Brazilian Pharmaceutical Market 2014-2024

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Contents
1. Executive Summary
1.1 Overview of Findings 1.2 Chapters in the Report 1.3 Research and Analysis Methods

2. Overview of the Brazil Pharmaceutical Market, 2014-2024

2.1 Market to Continue Strong Performance to 2024 2.2 The Sixth-Largest Economy in the World in 2012 2.2.1 Population Size the Biggest Driver for the Market 2.2.2 Generics Segment Continues to Grow in Importance 2.2.3 CNS Remains the Largest Therapeutic Area in 2012 2.2.4 Three Domestic Companies in Top Six for 2012 2.3 Why the Brazilian Market Matters: Regional and Global Market Context 2.3.1 Brazil Represented 46% of the Latin American Market in 2012 2.3.2 Brazil as Part of the BRIC/Pharmerging Markets in 2013 2.3.2 Brazil as Part of the BRIC/Pharmerging Markets in 20132.5.6 Other Players in the Market2.8.1 The Vaccines Market 3.1.1 Other Important Agencies 3.2 Over 62% Supplement SUS with Private Healthcare 3.2.1 CMED Adjusts Prices Up for 2013 3.2.2 Reimbursement for RENAME Drugs via Farmcia Popular 3.2.3 Private Insurance Market Growing, but Costs for Insurers Rising 3.3 M&A-Led Consolidation Continues in Both Wholesale and Retail Sectors 3.3.1 Celesio-Owned Panpharma Still the Top Distributor 3.3.2 RaiaDrogasil, Brazil Pharma and Other Major Chains Hold 47% of Retail Sector 3.3.3 Marketing Spend in Brazil Approaches $5bn

3. Brazilian Healthcare: Commercial Overview, 2014-2024

3.1 ANVISA The Key Institutional Body

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3.4 A Nation of Contrasts: Healthcare Variations in the Brazilian Regions 3.4.1 Southeast: Over 40% of the National Population, But Over Half of Pharmaceutical Market Revenues 3.4.2 Northeast: Shortest Life-Expectancies and Second-Highest Market Share 3.4.3 South: Smallest Region with Highest Per Capita GDP 3.4.4 MidWest: Landlocked Region with Lowest Population 3.4.5 North: Largest and Poorest Area Represents <5% of Market

4. Product Mix in the Brazilian Market, 2014-2024

4.1 How Much Ground Will Generics Gain by 2024? 4.2 Patented Pharmaceuticals: Still the Basis of the Brazil Market 4.2.1 PDPs and HTA: Government Attempts to Regulate Costs 4.2.2 The Battle for Biomanufacturing Capabilities 4.2.3 Can BioNovis and Orygen Build on Achs Biosimilar Advances? 4.2.4 At 55% More Expensive, Can Patented Products Hold Off the Generics Revolution? 4.2.5 Market Forecast for Prescription Pharmaceuticals, 2014-2024 4.3 Generic Pharmaceuticals: Rapid Expansion Since 2000 4.3.1 Pr-Genricos Anticipate 45% Market Capture 4.3.2 The Issue of Non-Bioequivalent Drugs 4.3.3 Counterfeits: Believed At Least 7% of Brazil's Drug Supply Affected 4.3.4 Generics Opportunity Not Yet Fully Harnessed 4.3.5 Market Forecast for Generic Pharmaceuticals, 2014-2024 4.4 OTC Segment: Still Favoured by Brazilian Consumers 4.4.1 Coming Out From Behind the Counter 4.4.2 Advertising: ABIMIP Lobbies on DTC Restrictions 4.4.3 Vitamins and Minerals Purchased by ~15% of Brazilians 4.4.4 From Analgesics to Erectile Dysfunction Treatments, Consumer Health Treatments Remain Prominent in the Market 4.4.5 Market Forecast for the OTC Segment, 2014-2024

