical services will be boosted by the pending formation of a healthcare unit for mental health patients in the Kingdom, recently announced by Bassam Hijjawi, director of the ministry's primary healthcare directorate.
Our forecasts for pharmaceutical market growth are underpinned by the expected 3.2% real GDP growth in 2010, which is based on a recovery in the banking sector and a potential pick-up in industrial production. Although we expect the economy to grow steadily over the next few years, it will still stop very short of reaching the levels of the 2004-2008 period, when the economy saw 8.3% average annual growth. In the meantime, we expect the consumer price index (CPI) growth to average around 3% per annum over the forecast period to 2014, which will also play a part in the development of pharmaceutical market values, especially the over-the-counter (OTC) segment.

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ReportsandReports – Algeria Pharmaceuticals and Healthcare Report Q4 2010

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BMI calculates Algerian pharmaceutical sales to have been DZD185.12bn (US$2.55bn) in 2009 and expects them to reach DZD208.56bn (US$2.84bn) in 2010. The market is characterised by a relatively low per-capita spend of US$73 (in 2009) and a large generics sector – 22% of total drug expenditure. We forecast pharmaceutical consumption growing to DZD295.54bn (US$4.22bn) by 2014, equivalent to a compound annual growth rate (CAGR) of 12.55% in local currency. Our long-term 10-year forecast is for the strong growth to continue, with the market reaching DZD407.14bn (US$5.82bn) in 2019.
The incidence of diabetes (especially type II) is on the rise in Algeria as both affluence and urbanisation increase. Official figures estimate that around 8% of Algerians suffer from the condition. Around 30,000 new cases of cancer are registered each year, although the country only has four specialist oncology centres. In January 2010, a conference on environmental health highlighted healthcare problems caused by various pollutants, calling for a national plan to tackle the issue.
The Algerian pharmaceutical industry is in urgent need of investment. Pharmaceuticals currently account for 0.008% of all exports but 4.5% of all imports. Algeria's import substitution legislation means drugs that can be manufactured in the country cannot be imported. Despite this, local firms are unable to meet local demand, leaving the market at risk of shortages, a situation several news reports have stated is becoming increasingly common. Currently, Algeria is not under pressure to diversify its exports due to its total trade surplus as a result of oil exports. However, the local industry's generic focus means it has immense potential to increase these exports.
Algerian drugmakers are set to face increasing competition from firms in neighbouring Tunisia, which are increasing capacity, expanding and exporting to other African markets. This ramping up of exports in Tunisia could not come at a worse time for Algeria, with local manufacturers unable to meet even local demand.
While the local market remains under-fulfilled, opportunities for local manufacturers may arise given the lack of any substantial government policies to promote and invest in the Algerian pharmaceutical sector. Tunisia will be more likely to attract foreign direct investment (FDI).
Algeria’s uncertain political environment, high levels of bureaucracy and corruption and the requirement to enter the country’s market through a joint venture deter significant FDI and will causeAlgeria to suffer in comparison with its North African neighbours. The situation will not be helped by the recent announcement that Algeria suspended meetings with WTO until 2011 after their last negotiation, held between March 29 and April 3 this year, failed to lead to membership.

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ReportsandReports- AKVION-Detailed Product Pipeline

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AKVION-Detailed Product Pipeline report contains detailed information on pipelines by phase and therapeutic indication as well as management information,deals and alliances and recent news on the company including key milestones.

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Each Life Science Analytics’ Pipeline Report provides the user with real detail on a company’s pipeline.

In addition to business summaries, contact information, company details and selected financial data, each report also contains extensive information in tabular and graphical formats on a company’s product pipeline and disease hub classification.

Product details consist of complete descriptions, therapeutic indication, drug class, mechanism of action and clinical trial information. Every report also includes detail on a company’s deals and alliances and recent corporate news including key milestones.

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Monitor a company’s research effectiveness by determining pipeline depth and numbers of products in development by clinical phase.

