Healthcare financing 21

Pharmaceutical expenditure in the context of healthcare spends 25

Private and public sources of healthcare financing 27

Epidemiological analysis 29

Major disease states 30

Structural challenges to pharmaceutical marketers in the BRIC countries 34

Healthcare delivery 35

Social aspects 35

Market factors 35

Pricing and reimbursement 36

Healthcare reform in the BRIC countries 38

Brazil 41

Healthcare system 41

Healthcare financing and expenditure 47

Political and regulatory issues 49

Russia 51

Healthcare system 51

Healthcare financing and expenditure 56

Pricing and reimbursement 57

Political and regulatory issues 58

India 59

Healthcare system 59

Healthcare financing and expenditure 63

Pricing and reimbursement 65

Political and regulatory issues 66

China 67

Healthcare system 67

Healthcare financing and expenditure 71

Pricing and reimbursement 73

Political and regulatory issues 74

Comparative dynamics between the BRIC markets and the global market 81

Market composition by therapeutic areas 84

Cardiovascular market analysis 87

CNS disorders market analysis 92

Cancer market analysis 98

Respiratory market analysis 102

Anti-infectives market analysis 106

Minor therapeutic areas analysis 112

Forecast sales by therapy area 113

Market breakdown by country 123

Brazil 124

India 125

China 126

Cardiovascular 129

CNS disorders 130

Cancer 132

Anti-infectives 133

Respiratory 135

Other therapeutic areas 136

Current and future potential 139

Brazil 148

Russia 151

India 153

China 155

Key multinational players 159

Sanofi-Aventis 159

Novartis 163

Pfizer 167

GlaxoSmithKline 171

Key medium-sized international players 175

Gedeon Richter 175

Servier 180

Menarini 184

Key Brazilian regional players 188

Aché Laboratórios Farmacêuticos 188

EMS 192

Medley 195

Key Indian regional players 198

Cipla 198

Nicholas Piramal 203

Key Chinese regional players 214

HLJ. Harbin 214

Jiang Su Hengrui Medicine 217

Yangzijiang/Yangtze River Group 221

Competitive strategy of key multinational players in the BRIC markets 227

Competitive strategy of key medium-sized players in the BRIC markets 229

Competitive strategy of regional pharmaceutical players in the BRIC markets 230

Brazil 230

India 232

China 233

List of Figures

Figure 1.1: Comparison of pharmaceutical sales in the markets of BRIC, EU5, US and Japan, 2005 20

Figure 1.2: Average total health expenditure as a proportion of GDP for BRIC, EU5 and the US, 2000-04 22

Figure 1.3: Healthcare expenditures across the four BRIC countries, 2004 23

Figure 1.4: Comparison of spends on pharmaceuticals between the US, 5 major EU markets and the BRIC markets, 2004 25

Figure 1.5: Private healthcare expenditure as a percentage of total healthcare expenditure in the BRIC countries, 2004 27

Figure 1.6: Structural challenges to pharmaceutical marketers in the BRIC countries 34

Figure 1.7: Major challenges in healthcare reform in the BRIC countries 39

Figure 1.8: Average total health expenditure as % of GDP for Brazil and the BRIC economies, 2000-04 43

Figure 1.9: Summary structure of Brazilian healthcare system 46

Figure 1.10: Summary structure of the Russian healthcare system 53

Figure 1.11: Average total health expenditure as % of GDP for Russia and the BRIC economies, 2000-04 54

Figure 1.12: Summary structure of the Indian healthcare system 60

Figure 1.13: Average total health expenditure as % of GDP for India and the BRIC economies, 2000-04 62

Figure 1.14: Summary structure of Chinese healthcare system 68

Figure 1.15: Average total health expenditure as % of GDP for China and the BRIC economies, 2000-04 70

Figure 1.16: Average private health expenditure for China, 2000-04 72

Figure 2.17: Cardiovascular market breakdown by therapy area sales for individual markets of BRIC, 2001-2005 92

Figure 2.18: CNS market breakdown by therapy area sales for individual markets of BRIC, 2001- 2005 97

Figure 2.19: Cancer market breakdown by therapy area sales for individual markets of BRIC, 2001- 2005 101

Figure 2.20: Respiratory market breakdown by therapy area sales for individual markets of BRIC, 2001-2005 105