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5. Therapeutic Areas in the Brazil Market, 2014-2024
5.1 Oncology to Overtake CNS Diseases by 2024 5.2 The Rise of Non-Communicable Diseases 5.3 CNS Conditions: Disease Burden Comparable to US 5.3.1 Domestic Companies Target OTC and Generic Pain Relief 5.3.2 Foreign Competition in the Analgesics Area 5.3.3 Prevalence of 10%+ Represents Major Opportunity in Antidepressant Space 5.3.4 CNS Conditions: A Therapeutic Area with Unique Relevance to Brazil 5.3.5 Market Forecast for CNS Therapeutic Area 2014-2024 5.4 Cardiovascular Diseases: Brazils Biggest Killer 5.4.1 Anti-hypertensives: One of the Nations Key Drugs 5.4.2 Decline of the Statins 5.4.3 Ache and Sanofi Among the Key Players in This Field 5.4.4 The Heart Disease Opportunity over the Next 10 Years 5.4.5 Market Forecast for Cardiovascular Therapeutic Area 2014-2024 5.5 Alimentary/Metabolic Diseases: Affecting More Than a Third of Brazilians 5.5.1 Lack of Diabetes Awareness Still an Issue 5.5.2 Biosimilar Insulins to Play an Important Role 5.5.3 EMS Generic Esomeprazole an Important Addition 5.5.4 Capturing the Alimentary/Metabolic Disease Opportunity 5.5.5 Market Forecast for Alimentary/Metabolic Therapeutic Area 2014-2024 5.6 Oncology: To Become the Biggest Therapeutic Area? 5.6.1 Breast Cancer Has the Highest Prevalence in Brazil 5.6.2 Biosimilars to Help Widen Medicine Access 5.6.3 Eurofarma, Cristalia and Libbs the Domestic Leaders 5.6.4 Will the Oncology Therapeutic Area Realise its Potential? 5.6.5 Market Forecast for Cancer Treatment 2014-2024 5.7 Infectious Diseases: Brazil Faces Unique Challenges 5.7.1 PPDs to Meet Vaccines Need 4.4.5 Market Forecast for the OTC Segment, 2014-2024

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5.7.2 Brazil Managing HIV Despite IP Concerns 5.7.3 Chagas Disease and Other Infectious Disease Concerns 5.7.4 Infectious Disease: The Past or the Future for Brazilian Pharma? 5.7.5 Market Forecast for Infectious Disease Treatment, 2014-2024 5.8 Other Therapeutic Areas

6. Domestic Companies in the Brazilian Market, 2014-2024

6.1 EMS Continues to Lead the Field with 8% Market Share 6.2 Purchase of Medley Means Multinationals Still Own Bulk of Market 6.2.1 Domestic Firms Control 70% of Generics Market 6.3 EMS Pharma: First Among Brazilian Generics Firms 6.3.1 Significant R&D, Manufacturing and Sales Capabilities 6.3.2 Targeting Expansion Oversees 6.3.3 Legrand and Germed Key Subsidiaries of EMS 6.4 Medley: Foreign-Owned Generics Leader Maintains 8% Market Share in 2012 6.5 Hypermarcas: Diversified Drugstore Chain 6.5.1 Neo Qumica Genericos: Third-Ranked in Generics Segment 6.5.2 Other Key Hypermarcas Subsidiaries Include Brainfarma 6.5.3 Hypermarcas Performance in 2012 6.6 Ach: The Major Acquisition Target in Brazil 6.6.1 Cardiovascular Drugs the Main Focus 6.6.2 Ache: Possible M&A? 6.6.3 A Large Domestic Merger an Alternative Possibility? 6.7 Laboratorios Eurofarma: Diversified Leader with Hospital, Generic and Veterinary Business Units 6.7.1 Vigorous Latin American Acquisitions Policy 6.7.2 Strong Presence in Cancer Treatment 6.8 Laboratorio Teuto Brasileiro: Largest Pharmaceutical Complex in Latin America 6.8.1 Melcon Partnership and Other Growth Strategies for Teuto

