Healthcare financing in the accession states 20

Private and public sources of healthcare financing 23

Structural challenges to pharmaceutical marketers in the accession states 25

Healthcare delivery 26

Social aspects 28

Market factors 28

Pricing and reimbursement 29

Healthcare reform in the accession countries 30

EU pharmaceutical policy and its implications for accession markets 32

EU competition law 32

Intellectual property rights 33

Marketing approvals 35

Parallel importing and pricing issues 36

Czech Republic 38

Poland 43

Slovenia 47

Latvia 55

Lithuania 60

Estonia 62

Hungary 66

Breakdown of market composition by therapeutic areas 77

Market breakdown by therapeutic areas over the period 2000-04: a

comparison between A8 and EU5 80

Key trends in the accession pharmaceutical markets: therapeutic class specific

analysis 82

Cardiovascular 82

Cardiovascular market analysis 82

Analysis of cardiovascular sales by country, 2000-04 85

Key growth drivers in the cardiovascular market 86

CNS 88

CNS market analysis 88

Analysis of CNS sales by country, 2000-04 90

Key growth drivers in the CNS market 91

Respiratory 92

Respiratory market analysis 93

Analysis of respiratory sales by country, 2000-04 94

Key growth drivers in the respiratory market 95

Anti-infectives 96

Anti-infectives market analysis 96

Analysis of anti-infectives sales by country, 2000-04 98

Key growth drivers in the anti-infectives market 99

Cancer 99

Cancer market analysis 99

Analysis of cancer sales by country, 2000-2004 102

Key growth drivers in the cancer market 103

Others 104

Analysis of sales across other therapeutic areas in the accession

countries, 2000-04 104

Sales forecasts in the accession pharmaceutical market by therapeutic area 105

The A8 113

The EU5 117

Other brands 120

Original brands 122

Licensed brands 125

Unbranded drugs 127

Cardiovascular 131

CNS 133

Cancer 134

Anti-infectives 135

Respiratory 137

Other therapeutic areas 138

Overview of the performance of major companies in the accession region 146

Key regional players 151

Zentiva 151

Gedeon Richter 155

KRKA 161

Polpharma 164

Pliva 167

Key multinational players 171

Novartis 171

Sanofi-Aventis 174

GlaxoSmithKline 178

Servier 181

Pfizer 184

Competitive strategy of key regional players in the accession

pharmaceutical market 189

Competitive strategy of key multinational players in the accession

pharmaceutical market 190

Strategies for companies to succeed within the top therapeutic areas 191

List of Figures

Figure 1.1: Average total health expenditure as a proportion of GDP for EU5 and A8 regions,2000-04 21

Figure 1.2: Structural challenges shaping A8 market development 25

Figure 1.3: Structural challenges in healthcare delivery in the A8 region 27

Figure 1.4: Major challenges in healthcare reform across the A8 region 31

Figure 1.5: Average total health expenditure as % of GDP for the Czech Republic, the A8 and the EU5, 2000-04 39

Figure 1.6: Direct personal expenditure of individuals on health services in the Czech Republic, 2000-04 40

Figure 1.7: Cash expenditure on healthcare paid directly by individuals in the Czech Republic,2004 41

Figure 1.8: Average total health expenditure as % of GDP for Poland, the A8 and the EU5, 2000-04 44

Figure 1.9: Average total health expenditure as % of GDP for Slovenia, the A8 and the EU5,2000-04 47

Figure 1.10: Average total health expenditure as % of GDP for Slovakia, the A8 and the EU5,2000-04 51

Figure 1.11: Average total health expenditure as % of GDP for Latvia, the A8 and the EU5, 2000- 04 55

Figure 1.12: Average total health expenditure as % of GDP for Lithuania, the A8 and the EU5, 2000-04 60

Figure 1.13: Average total health expenditure as % of GDP for Estonia, the A8 and the EU5, 2000-04 63

Figure 1.14: Total health expenditure as % of GDP for Hungary, the A8 and the EU5, 2000-04 66

Figure 1.15: Historic and present challenges in healthcare reform in the A8 71

Figure 2.16: Forecast A8 market composition by therapy area, 2004 and 2011 107

Figure 3.17: Comparison of sales in the A8 and the EU5 by product category, 2004 118

Figure 3.18: Comparison of sales in the A8 pharmaceutical markets by product category, 2004 120

Figure 3.19: Comparison of licensing sales in the A8 pharmaceutical markets, 2004 130

Figure 4.20: Breakdown of the leading pharmaceutical companies in the A8, 2004 145

Figure 4.21: Growth dynamics of the leading pharmaceutical companies in the A8, 2004 149

Figure 4.22: Outlook for leading pharmaceutical companies in the A8 region, 2005-11 188

List of Tables

Table 1.1: Recent statistics on healthcare sector in the A8 markets, 2004 22

Table 1.2: Public and private healthcare financing in the A8 markets, 2004 23

Table 1.3: Summary of pricing and reimbursement policies across the A8 markets 29

Table 1.4: Healthcare resources in the Czech Republic, the A8 and EU5 countries, 2004 42

Table 1.5: Healthcare resources in Poland, the A8 and EU5 countries, 2004 45

Table 1.6: Estimation of expenses for healthcare services in Slovenia, 2000-03 48