Figure 2.21: Anti-infectives market breakdown by therapy area sales for individual markets of BRIC, 2001-2005 111

Figure 3.22: Comparison of sales in the global and BRIC markets by product category, 2005 122

Figure 3.23: Comparison of sales in the BRIC market by product category, 2005 127

Figure 3.24: Penetration of original brands across therapy areas in the BRIC markets, 2005 140

Figure 3.25: Forecast prospects for market development of major categories of brands by indication, 2006-11 141

Figure 4.26: Breakdown of the leading pharmaceutical companies in the BRIC markets, 2005 145

Figure 4.27: Growth dynamics of the leading pharmaceutical companies in Brazil, 2005 150

Figure 4.28: Growth dynamics of the leading pharmaceutical companies in Russia, 2005 152

Figure 4.29: Growth dynamics of the leading pharmaceutical companies in India, 2005 154

Figure 4.30: Growth dynamics of leading pharmaceutical companies in China, 2005 156

Figure 5.31: Presence of multinational pharmaceutical players in the BRIC market, 2005 227

Figure 5.33: Presence of domestic Brazilian pharmaceutical players in the BRIC market, 2005 231

Figure 5.34: Presence of domestic Indian pharmaceutical players in the BRIC market, 2005 232

Figure 5.35: Presence of domestic Chinese pharmaceutical players in the BRIC market, 2005 234

List of Tables

Table 1.1: Recent statistics on healthcare sector in the BRIC markets, 2004 24

Table 1.2: Comparison of spends on pharmaceuticals between the US, 5 major EU markets and the BRIC markets, 2004 26

Table 1.3: Public and private healthcare financing in the BRIC markets, 2004 28

Table 1.4: Prevalence rates of cardiovascular diseases among the 4 BRIC markets, 2004 30

Table 1.5: Incidence rates* of cancer among the 4 BRIC markets, 2004 31

Table 1.6: Summary of pricing and reimbursement policies across the BRIC markets, 2004 37

Table 1.7: Number of healthcare facilities in Brazil by type of care and type of holding facility, 1980-2002 44

Table 1.8: Health system expenditure & financing in Brazil, 2000-04 47

Table 1.9: Healthcare facility statistics for Russia, 2000-04 55

Table 1.10: Health system expenditure & financing in Russia, 2000-04 56

Table 1.11: Health system expenditure & financing in India, 2000-04 63

Table 1.12: Health system expenditure & financing in China, 2000-04 71

Table 2.13: Pharmaceutical market dynamics across the BRIC countries, 2004-05 80

Table 2.14: Breakdown of sales by major therapeutic area across the combined BRIC market, 2004–05 81

Table 2.15: Breakdown of sales by major therapeutic area across the global market, 2004–05 82

Table 2.16: Breakdown of sales by therapeutic area across the BRIC and the global markets, 2005 84

Table 2.17: Sales by major classes across the BRIC cardiovascular market, 2004–05 87

Table 2.18: Cardiovascular sales in the BRIC markets by indication and country, 2004-05 90

Table 2.19: Sales by major classes across the BRIC CNS market, 2004–05 93

Table 2.20: CNS sales in the BRIC markets by indication and country, 2004-05 95

Table 2.21: Sales by major classes across the BRIC cancer market, 2004-2005 98

Table 2.22: Cancer sales in the BRIC markets by indication and country, 2004-05 99

Table 2.23: Sales by major classes across the BRIC respiratory market, 2004–05 102

Table 2.24: Respiratory sales in the BRIC markets by indication and country, 2004-05 103

Table 2.25: Sales by major classes across the BRIC anti-infectives market, 2004–05 106

Table 2.26: Anti-infectives sales in the BRIC markets by indication and country, 2004-2005 108

Table 2.27: Sales of other therapeutic categories in the BRIC markets, 112

Table 2.28: Forecast sales by therapeutic area across the BRIC markets, 2005-11 114

Table 3.29: Sales in the BRIC countries and global pharmaceutical markets by product category, 2004-05 120

Table 3.30: Sales in the BRIC pharmaceutical markets by category, 2004-05 123

Table 3.31: Therapeutic sales in the BRIC pharmaceutical markets by product category, 2005 128

Table 3.32: Sales of cardiovascular therapeutics in the BRIC markets by product category, 2005 129

Table 3.33: Sales of CNS therapeutics in the BRIC markets by product category, 2005 130