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6.9 Biolab-Sanus Farma: 100+ Products, Four Exclusive 6.9.1 Collaborations with Emcure and Merz 6.10 Laboratrio Cristlia: R&D Leader 6.10.1 Leader in API Manufacturing 6.10.2 Involved in Nearly Half of All PDP Arrangements 6.11 Libbs Farmacutica: Key Player in Cancer Treatment 6.11.1 Working on a Biosimilar Opening New Possibilities 6.12 Uniao Quimica Farmaceutica Nacional: Expanding in Minas Gerais 6.13 Other Domestic Players 6.14 The Major Biosimilar Collaborations 6.14.1 BioNovis: Aiming at Commercialisation by 2015 6.14.2 Orygem Biotecnologia 6.15 Other Potential Sources of Innovation 6.15.1 Fundao Oswaldo Cruz: At the Heart of PDP 6.15.2 ANVISA Reform of Brazilian Patent System

7. Multinational Companies in the Brazilian Market, 2014-2024

7.1 M&A Propels Sanofi into First Position 7.2 Multinational Investment in the Market Continues to Grow 7.3 Sanofi: Medley Purchase Makes French Giant the Outright Leader 7.3.1 Genzyme and Consumer Health the Main Growth Drivers 7.3.2 Generics Sales Stall in 2012 7.3.3 Inventory and 2013 Results 7.4 Novartis: Brazil Now Sixth-Largest Market 7.4.1 Sandoz Sales Grow by 29% in 2012 7.4.2 Pricing and Reimbursement Solutions to Bring Original Drugs to Brazil 7.4.3 Co-operating on Technology Transfer and Other Ideas 7.5 Roche: Double-Digit Brazilian Growth in 2012 7.5.1 Positioned to Tap the Oncology Opportunity

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7.5.2 Herceptin, Pricing and Reimbursement 7.6 Merck & Co. Long-Standing Presence in the Brazilian Market 7.6.1 Gardasil Added to SUS in 2013 7.6.2 ExcelRX JV to Increase Mercks Standing in Brazil 7.7 Pfizer: Targeting Emerging Market Growth via M&A 7.7.1 Portfolio Ranges from Orphan Biologics to Multivitamins 7.7.2 How Will a Pfizer Break-Up Affect Emerging Market Plans? 7.8 Bayer: Brazil Fifth-Largest Market for Diversified Conglomerate 7.8.1 Consumer Health a Major Focus in Brazil 7.9 AstraZeneca: Struggling with Patent Expiries in Brazil 7.9.1 Possible Future Growth Drivers Include Diabetes 7.10 Boehringer Ingelheim: Pain, Cardiovascular and Respiratory Drugs Bolster Strong National Portfolio 7.10.1 Technology Transfer Deal for Sifrol 7.11 Takeda: Entering the Top 10 with Multigrip OTC Acquisition 7.11.1 Nycomed Generics and Original Products Also Key to Strategy 7.12 Merck Serono: Over 6% Consumer Health Growth Forecast 7.13 Other Big-Pharma Competitors 7.13.1 Johnson & Johnson: Focusing on Consumer Health and Commodities 7.13.2 GlaxoSmithKline: Vaccines Technology Transfer Opportunities 7.13.3 Abbvie: Humira to Face Biosimilar Challenge in Brazil? 7.13.3.1 Abbott: Generics and Diagnostics-Led Growth Strategy 7.13.4 Eli Lilly: Patent Expiries Hit Emerging Market Revenues. 7.13.5 Bristol-Myers Squibb: Divesting its Brazilian OTC Portfolio Rights 7.13.6 Baxter: Entering Brazilian Haemophilia Market via Tech Transfer 7.13.7 Amgen Signals Brazilian Intent with Bergamo Acquisition 7.13.8 Other Top Biotechs Enter Brazil 7.13.9 Other Top Japanese Companies Trail Behind Takeda in Brazil 7.14 Will Multinational Generics Leaders Compete in Brazil? 7.14.1 Teva Pharmaceutical Industries: Generics Giant Targets Brazil

