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The Middle Eastern Pharmaceutical Market Outlook To 2014: Policy Environment, Market Structure, Competitive Landscape, Growth Opportunities-Aarkstore

Egypt, Turkey, Saudi Arabia, Israel, Jordan, United Arab Emirates, Lebanon and Kuwait are the major countries of the Middle East with a total population of around 213m. Turkey, one of the key pharmerging markets of the world, is a strong proponent of liberal trade and investment policies. It has an open trading system, especially with countries in the EU, with which it forged a customs union agreement in 1996. Among the Gulf countries, Saudi Arabia is considered as the most attractive healthcare market in the Gulf which is mainly because of its rapidly growing population, enormous economic resources.

The Middle East pharmaceutical market is diverse, with a significant presence of leading global players alongside domestic pharmaceutical companies such as Ibrahim, Bilim and Deva. The market dynamics are further shaped by the presence of several leading suppliers of branded generics and APIs (active pharmaceutical ingredients) such as Teva, Hikma, Ibrahim, etc. Although, Middle East countries were a late entrant to the biotech sector, countries like Turkey, Saudi Arabia, UAE and Israel has made a dramatic progress in recent years, which was mainly due to several government initiatives. Moreover, several public-private partnerships also boosted the growth of pharmaceutical sector in the Middle East region.

Key findings

• The Middle East pharmaceutical market was valued at $14.8bn in 2008, registering a y-o-y sales growth of 12.6%, and is forecast to return at a CAGR of 8.1% between 2008 and 2014 to reach a total value of 23.5bn in 2014. The general anti-infective market is expected to generate the highest sales of $3.9bn in 2014, followed by alimentary canal & metabolic disorders at $3.7bn.

• General anti-infectives, alimentary canal & metabolism and cardiovascular disorders remained as top selling therapeutic categories in the Middle East, while registering 2008 sales of $2.6bn, $2.3bn and $1.9bn respectively.

• The leading brands in the Middle East pharmaceutical market had a predominance of respiratory and cardiovascular drugs. However, the top 10 brands constituted a very small fraction of the Middle East market, with other drugs making up 94.1% of the total market in 2008. GSK’s asthma and COPD drug Seretide dominated the market with 2008 sales of $134m, a strong growth of 21% over 2007.

Key features of this report

• The macroeconomic environment in the Middle East countries includes the population profile, disease burden and macroeconomic comparison (involving economic landscape and healthcare spending) for all the major Middle East markets

• Profiles of the healthcare system across the 8 markets (Egypt, Turkey, Saudi Arabia, Israel, Jordan, UAE, Lebanon and Kuwait) of the Middle East region

• Overview of key recent events in the Middle East pharmaceutical market that have impacted treatment trends and sales potential across all the Middle East countries

• Forecasts and analysis of the leading products in the Middle East market over the period 2008–14 spread across the major indications and classes of treatments

Use this report to

• Develop insights for the Middle East pharmaceutical market, pricing & regulation and detailed epidemiological status of the common indications/risk factors across 8 major countries of the Middle East region

• Quickly understand how recent events are affecting the performance of major products, and how their marketers are confronting competitive challenges in the Middle East market place

• Gain up-to-date competitive intelligence across a wide-range of marketed products, R&D pipeline, market share data, sales forecast and competitive landscape for the major players in the Middle East market

Discover

• What will be the major growth indications in the Middle East pharmaceutical market over the period 2008–14?

• Which companies (both multinational and domestic) will become the key players in the Middle East market over the period 2008–14?

• Which products will be impacted by generic competition over the period 2008–14?

• Which products will be the future growth drivers for the Middle East pharmaceutical market?