Table 3.34: Sales of cancer therapies in the BRIC markets by product category, 2005 132

Table 3.35: Sales of anti-infectives in the BRIC markets by product category, 2005 133

Table 3.36: Sales of respiratory in the BRIC markets by product category, 2005 135

Table 3.37: Licensing trends in other therapeutic areas of the BRIC markets, 2005 136

Table 4.38: Sales of leading companies in the BRIC markets, 2004-05 147

Table 4.39: Sales of leading pharmaceutical companies in Brazil, 2004-05 149

Table 4.40: Sales of leading pharmaceutical companies in Russia, 2004-05 151

Table 4.41: Sales of leading pharmaceutical companies in India, 2004-05 153

Table 4.42: Sales of leading pharmaceutical companies in China, 2004-05 155

Table 5.43: Sanofi-Aventis’ sales by country in the BRIC pharmaceutical markets, 2004-05 160

Table 5.44: Sanofi-Aventis’ portfolio sales in the BRIC pharmaceutical markets, 2004-05 161

Table 5.45: Novartis’ sales by country in the BRIC pharmaceutical markets, 2004-05 164

Table 5.46: Novartis’ portfolio sales in the BRIC pharmaceutical markets, 2004-05 165

Table 5.47: Pfizer’s sales by country in the BRIC pharmaceutical markets, 2004-05 167

Table 5.48: Pfizer’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 168

Table 5.49: GSK’s sales by country in the BRIC pharmaceutical markets, 2004-05 171

Table 5.50: GSK’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 172

Table 5.51: Gedeon Richter’s sales by country in the BRIC pharmaceutical markets, 2004-05 176

Table 5.52: Gedeon Richter’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 176

Table 5.53: Gedeon Richter’s corporate agreements, 2000-2006 178

Table 5.54: Servier’s sales by country in the BRIC pharmaceutical markets, 2004-05 180

Table 5.55: Servier’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 181

Table 5.56: Servier’s corporate agreements, 2000-2006 183

Table 5.57: Menarini’s sales by country in the BRIC pharmaceutical markets, 2004-05 184

Table 5.58: Menarini’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 185

Table 5.59: Menarini’s corporate agreements, 2000-2006 186

Table 5.60: Aché’s sales by country in the BRIC pharmaceutical markets, 2004-05 188

Table 5.61: Ache’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 189

Table 5.62: Aché’s corporate agreements, 2000-2006 191

Table 5.63: EMS’ sales by country in the BRIC pharmaceutical markets, 2004-05 192

Table 5.64: EMS’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 193

Table 5.65: EMS’s corporate agreements, 2000-2006 194

Table 5.66: Medley’s sales by country in the BRIC pharmaceutical markets, 2004-05 195

Table 5.67: Medley’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 196

Table 5.68: Medley’s corporate agreements, 2000-2006 197

Table 5.69: Cipla’s sales by country in the BRIC pharmaceutical markets, 2004-05 198

Table 5.70: Cipla’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 199

Table 5.71: Cipla’s corporate agreements, 2000-2006 202

Table 5.72: Nicholas Piramal’s sales by country in the BRIC pharmaceutical markets, 2004-05 203

Table 5.73: Nicholas Piramal’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 204

Table 5.74: Nicholas Piramal’s corporate agreements, 2000-2006 207

Table 5.75: Ranbaxy’s sales by country in the BRIC pharmaceutical markets, 2004-05 209

Table 5.76: Ranbaxy’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 210

Table 5.77: Ranbaxy’s corporate agreements, 2000-2006 213

Table 5.78: HLJ. Harbin’s sales by country in the BRIC pharmaceutical markets, 2004-05 215

Table 5.79: HLJ. Harbin’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 216

Table 5.80: JS.Hengrui’s sales by country in the BRIC pharmaceutical markets, 2004-05 217

Table 5.81: JS.Hengrui’s portfolio sales in the BRIC pharmaceutical markets, 2004-05 218

Table 5.82: JS. Hengrui’s corporate agreements, 2000-2006 220

Table 5.83: Yangtze’s sales by country in the BRIC pharmaceutical markets, 2004-05 221

Table 5.84: Yangtze portfolio sales in the BRIC pharmaceutical markets, 2004-05 222

Table 5.85: Yangtze’s corporate agreements, 2000-2006 224