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7.14.2 Mylan: Agile Acquisition Boosts Latin American Strategy 7.14.3 Actavis: Newly-Merged Player to Challenge in Brazil 7.14.4 Ranbaxy Hands Over to Daiichi, but Other Indian Companies Still in the Hunt in Brazil 7.14.5 Glenmark, Strides and Biocon Looking to Enter Brazil 7.14.6 Valeant: Aggressive M&A Drive Into the Market 7.15 Brazil as Research Destination 7.16 Other Multinational Business in Brazil

8. Qualitative Analysis of the Brazilian Market, 2014-2024

8.1 A Crucial Market for the Pharmaceutical Industry? 8.2 Governmental Regulation Remains an Issue 8.3 Room to Expand in Therapeutic Areas and Geographical Regions 8.4 IP Protection: Doubts, Red Tape and Counterfeiting Remain Issues 8.5 Large and Ageing Population Eager to Buy Medicines 8.6 Improved Biotechnology and Digital Among Governments Goals 8.7 Can Economic Growth Keep Pace With Healthcare Costs? 8.8 Political Environment the Decisive Influence on the Market

9. Conclusions from the Research and Analysis

9.1 Brazil Likely to Outperform Most Other Top 10 Pharma Markets 9.2 Generics to be the Fastest-Growing Segment 9.3 Technology Transfer Crucial to Patented Drugs Market 9.4 Generics and Patented Products: Opportunities for Multinationals 9.5 Anti-cancer Drugs: Biggest Therapeutic and Commercial Opportunity 9.6 Concluding Remarks

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List of Tables
Table 1.1 Currency Exchange Rates Table 2.1 Brazilian Pharmaceutical Market: Revenues ($m), AGR (%), CAGR (%), 2012-2017 Table 2.2 Brazilian Pharmaceutical Market: Revenues ($m), AGR (%), CAGR (%), 2018-2024 Table 2.3 Product Mix Breakdown: Revenues ($m), Market Share (%), 2012 Table 2.4 Therapeutic Area Breakdown: Revenues ($m), Market Share (%), 2012 Table 2.5 Leading Companies in the Brazilian Pharma Market: Revenues ($m), Market Shares (%), 2012 Table 2.6 Leading National Markets Worldwide: Revenues ($m), Market Shares (%), 2012 Table 2.7 Leading National Markets in Latin America: Revenues ($m), Market Shares (%), 2012 Table 2.8 Leading National Pharmerging Markets: Revenues ($m), Market Shares (%), 2012 Table 3.1 Members of FenaSade, 2013 Table 4.1 Brazilian Pharma Market Breakdown by Product Type: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2012-2017 Table 4.2 Brazilian Pharmaceutical Market Product Mix Breakdown: Revenues ($m), Market Shares (%), 2017 Table 4.3 Brazilian Market Breakdown by Product Type: Revenues ($m), AGR (%), CAGR (%), Market Shares (%) 2018-2024 Table 4.4 Brazilian Pharmaceutical Market Product Mix Breakdown: Revenues ($m), Market Shares (%), 2024 Table 4.5 Selected Technology Transfer Agreements in Brazil 1985-2013 Table 4.6 Patented Pharmaceuticals: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2012-2017 Table 4.7 Patented Pharmaceuticals: Revenues ($m), AGR (%), CAGR (%), 2018-2024 Table 4.8 Generic Pharmaceuticals: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2012-2017 Table 4.9 Generic Pharmaceuticals: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2018-2024

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Table 4.10 OTC Pharmaceuticals: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 20122017 Table 4.11 OTC Pharmaceuticals: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 20182024 Table 5.1 Brazilian Market Breakdown by Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Shares (%) 2012-2017 Table 5.2 Therapeutic Area Breakdown: Revenues ($m), Market Share (%), 2017 Table 5.3 Brazilian Market Breakdown by Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Shares (%) 2018-2024 Table 5.4 Therapeutic Area Breakdown: Revenues ($m), Market Shares (%), 2024 Table 5.5 CNS Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Shares (%), 20122017 Table 5.6 CNS Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 20182024 Table 5.7 Cardiovascular Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2012-2017 Table 5.8 Cardiovascular Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2018-2024 Table 5.9 Alimentary/Metabolic Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2012-2017 Table 5.10 Alimentary/Metabolic Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2018-2024 Table 5.11 Oncology Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2012-2017 Table 5.12 Oncology Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2018-2024 Table 5.13Infectious Disease Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2012-2017 Table 5.14 Infectious Disease Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2018-2024

