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Peru Pharmaceuticals and Healthcare Report Q1 2013

Business Monitor International, January 2013, Pages: 111

BMI View:

We have recently revised downwards our 2012 pharmaceutical sales growth for Peru, due to the recent price cuts in the prescription drug sector, which accounts for over 74% of total pharmaceutical sales. Still, our projected compound annual growth rate (CAGR) between 2011 and 2016 remains largely unchanged as BMI believes Peru still offers considerable longer-term benefits to local and foreign pharmaceutical companies because of the country's ageing population, increasing disease burden and the expected change in drug consumption patterns.

Headline Expenditure Projections

- Pharmaceuticals: PEN3.90bn (US$1.42bn) in 2011 to PEN4.11bn (US$1.57bn) in 2012; +5.3%
in local currency terms and +10.4% in US dollar terms. Forecast revised downwards from Q412 due to price cuts in the prescription drug sector.

- Healthcare: PEN19.52bn (US$7.09bn) in 2011 to PEN20.73bn (US$7.90bn) in 2012; +6.2% in local currency terms and +11.4% in US dollar terms. US dollar forecast unchanged from Q412.

- Medical devices: PEN897mn (US$326mn) in 2011 to PEN954mn (US$363mn) in 2012; +6.3%
in local currency terms and +11.6% in US dollar terms. Forecast slightly lower than Q412 on account of macroeconomic factors.

Risk/Reward Rating:

Peru's composite score for Q113 stands at an unchanged 47.7 out of the maximum 100, which again places the country ninth out of the 17 countries surveyed in our Pharmaceutical Risk/Reward Ratings (RRRs) matrix for the Americas. Peru will continue to be viewed as a moderately promising longer-term pharmaceutical market for multinationals, on account of the below-average industry rewards and risks, although we expect continued improvements in the country's operating climate. Globally, Peru is ranked 54th (up from 55th in the previous quarter) out of the 95 markets surveyed in our pharmaceuticals universe, above Kazakhstan and below Indonesia.

Key Trends And Developments

- According to Peru's pharmaceutical industry association, the Asociación de Industrias Farmacéuticas Nacionales (Adifan), local drug sales in the first five months of 2012 amounted to PEN 1,126mn (US$418.5mn), which equates to an increase of 4.67% compared to the same period in 2011. Adifan President José Enrique Silva said the growth in generic drug volumes
(6.00%) was higher than in value terms (4.67%), due to the drug price decreases this year. He said since 2009 there was steady drug price increase in line with the strong Peruvian economy growth. However, prescription drug sales, experienced growth of 5.24% in value terms and a 6.45% increase in volume terms in the first five months of this year.

- The 'play and attack' rules of Peruvian pharmacists have changed after re-composition and natural consolidation of the country's pharmaceutical sector into three groups. The first, most visible effect of the change in tactics is aggressive competition related to offers, discounts and promotions to attract customers, said Boticas Arcángel's CEO, Gustavo Bravo, in November 2012. The second effect was the rise in partnerships, which became apparent when Interbank acquired Inkafarma in January 2011, and Fasa Mifarma collaborated with Banco Falabella.

Major pharmaceutical groups will reportedly continue to rely on promotional tactics, although they will study new movements to expand their operations.

BMI Economic View:

While we anticipate headline growth in Peru to slow in the coming years, as China's hard landing feeds through into a more moderate expansion of the mining sector, we continue to expect the country's economy to remain one of the most dynamic in Latin America. Moreover, we see a number of interesting investment opportunities at the sector level.

BMI Political View:

We see no end to political risk in Peru over the coming quarters, highlighting in particular that the government will continue to struggle to fight insurgent group Sendero Luminoso in one of the country's most dangerous regions. Moreover, with energy and infrastructure investment on the rise,
President Ollanta Humala's ability to provide a stable working environment for firms will be essential to ensuring continued foreign investment in the country.