Table 1.7: Healthcare resources in Slovenia, the A8 and EU5 countries, 2004 49

Table 1.8: Healthcare resources in Slovakia, the A8 and EU5 countries, 2004 53

Table 1.9: Healthcare resources in Latvia, the A8 and EU5 countries, 2004 57

Table 1.10: Healthcare resources in Lithuania, the A8 and EU5 countries, 2004 61

Table 1.11: Healthcare resources in Estonia, the A8 and EU5 countries, 2004 65

Table 1.12: Healthcare resources in Hungary, the A8 and EU5 countries, 2004 68

Table 2.13: Pharmaceutical market dynamics across the A8 countries, 2000-04 76

Table 2.14: Breakdown of sales by therapeutic areas across the EU5 and A8 markets, 2004 78

Table 2.15: Breakdown of sales by major therapeutic area across EU5, 2000–04 80

Table 2.16: Breakdown of sales by major therapeutic area across A8, 2000–04 81

Table 2.17: Sales by major classes across the cardiovascular market in the A8 countries, 2000–04 83

Table 2.18: Sales by A8 country in the cardiovascular market, 2000 and 2004 85

Table 2.19: Sales by major classes across the CNS market in the A8 countries, 2000–04 88

Table 2.20: Sales by A8 country in the CNS market, 2000 and 2004 90

Table 2.21: Sales by major classes across the respiratory market in the A8 countries, 2000–04 93

Table 2.22: Sales by A8 country in the respiratory market, 2000 and 2004 94

Table 2.23: Sales by major classes across the anti-infectives market in the A8 countries, 2000–04 96

Table 2.24: Sales by A8 country in the anti-infectives market, 2000-2004 98

Table 2.25: Sales by major classes across the cancer market in the A8 countries, 2000–04 100

Table 2.26: Sales by A8 country in the cancer market, 2000-2004 102

Table 2.27: Sales of other therapeutic categories in the A8 countries, 2000-04 105

Table 2.28: Sales forecasts for key therapeutic areas in the A8 market, 2004–11 106

Table 3.29: Sales in the A8 and EU5 pharmaceutical markets by product category, 2000-04 112

Table 3.30: Sales in the A8 pharmaceutical markets by product category, 2000-04 114

Table 3.31: Sales in the A8 pharmaceutical markets by product category, 2000-04 (cont.) 115

Table 3.32: Sales of other brands in the A8 pharmaceutical markets, 2000-04 121

Table 3.33: Sales of original brands in the A8 pharmaceutical markets, 2000-04 123

Table 3.34: Sales of licensed brands in the A8 pharmaceutical markets, 2000-04 125

Table 3.35: Sales of unbranded drugs in the A8 pharmaceutical markets, 2000-04 127

Table 3.36: Therapeutic sales in the A8 pharmaceutical markets by product category, 2004 128

Table 3.37: Sales of cardiovascular therapeutics in the A8 pharmaceutical markets by product category, 2004 132

Table 3.38: Sales of CNS therapeutics in the A8 pharmaceutical markets by product category, 2004 133

Table 3.39: Sales of cancer therapeutics in the A8 pharmaceutical markets by product category, 2004 135

Table 3.40: Sales of anti-infective therapeutics in the A8 pharmaceutical markets by product category, 2004 136

Table 3.41: Sales of respiratory therapeutics in the A8 pharmaceutical markets by product category, 2004 137

Table 3.42: Sales of other therapeutics in the A8 pharmaceutical markets by product category, 2004 139

Table 4.43: Sales of leading pharmaceutical companies in the A8 region, 147

Table 4.44: Zentiva’s sales in the A8 pharmaceutical markets, 2000-04 153

Table 4.45: Zentiva’s corporate agreements, 2003-2006 154

Table 4.46: Gedeon Richter’s sales in the A8 pharmaceutical markets, 2000-04 157

Table 4.47: Gedeon Richter’s corporate agreements, 2000-2006 158

Table 4.48: KRKA’s sales in the A8 pharmaceutical markets, 2000-04 162

Table 4.49: KRKA’s corporate agreements, 2000-2006 162

Table 4.50: Polpharma’s sales in the A8 pharmaceutical markets, 2000-04 165

Table 4.51: Polpharma’s corporate agreements, 2000-2006 165

Table 4.52: Pliva’s sales in the A8 pharmaceutical markets, 2000-04 168

Table 4.53: Pliva’s corporate agreements, 2000-2006 169

Table 4.54: Novartis’ sales in the A8 pharmaceutical markets, 2000-04 172

Table 4.55: Novartis’ corporate agreements, 2000-2006 174

Table 4.56: Sanofi-Aventis’ sales in the A8 pharmaceutical markets, 2000-04 175

Table 4.57: Sanofi-Aventis’ corporate agreements, 2000-2006 177

Table 4.58: GSK’s sales in the A8 pharmaceutical markets, 2000-04 178

Table 4.59: GSK’s corporate agreements, 2000-2006 180

Table 4.60: Servier’s sales in the A8 pharmaceutical markets, 2000-04 182

Table 4.61: Servier’s corporate agreements, 2000-2006 184

Table 4.62: Pfizer’s sales in the A8 pharmaceutical markets, 2000-04 185