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Table 6.1 Leading Domestic Companies in the Brazilian Market: Revenues ($m), Market Shares (%), 2012 Table 6.2 EMS: Overview, 2013 Table 6.3 Medley: Overview, 2013 Table 6.4 Hypermarcas: Overview, 2013 Table 6.5 Ach: Overview, 2013 Table 6.6 Eurofarma: Overview, 2013 Table 6.7 Teuto: Overview, 2013 Table 6.8 Biolab Sanus: Overview, 2013 Table 6.9 Cristlia: Overview, 2013 Table 6.10 Libbs: Overview, 2013 Table 6.11 Uniao Quimica: Overview, 2013 Table 7.1 Leading Multinational Companies in the Brazilian Market: Revenues ($m), Market Shares (%), 2012 Table 7.2 Selected Multinational M&A Transactions in Brazilian Market, 2009-2012 Table 7.3 Sanofi: Overview, 2013 Table 7.4 Novartis: Overview, 2013 Table 7.5 Roche: Overview, 2013 Table 7.6 Merck: Overview, 2013 Table 7.7 Pfizer: Overview, 2013 Table 7.8 Bayer: Overview, 2013 Table 7.9 AstraZeneca: Overview, 2013 Table 7.10 Boehringer Ingelheim: Overview, 2013 Table 7.11 Takeda: Overview, 2013 Table 7.12 Merck Serono: Overview, 2013 Table 8.1 Brazilian Pharmaceutical Market: Strengths and Weaknesses, 2013 Table 8.2 Brazilian Pharmaceutical Market: Opportunities and Threats, 2013 Table 8.3 Brazilian Pharmaceutical Market: STEP Analysis, 2013-2024

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List of Figures
Figure 2.1 Brazilian Pharmaceutical Market: Revenues ($m), 2012-2024 Figure 2.2 Demographic Breakdown of Brazilian Population by Age, 2013 Figure 2.3 Brazilian Pharmaceutical Market Product Mix Breakdown: Revenues ($m), Market Shares (%), 2012 Figure 2.4 Brazilian Pharmaceutical Market Product Mix Breakdown: Revenues ($m), Market Shares (%), 2012 Figure 2.5 Leading Companies in the Brazilian Market: Revenues ($m), Market Shares (%), 2012 Figure 2.6 Leading National Markets Worldwide: Revenues ($m), Market Shares (%), 2012 Figure 2.7 Leading National Markets in Latin America: Revenues ($m), Market Shares (%), 2012 Figure 2.8 Leading National Pharmerging Markets: Revenues ($m), 2012 Figure 2.9 BRIC National Markets: Revenues ($m), 2012 Figure 3.1 Public/Private Balance in Healthcare Provision, 2008 Figure 3.2 CMED-Mandated Maximum Drug Price Rises, 2009-2013 Figure 3.3 Distribution (%) of Revenues Among Brazilian Regions, 2012 Figure 4.1 Brazilian Pharmaceutical Market Product Mix Breakdown: Revenues ($m), Market Shares (%), 2017 Figure 4.2 Brazilian Pharmaceutical Market Product Mix Breakdown: Revenues ($m), Market Shares (%), 2024 Figure 4.3 Brazilian Pharmaceutical Market Product Mix Breakdown: Revenues ($m), 2012-2024 Figure 4.4 Brazilian Pharmaceutical Market Product Mix Breakdown: Revenues ($m), 2012, 2017, 2024 Figure 4.5 Biologics in the Brazilian Market: Product Mix Breakdown: Revenues ($m) and Shares (%), 2012 Figure 4.6 Biologics in the Brazilian Market: Product Mix Breakdown: Revenues ($m), 2012, 2017 and 2024 Figure 4.7 Drivers and Restraints for Prescription Pharmaceuticals, 2013 Figure 4.8 Patented Pharmaceuticals: Revenues ($m), 2012-2024 Figure 4.9 Drivers and Restraints for Prescription Pharmaceuticals, 2013