Executive Summary 7

SWOT Analysis 9

Peru Pharmaceuticals And Healthcare Industry SWOT 9

Peru Political SWOT 10

Peru Economic SWOT 11

Peru Business Environment SWOT 11

Pharmaceutical Risk/Reward Ratings 12
Table: Americas Pharmaceutical Risk/Reward Ratings, Q113 12

Rewards 13

Risks 14

Peru - Market Summary 15

Regulatory Regime 16

Recent Regulatory Developments 17

Pharmaceutical Advertising 18

OTC Medicines 19

Phytotherapeutics 19

Regional Harmonisation 20

Intellectual Property Regime 20

IP Shortcomings 21

Counterfeit Pharmaceuticals 23

Trade Agreements 24

Pricing Regime 25
Table: Peruvian Watchdog of Pharmaceutical Products (Observatorio Peruano de Productos Farmacéuticos, OPPF) 26

Reimbursement Regime 26

Government Tenders 27
Table: Public Procurement of Pharmaceuticals by Provider, 2007-2009 (Million Soles) 28

Pricing And Reimbursement Developments 29

Industry Developments 32

Epidemiology 32
Table: Selected Causes of Death by Sex, 2010 32

Non-Communicable Diseases 35

Communicable Diseases 36

Healthcare Sector 38
Table: MINSA's Decentralised Institutions & Institutes, 2011 38

Healthcare Sector Developments 39

Healthcare Finances 41

Healthcare Provision 42
Table: Infrastructure, 2004-2009 42
Table: Key Goals of Parsalud II In Nine Regions 43

Health Insurance 43

Research and Development (R&D) 44

Clinical Trials 45

Medical Devices 46

Industry Forecast Scenario 48

Pharmaceutical Market Forecast 48
Table: Pharmaceutical Sales Indicators 2008-2016 50

Healthcare Market Forecast 51
Table: Healthcare Expenditure Indicators 2008-2016 52
Table: Healthcare Governmental Indicators 2008-2016 52
Table: Healthcare Private Indicators 2008-2016 53

Key Growth Factors - Macroeconomic 54
Table: Puru Macro Indicators 58

Prescription Drug Market Forecast 59
Table: Prescription Drug Sales Indicators 2008-2016 60

Patented Drug Market Forecast 61
Table: Patented Drug Market Indicators 2008-2016 62

Generic Drug Market Forecast 63
Table: Generic Drug Sales Indicators 2008-2016 66

OTC Medicine Market Forecast 67
Table: OTC Medicine Sales Indicators 2008-2016 68

Pharmaceutical Trade Forecast 69
Table: Exports and Imports Indicators 2008-2016 71

Medical Device Market Forecast 72
Table: Medical Devices Sales Indicators 2008-2016 73

Other Healthcare Data 74

Key Risks To BMI's Forecast Scenario 75

Competitive Landscape 76

Pharmaceutical Sector 76
Table: Peruvian Pharmaceutical Companies That Acquired GMP Accreditation In 2006 76

Table Members of ADIFAN, 2011 77
Table: Members of ALAFARPE, 2011 78
Table: Members of COMSALUD, 2011 78

Foreign Industry 80

Domestic Industry 82
Table: Domestic Production, 1992-2009 82

Pharmaceutical Distribution 83

Pharmaceutical Retail 84

Company Profiles 88

Domestic Companies 88

Farmaindustria 88

Unimed 90

Hersil 91

Multinational Companies 93

Sanofi 93

Merck & Co 94

GlaxoSmithKline 95

Novartis 96

Pfizer 97

AstraZeneca 98

Teva (Corporación Medco) 99

Demographic Outlook 101
Table: Peru's Population By Age Group, 1990-2020 ('000) 02
Table: Peru's Population By Age Group, 1990-2020 (% of total) 03
Table: Peru's Key Population Ratios, 1990-2020 04
Table: Peru's Rural And Urban Population, 1990-2020 04

Glossary 105

BMI Methodology 107

How We Generate Our Pharmaceutical Industry Forecasts 07

Pharmaceuticals Business Environment Ratings 08

Risk/Reward Ratings Methodology 08

Ratings Overview 08
Table: Pharmaceutical Business Environment Indicators 09

Weighting 10
Table: Weighting Of Components 10

Sources 10

Company Profiles
Domestic Companies
Farmaindustria
Unimed
Hersil
Multinational Companies
Sanofi
Merck & Co
GlaxoSmithKline
Novartis
Pfizer
AstraZeneca
Teva (Corporación Medco)

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