Which therapeutic categories are predicted to offer substantial commercial opportunity in the forecast period from 2008–14    Table of Contents :  Introduction

Diabetes mellitus is a chronic metabolic disorder that results due to a failure of the body to produce the hormone insulin and/or an inability of the body to respond adequately to circulating insulin. Type 1 diabetes, previously referred to as insulin-dependent diabetes mellitus (IDDM), occurs most commonly in children or young adults and constitutes 5–10% of the diagnosed diabetes patient population. Type 2 diabetes, previously known as adult-onset diabetes or non-insulin-dependent diabetes mellitus (NIDDM), accounts for 90–95% of diagnosed diabetes cases globally and typically develops in middle-aged adults. The 2008 prevalence of diabetes mellitus, together in the seven major markets, was 8.5% with Germany having the highest prevalence rate at 11.8%. But the disease has been growing at epidemic proportions, a fact that has driven extensive R&D in this therapy area.

The global diabetes market was worth $27.3bn in 2008 and was led by insulin analogs which captured 45.0% of the market followed by glitazones that captured a share of 22.8%. US is the largest diabetes market globally with sales of $12.9b in 2008 and a market share of 47.6%. However the highest growth in sales y-o-y was exhibited by several early emerging economies such as UAE at 59.7%.

Scope of this report

• Epidemiological analysis of the therapy area and forecast prevalence over the period 2009-14 .

• Forecasts and analysis of the key products in the diabetes market over the period 2009-14 spread across the major classes of treatments.

• Overview of key events in the global diabetes market that have impacted treatment trends and sales potential.

• Strategic and growth analysis of leading pharmaceutical corporations based on sales focus by drug class, currently marketed products and R&D product portfolios.

Key findings from this report

• Biguanides, mainly comprised of metformin, are the core first line therapy in diabetes care. These drugs have been used in diabetes therapy for over a decade. Some of their advantages include, efficacy, low cost, extensive experience, lack of incidences of hypoglycemia and weight neutrality. Metformin lost patent protection in 2002 and the class is now much genericized and has been ceding market share to other therapies.

• Insulin captured the largest market share (45%) among available diabetes treatments and is likely to dominate the market in the forecast period. However, though insulin analogs have become well established in the market, inhaled insulin is yet to make its mark.

• Significant R&D has been observed in the pre-insulin market leading to the development of several novel and safer therapies. The comparative performance of these therapies, such as the DPP-IV inhibitors and GLP-1 analogs would shape the diabetes market landscape through 2014 and in the long term.

Key issues

• Revised FDA guidelines make the regulatory environment challengingIn December 2008, the FDA announced that the companies developing diabetes drugs will be required to conduct longer and larger studies to avoid any “unacceptable” cardiovascular risk. Companies are now required to conduct meta analyses for cardiovascular safety in the Phase II and III trials and rule out the possibility of an increased ardiovascular disease risk by 80% or more.

• Inhaled insulin still a distant realityInsulin therapy takes up the biggest share of diabetes treatment and has been an area of extensive research. While several different purer forms of insulin have emerged over a period of time, nasally administered insulin is still a distant reality. Inhaled insulin may aid compliance, leading to superior long term outcomes. Pfizer/Nektar’s Exubera was the first to be launched inhaled insulin but it had a troubled launch and was subsequently discontinued in October 2007. The only inhaled insulin which is still under development is Technosphere, being developed by Mannkind/Afresa. This insulin uses a technology that facilitates absorption of proteins and peptides through the pulmonary route.

Use this report to:

• Which companies were the leading players in the diabetes therapy area in 2008?

• How have recent major launches from the key market players performed?

• Which companies will become the key players in the diabetes market over the period 2009-14?

• Which products will be impacted by generic competitors over the period 2009-14?