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Figure 4.10 Generic Pharmaceuticals: Revenues ($m), 2012-2024 Figure 4.11 Drivers and Restraints for Generic Pharmaceuticals, 2013 Figure 4.12 OTC Pharmaceuticals: Revenues ($m), 2012-2024 Figure 5.1 Therapeutic Area Breakdown: Revenues ($m), Market Shares (%), 2017 Figure 5.2 Therapeutic Area Breakdown: Revenues ($m), Market Shares (%), 2024 Figure 5.3 Therapeutic Area Breakdown: Revenues ($m), 2012-2024 Figure 5.4 Therapeutic Area Breakdown: Revenues ($m), 2012, 2017, 2024 Figure 5.5 Drivers and Restraints for CNS Therapeutic Area, 2013 Figure 5.6 CNS Therapeutic Area: Revenues ($m), 2012-2024 Figure 5.7 Drivers and Restraints for Cardiovascular Therapeutic Area, 2013 Figure 5.8 Cardiovascular Therapeutic Area: Revenues ($m), 2012-2024 Figure 5.9 Drivers and Restraints for Alimentary/Metabolic Therapeutic Area, 2013 Figure 5.10 Alimentary/Metabolic Therapeutic Area: Revenues ($m), 2012-2024 Figure 5.11 Drivers and Restraints for Oncology Therapeutic Area, 2013 Figure 5.12 Oncology Therapeutic Area: Revenues ($m), 2012-2024 Figure 5.13 Drivers and Restraints for Infectious Disease Therapeutic Area, 2013 Figure 5.14 Infectious Disease Therapeutic Area: Revenues ($m), 2012-2024 Figure 6.1 Leading Domestic Companies in the Brazilian Market: Revenues ($m), Market Shares (%), 2012 Table 7.1 Leading Multinational Pharma Companies in the Brazilian Market: Revenues ($m), Market Shares (%), 2012 Figure 9.1 Brazilian Pharmaceutical Market: Revenues ($m), 2012-2017 Figure 9.2 Brazilian Pharmaceutical Market: Revenues ($m), 2018-2024 Figure 9.3 Product Mix: Revenues ($m), 2012-2017 Figure 9.4 Product Mix: Revenues ($m), 2018-2024 Figure 9.5 Top 10 Companies in the Brazilian Pharma Market, 2012 Figure 9.6 Therapeutic Areas: Revenues ($m) in Brazil, 2012-2017 Figure 9.7 Therapeutic Areas: Revenues ($m) in Brazil, 2018-2024

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Abbott Laboratories

Companies and Other Organisations Mentioned in Report

Abbott Laboratories (including Abbvie) Ach Laboratrios Farmacuticos Actavis Agncia Nacional de Saude Suplementar Agncia Nacional de Vigilncia Sanitria (ANVISA) Agila Specialties AlfaRio Alliance Boots Allianz Health AMB (Brazilian Medical Association) American Diabetes Association American Varian Medical Systems Amgen Amil Participaes Antaris Consulting Arena Pharmaceuticals Arseus Associao Brasileira da Indstria de Medicamentos Isentos de Prescrio (ABIMIP) Associao Brasileira das Redes de Farmcias e Drogarias (ABRAFARMA) Associao Brasileira de Reabilitao de Coluna Associacao da Industria Farmaceutica de Pesquisa (InterFarma) Associao Nacional de Assistencia ao Diabetico (ANAD) Astellas AstraZeneca Athos Pharma Axis Biotec Baxter Bayer

