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United States Pharmaceuticals and Healthcare Report Q3 2012

Business Monitor International, July 2012, Pages: 104

The United States Pharmaceuticals and Healthcare Report provides industry professionals and strategists, corporate analysts, pharmaceutical associations, government departments and regulatory bodies with independent forecasts and competitive intelligence on United States's pharmaceuticals and healthcare industry.

BMI View: The US pharmaceutical market is entering a period of relative stagnation. Patent expiries, fewer insured patients and greater use of rebates and discounts are creating severe headwinds to growth.

A major downside risk is reduced tolerance for medicine price increases from payers, both public and private. We stress, however, that the US pharmaceutical market is still the most attractive globally, due to its large size and rapid uptake of newly approved innovative, and therefore high-priced, medicines.

Headline Expenditure Projections
- Pharmaceuticals: US$337.1bn in 2011 to US$343.1bn in 2012; +1.8% growth in local currency terms. Market size increased since Q212 due to new historic data, resulting in an upgraded forecast.

- Healthcare: US$2,708bn in 2011 to US$2,864bn in 2011; +5.8% growth in local currency terms. Market size increased since Q212 due to new historic data, resulting in an upgraded forecast.

- Medical devices: US$133bn in 2010 to US$139bn in 2011; +4.4% growth in local currency terms. Forecast is up slightly from Q212 due to new historic data.

Risk/Reward Rating: The US Pharmaceutical Risk/Reward Rating (RRR) for Q312 is 79.1 out of 100, which is unchanged from the previous quarter. The country scores well above average for all indicators, except market growth, which is in the low single-digits. Key attributes include transparent regulations, an ageing population and a stable economic/political framework.

Key Trends And Developments
- In May 2012, BMI switched its primary data provider for US OTC medicine sales from the Association of the European Self-Medication Industry (AESGP) to the Consumer Healthcare Products Association (CHPA), which provides more reliable numbers over a longer time frame.

- In May 2012, Swiss pharmaceuticals firm Novartis acquired US dermatology specialist Fougera. The acquisition reportedly cost Novartis US$1.525bn and will allow it to emerge as a global leader in the production of generic dermatology treatments.

- In April 2012, a ruling by the US Supreme Court allowed generic drug manufacturers to challenge attempts from pharmaceutical firms to extend the remit of existing patent descriptions. The ruling overrides a decision by the court of appeals in 2010. It follows Novo Nordisk's efforts to amend the phrasing of a patent covering its Prandin (repaglinide) drug.

- In April 2012, BMI revised upwards its forecast for the US pharmaceutical market, following the receipt of newly released historic data. We now expect combined sales of prescription drugs and over-the-counter medicines to increase from US$337bn in 2011 to US$343bn in 2012, equating to 1.8% growth.

The US Food and Drug Administration (FDA) gained the authority to approve biosimilars as part of the Patient Protection and Affordable Care Act (PPAC Act) signed by President Barack Obama on March 23 2010, which is also referred to as the Biologics Price Competition and Innovation Act 2009 (BPCI Act).

BMI Economic View: With the bounce in US growth in the latter part of 2011 set to moderate as 2012 progresses, we are maintaining our 2012 real GDP growth forecast of 2.0%, followed by 2.4% in 2013.

The biggest risks come from abroad, with the European debt and economic crisis representing a constant threat to US economic stability.

BMI Political View: The November 2012 presidential and congressional elections are finely poised. The Republican Party is set to gain ground on the Democratic Party in the Senate, but the presidential race is much tougher to call. The outcome of the elections will be crucial in determining medium-term policy direction. But in the interim we expect continued policy paralysis.

Executive Summary 5

SWOT Analysis 7

US Pharmaceuticals And Healthcare Industry SWOT 7

United States Political SWOT 8

United States Economic SWOT 8

United States Business Environment SWOT 9

Pharmaceutical Risk/Reward Ratings 10
Table: Americas Pharmaceutical Risk/Reward Ratings, Q312 10

Rewards 11

Risks 12

US – Market Summary 13

Regulatory Regime 15

Innovative Drug Regulations 16

Generic Drug Regulations 18

Biosimilar Regulations 20

OTC Medicine Regulations 22

Medical Device Regulations 23

Promotion Regulations 24

Intellectual Property Regulations 26

Pricing And Reimbursement Environment 27

Part D 29

Industry Developments 30

Epidemiology 30

Healthcare Sector 31

Research & Development Sector 32

Clinical Trials 33

Contract/Clinical Research Organisations 34

Medical Device Industry 35

Industry Forecast Scenario 36

Pharmaceutical Market Forecast 36
Table: Pharmaceutical Sales Indicators 2008-2016 38

Key Growth Factors – Industry 39
Table: Healthcare Expenditure Indicators 2008-2016 41
Table: Healthcare Governmental Indicators 2008-2016 41
Table: Healthcare Private Indicators 2008-2016 42

Key Growth Factors – Macroeconomic 43
Table: US GDP By Expenditure, Real Growth, 2008-2016 54

Prescription Drug Market Forecast 55
Table: Prescription Drug Sales Indicators 2008-2016 56
Table: Top 10 Therapeutic Classes By Sales (US$bn) 57
Table: Top 10 Therapeutic Classes By Dispensed Prescriptions (mn) 57

Patented Drug Market Forecast 58
Table: Patented Drug Market Indicators 2008-2016 59

Generic Drug Market Forecast 60
Table: Generic Drug Sales Indicators 2008-2016 61

OTC Medicine Market Forecast 62
Table: OTC Medicine Sales Indicators 2008-2016 63

Medical Device Market Forecast 64
Table: Medical DevicesSales Indicators 2008-2016 65

Pharmaceutical Trade Forecast 66
Table: Exports And Imports Indicators 2008-2016 68

Key Risks To our Forecast Scenario 69

Competitive Landscape 70

Research-Based Industry 70
Table: Top 10 Companies By US Prescription Sales (US$bn) 71
Table: Top 10 Drugs By US Sales (US$bn) 71

Research-Based Industry – Key Developments 72

Generic Drugmakers 72
Table: Top 10 Companies By US Dispensed Prescriptions (mn) 73

Drug Distribution Sector 73

Pharmacy Retail Sector 75
Table: US Dispensed Prescription Drug Distribution By Channel Distribution Volume (mn) 76

Company Profiles 77

US Companies 77

Pfizer 77

Merck & Co 81

Eli Lilly 84

Amgen 86

Watson Pharmaceuticals 88

Foreign Companies 90

GlaxoSmithKline 90

AstraZeneca 92

Demographic Outlook 94
Table: Population By Age Group, 1990-2020 (‘000) 95
Table: Population By Age Group, 1990-2020 (% of total) 96
Table: Key Population Ratios, 1990-2020 97
Table: Rural And Urban Population, 1990-2020 97

Glossary 98

BMI Methodology 100

How We Generate Our Pharmaceutical Industry Forecasts 100

Pharmaceuticals Business Environment Ratings 101

Risk/Reward Ratings Methodology 101

Ratings Overview 101
Table: Pharmaceutical Business Environment Indicators 102

Weighting 103
Table: Weighting Of Components 103

Sources 103

Pfizer

Merck & Co

Eli Lilly

Amgen

Watson Pharmaceuticals

GlaxoSmithKline

AstraZeneca

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