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ReportsandReports- Akrimax Pharmaceuticals, LLC-Detailed Product Pipeline

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Akrimax Pharmaceuticals, LLC-Detailed Product Pipeline report contains detailed information on pipelines by phase and therapeutic indication as well as management information,deals and alliances and recent news on the company including key milestones.

Scope of the reports
Each Life Science Analytics’ Pipeline Report provides the user with real detail on a company’s pipeline.

In addition to business summaries, contact information, company details and selected financial data, each report also contains extensive information in tabular and graphical formats on a company’s product pipeline and disease hub classification.

Product details consist of complete descriptions, therapeutic indication, drug class, mechanism of action and clinical trial information. Every report also includes detail on a company’s deals and alliances and recent corporate news including key milestones.

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Understand a company’s strategic position by accessing detailed independent intelligence on its product pipeline.

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Monitor a company’s research effectiveness by determining pipeline depth and numbers of products in development by clinical phase.

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ReportsandReports – Taiwan Pharmaceuticals and Healthcare Report Q4 2010

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In our Q410 update, Taiwan has again retained sixth place – on a regional basis – in BMI’s Pharmaceuticals & Healthcare Business Environment Ratings, out of the 17 markets surveyed in Asia Pacific. Globally, Taiwan’s TWD123.4bn (US$3.81bn) pharmaceutical market is viewed as the 27th most attractive, out of the 83 markets surveyed within our ever-expanding pharmaceutical universe. However, although well-developed, the Taiwanese market represents a challenging proposition, given its strict pricing and reimbursement environment, which hampers market access for innovative medicines, as well as pending patent expirations. We therefore forecast an unspectacular compound annual growth rate (CAGR) to 2014, which will come in at 3.72% in local currency terms, to give the overall market value as TWD148.1bn (US$4.94bn). Given the increase in trade links between China and Taiwan, the two countries are working towards regulatory system improvements. To this end, they recently signed a cross-strait bilateral agreement on the protection of intellectual property rights (IPR), which also concerns pharmaceuticals. The agreement aims to encourage and protect innovation, as the countries aim to create a formal platform for solving disputes and improve their international competitiveness. In a related – and worrying – development, however, an official investigation reportedly found that as much as 25% of pharmaceutical products in Taiwan are counterfeit, substandard or illegal, which is an area in need of attention.
In the meantime, the Taiwanese government remains committed to the development of the country’s biotechnology industry. The authorities are aiming to make the biotech industry one of their priority sectors for attracting foreign investment, with a view to increasing the annual output value of the industry to more than TWD1trn (US$30.86bn) in four years. The government also envisages an increase in the research and development (R&D) contribution in the field of biotechnology to some 3% of GDP by 2014. However, in a development that somewhat clouds the attractiveness of the country’s biotechnology sector, the director of well-known Academia Sinica's Institute of Biomedical Sciences, Chen Yuan-tsong, was being investigated by the Shilin District Prosecutors Office in Taiwan over the potentially illegal awarding of contracts.
In terms of other major developments in Taiwan that will have an impact on the performance of its pharmaceutical market, we expect that consumer price index (CPI) will finish the year at 2.0%, on the back of continued economic expansion and demand-pull pressures. However, while the Taiwan's economy is demonstrating a continued recovery (we expect a 5% GDP expansion in 2010), the pressures on public healthcare and pharmaceutical finances posed by the lack of separation between prescribing and dispensing and overprescribing, among other factors, will preclude a stronger value growth of the pharmaceutical market. Additionally, we reiterate our below-consensus 3.4% real growth forecast for 2011, expecting a coming Chinese slowdown to weigh heavily on Taiwan's economy next year.