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BD Biocon Biogen Idec Biolab Emcure Biolab-Sanus Farma Biomm Bionovis Biosidus Biovail Corporation Boehringer Ingelheim Boiron Bradesco Sade Brainfarma Industria e Farmaceutica Brasil Pharma Brazilian Development Bank (BNDES) Bristol-Myers Squibb BTG Pactual Bunker Industria Farmaceutica Caixa Seguros Cmara de Regulao do Mercado de Medicamentos (CMED) Cannes RJ Participacoes Castro Marques Group Celesio Chemo Claris Lifesciences CMED Comisso Nacional de Incorporao de Tecnologia (CONITEC) Comit Tcnico Assessor de Imunizaes (CTAI) Conselho Administrativo de Defesa Econmica Corporacion Infarmasa

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CPhI Worldwide CVS Pharmacy Daiichi Sankyo Datamatrix Delta Instituto Terapeutico Dimed Disaq Pharmaceuticals DM Industria Farmaceutica Dong-A DPSP Drogarias Tamoio Eisai Eli Lilly Emcure EMS Eurofarma Everis Excel RX FarmaBrasil group Farmcia Popular Farmadacta Informatica Farmais Far-Manguinhos Farmindustria FDA Federao Nacional de Sade Suplementar Federal Council of Medicine (CFM) Fiocruz Food and Drug Administration (US FDA) Forest Laboratories

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GE Genfar Genzyme Germed Pharma Gilead Sciences GlaxoSmithKline (GSK) Glenmark Golden Cross Assistance Grnenthal Grupo Bradesco Grupo Cimed Guararapes Health Canada Hebron Hemobrs Hospital das Clnicas Hospital Israelita Albert Einstein Hospital Santa Catarina Hypermarcas IMA Laboratories Indian Council of Medical Research Infectious Disease Research Institute (IDRI) Institut Pasteur Instituto Butantan Instituto de Estudos de Sade Suplementar (IESS) Interagile Propaganda e Promocoes Intermdica Itauseg Health Johnson &Johnson (J&J) Kenya Medical Research Institute

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Laboratorio Cristlia Laboratrio Daudt Oliveira Laboratrio Farmaceutico do Estado de Pernambuco (LAFEPE) Laboratorio Quimico Farmaceutico Bergamo Laboratorio Teuto Brasileiro Laboratorios Gautier Laboratrios Kendrick Laboratrios Klinger Do Brasil Laramara Legrand Libbs Farmacutica Locafarma Solucoes de Transportes e Logistica Luper Indstria Farmacutica Mais Econmica Mantecorp Industria Quimica e Farmaceutica Maritima Seguros Mayne Pharma Mdecins sans Frontires Medley Meizler Biopharma Melcon Merck & Co. Merck Serono Merz Pharma Metlife Dental Plans Minas Gerais State Department of Health Ministrio da Sade (Ministry of Health, Brazil) moksha8 Multilab Industria e Comercio de Produtos Farmaceuticos Mylan

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Nature's Plus Farmaceutica Neo Qumica Neuberger Machines Novartis Novo Nordisk Nycomed Odontoprev Omint Health Services Oncoprod Optimer Pharmaceuticals Orygen Biotecnologia Oswaldo Cruz Foundation Otsuka Pan American Health Organization Panarello Panpharma Pasteur Institute Pele Nova Penha Pfizer Pharmaceutical Product Development, LLC (PPD) PharmaPraxis Porto Seguro Probiomed Probiotica Procter & Gamble Profarma Pr-Genricos Promovendas Representacoes Protalix BioTherapeutics Quesada Farmaceutica

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Quintiles RaiaDrogasil Ranbaxy Reckitt Benckiser Regional Council of Medicine, State of So Paulo Roche Rosrio Sabin Vaccine Institute Sandoz Sanofi SantAna Santa Cruz Shasun Pharma Siemens Sincamesp Sinclair IS Pharma Sindusfarma Sistema nico de Saude (SUS) Strides Arcolab SulAmrica Sun Supera Farma Laboratorios Takeda Telefnica Digital Tempo Participaes Teva Pharmaceutical industries TKS Farmaceutica Torrent Toshiba UCB

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UERJ UFMG UFRJ Uniao Quimica UNICAMP UNIFESP Unimed Seguros UnitedHealth University of So Paulo Valeant Varian Medical Systems Volta Walgreens Watson Pharmaceuticals (now Actavis) Wheaton Brazil Wockhardt World Health Organization (WHO) Zydus Cadila

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Brazilian Pharmaceutical Market 2014-2024

5.4.4 The Heart Disease Opportunity Over the Next 10 Years
Figure 5.7 indicates drivers and restraints for the cardiovascular therapeutic area in Brazil.

Figure 5.7 Drivers and Restraints for the Cardiovascular Therapeutic Area, 2013
Restraints

Patent expiries for statin drugs take away a key revenue driver for the therapeutic area Very high prevalence of cardiovascular disease, with strokes and heart attacks likely to rise sharply over the forecast period Government access to hypertension treatments allows major take-up for this leading unmet medical need Significant interest from companies at home and abroad Drivers Awareness of hypertension remains low among the population Heavy OTC use may restrict opportunities for more expensive Rx drugs

Source: visiongain 2013 The main driver for the cardiovascular therapeutic area lies simply in the vast levels of medical need in the country. If, as some estimates suggest, almost 60 million Brazilians suffer from some form of cardiovascular condition (principally hypertension), then this is a major commercial opportunity. The difficulty comes in the fact that the majority of cardiovascular treatments are preventative and depend on good information for personal health management on the part of the population. Since many of the most important cardiovascular drugs have also lost patent protection, the growth of the generics segment will be a necessary factor in the continued expansion of this therapeutic area. For example, generic simvastatin is a market leader, and other generic statins and other molecules will become key drivers in the near-term. The widespread use of OTC cardiovascular treatments may be a restraint on the market inasmuch as it restricts use of the major prescription drugs.

5.4.5 Market Forecast for Cardiovascular Therapeutic Area 2014-2024

The cardiovascular therapeutic field will expand with a five-year CAGR of 6% to achieve 2017 revenues of $6211m. Over this period, its market share will decline from 17% to 15%. See Table 5.7. By 2024, revenues for the therapeutic area will reach $8790m, with a CAGR of 6% across the forecast period as a whole. See Table 5.7, Table 5.8 and Figure 5.8.

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Brazilian Pharmaceutical Market 2014-2024

Table 5.7 Cardiovascular Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2012-2017
2012 Revenues ($m ) AGR (%) CAGR (%, 2012-2017) Market share (%)
Source: visiongain 2013

2013 4865 7

2014 5237 8

2015 5566 6

2016 5914 6

2017 6211 5 6

4544

17

16

16

16

16

15

Table 5.8 Cardiovascular Therapeutic Area: Revenues ($m), AGR (%), CAGR (%), Market Share (%), 2018-2024
2018 Revenues ($m ) AGR (%) CAGR (%, 2018-2024) CAGR (%, 2012-2024) Market share (%)
Source: visiongain 2013

2019 6931 5

2020 7280 5

2021 7561 4

2022 7975 5

2023 8366 5

2024 8790 5 5 6

6570 6

15

14

14

14

14

13

13

5.5 Alimentary/Metabolic Diseases: Affecting More Than a Third of Brazilians

Prevalence of alimentary/metabolic conditions in Brazil is high, with over a quarter of the population suffering from gastrointestinal conditions including gastroesophageal reflux disease and inflammatory bowel conditions. Two of the top-selling generic drugs in the country in H1 2013 were pantoprazole and omeprazole, the proton pump inhibitors for reducing stomach acid, which jointly accrued over $90m in revenues for that six-month period. Diabetes is also a major issue in Brazilian healthcare, with WHO estimates indicating that prevalence will increase by two-thirds between 2010 and 2030. Since 2006, diabetes treatments are now distributed free via the Farmcia Popular channel discussed previously.

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