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ReportsandReports – South Korea Pharmaceuticals and Healthcare Report Q4 2010

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BMI would describe South Korea as a transitional pharmaceutical market. Characteristic of an emerging market, combined sales of prescription drugs and over-the-counter (OTC) medicines are forecast to post high single-digit compound annual growth rates (CAGRs) over the next five years. However, the operating environment is similar to that seen in traditional markets.
South Korea’s Pharmaceutical Business Environment Rating (BER) has increased from 66.9 out of 100 in Q310 to 67.0 in Q410, due to a slight improvement in our evaluation of the Country Risks. Scores for the other main BER sub-categories – Industry Rewards, Country Rewards and Industry Risks – have remained unchanged from the previous quarter.
However, South Korea has dropped from first to third in the 17-country ratings system, due to improved BER scores recorded by Australia (66.9 to 70.2) and Japan (66.7 to 68.8). Indicative of a developed pharmaceutical market, selling and administrative expenses recorded by drugmakers operating in South Korea dropped in 2009, as the government enforced new rules on illegal rebates and other inappropriate marketing practices. The most aggressive cost-container was Swiss multinational Roche, which reduced its 'selling and administrative' expenditure by 45%. The next biggest cuts were implemented by Abbott Korea (-12.5%), Baxter Korea (-11.4%), AstraZeneca Korea (-9.8%) and Janssen Korea (-6.1%).
The largest local drugmaker according to Q110 sales was Green Cross. However, its revenue was boosted significantly (+125%) by demand for its H1N1 swine flu vaccine. Without this exceptional demand driver, the largest firm would have been Dong-A, with sales of US$178mn in first three months of this year. Three firms – Hamni, Choongwae and Chong Kun Dang – attributed their below-average financial results on a challenging operating environment.
It is BMI’s view that South Korea will emerge as a global leader in biosimilar research and development. In April 2010, the Korea Food and Drug Administration (KFDA) announced plans to publish guidelines for approving improved generic versions of biological products before the end of H110. The administration already has guidelines for generic versions of brand-name biological products, but the new guidelines will be for improved versions which are differently prepared from the same active ingredients used in brand-name ones.
A May 2010 survey by The Korea Chamber of Commerce and Industry revealed that progress in the country's medical tourism industry has been slow, despite it being a year since the Korean government allowed local hospitals to sell medical treatments to foreign patients in an effort to boost the medical tourism industry.

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ReportsandReports – Slovenia Pharmaceuticals and Healthcare Report Q4 2010

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In BMI’s Business Environment Ratings (BERs) table for Q410, Slovenia is ranked ninth of the 20 markets assessed in CEE, up by one place in relation to the previous quarter. Overall, Slovenia’s attractiveness suffers from a small market size and low forecast growth, although the high per-capita GDP and widespread health awareness play in favour of pharmaceutical companies.

In addition to a EUR49mn (US$61mn) reduction in its healthcare budget in early June 2010, the Slovenian Ministry of Health has now proposed a series of pharmaceutical cost-containment measures. These developments will impact sales and increase price competition in the country's drug market. Efforts to contain publicly-funded pharmaceutical costs in Slovenia are not dissimilar to the actions of other European states to limit healthcare expenditure and generally cut their budgets. Slovenia's continuing economic difficulties are significant, but not disproportionate to the rest of Europe, with nominal GDP growth of -6% in 2009 and a government budget deficit of EUR1.8bn (US$2.25bn), almost 5% of GDP.

With public sector healthcare spending representing 74% of the total healthcare market, any reduction in government funding will have a significant impact on the rest of the market. However, Slovenia's welldeveloped system of prescription co-payments for more expensive drugs means that introducing private payments will reduce the impact of the healthcare cuts and cost-containment measures. Though the cost-containment measures are not price erosion mechanisms like those seen in Greece, Portugal and Spain, the intention of the proposed measures align with BMI's short-term core view that government price erosion mechanisms will accelerate across Europe. In recent years, drug expenditure has risen steadily in Slovenia, with a compound annual growth rate (CAGR) of 6.3% in local currency terms and 5.72% in US dollar terms between 2004 and 2009. BMI forecasts that between 2009 and 2014 the drug market will experience a CAGR of just 3.76% in local currency terms and 3.27% in US dollar terms, to reach a value of EUR653mn (US$816mn) in 2014, up from EUR543mn (US$695mn) in 2009.

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