“Table of ContentsThe Middle Eastern Pharmaceutical Market Outlook to 2014Executive Summary 12The macroeconomic environment in the Middle East 12Healthcare systems in the Middle East 13Pharmaceutical market analysis of the Middle East 14Competitive landscape of the Middle Eastern pharmaceutical market 15Scope and Methodology 18Scope 18Methodology 18Chapter 1 The macroeconomic environment in the Middle East 20Summary 20Introduction 21Population profile 22Disease burden 24Macroeconomic comparison of the Middle East 30Economic landscape of key Middle Eastern countries 32Egypt 32Turkey 33Saudi Arabia 34Israel 35Jordan 36UAE 36Lebanon 38Kuwait 38Healthcare spending 39Chapter 2 Healthcare systems in the Middle East 42Summary 42Introduction 43Profiles of the healthcare systems across Middle Eastern countries 43Egypt 43Healthcare system 43Intellectual property rights 44Pricing and reimbursement 45Key recent events 46Turkey 47Healthcare system 47Intellectual property rights 49Pricing and reimbursement 50Key recent events 52Saudi Arabia 53Healthcare system 53Intellectual property rights 54Pricing and reimbursement 55Key recent events 57Israel 58Healthcare system 58Intellectual property rights 58Pricing and reimbursement 59Key recent events 61Jordan 62Healthcare system 62Intellectual property rights 63Pricing and reimbursement 63Key recent events 64UAE 65Healthcare system 65Intellectual property rights 66Pricing and reimbursement 67Key recent events 68Lebanon 68Healthcare system 68Intellectual property rights 69Pricing and reimbursement 70Key recent events 71Kuwait 71Healthcare system 71Intellectual property rights 72Pricing and reimbursement 72Key recent events 73Chapter 3 Pharmaceutical Market analysis in the Middle East 76Summary 76Introduction 77Pharmaceutical market overview 77Therapy area analysis 80Therapy area sales forecast 81Therapy area analysis by country 82Egypt 82Turkey 85Saudi Arabia 88Israel 90Jordan 93UAE 94Lebanon 97Kuwait 100Leading brands analysis 103Seretide (GSK) 104Lipitor (Pfizer) 104Augmentin (GSK/MUP) 104Glivec (Novartis) 105Co-Diovan (Novartis) 105Spiriva (Boehringer Ingelheim) 106Plavix (Sanofi-Aventis) 106Cipralex (Lundbeck) 107Lansor (Sanovel) 107Symbicort (AstraZeneca) 108Leading brands sales forecast 108Key brand analysis by country 110Egypt 110Flumox and Cefotax (Eipico) 110Amaryl (Sanofi-Aventis) 111Cataflam (Novartis) 111Augmentin (MUP) 111Turkey 112Foradil Combi (Novartis) 113Taxotere (Sanofi-Aventis) 113Herceptin (Roche) 114Saudi Arabia 114Augmentin (GSK) 115Snafi (Spimaco) 116 (Pfizer) 116Nexium (AstraZeneca) 116Israel 116Norditropin (Novo Nordisk) 117Seretide (GSK) 118Tritace (Sanofi-Aventis) 118Jordan 118Amoclan (Hikma) 119Similac Gain and Similac Advance (Abbott Nutrition) 119Cerelac (Nestle) 120United Arab Emirates 121 (Eli Lilly) 121Plavix (Sanofi-Aventis) 122Zinnat (GSK) 122Lebanon 122Pariet (J&J) 123Concor (Merck KGaA) 123Crestor (AstraZeneca) 124Kuwait 124Rocephin (Roche) 125Xenical (Roche) 125Yasmin (Bayer) 126Chapter 4 Competitive landscape of the Middle Eastern pharmaceutical market 128Summary 128Introduction 129Leading players 129Analysis of key players in the Middle East 133Novartis 133Overview 133Sales focus by leading drug class 133Marketed product portfolio 135Novartis’ pipeline focus 138Strategic growth analysis 139GSK 142Overview 142Sales focus by leading drug class 142Marketed product portfolio 144GSK’s pipeline focus 146Strategic growth analysis 147Sanofi-Aventis 150Overview 150Sales focus by leading drug class 150Marketed product portfolio 152Sanofi-Aventis pipeline focus 154Strategic growth analysis 155Pfizer 157Overview 157Sales focus by leading drug class 157Marketed product portfolio 159Pfizer’s pipeline focus 161Strategic growth analysis 162Ibrahim 165Overview 165Sales focus by leading drug class 166Marketed product portfolio 167Ibrahim’s pipeline focus 169Strategic growth analysis 169Leading players analysis by country 171Egypt 171Turkey 172Saudi Arabia 174Israel 176Jordan 178UAE 180Lebanon 182Kuwait 183Chapter 5 Appendix 186Anatomical therapeutic classification (ATC) 186A: Alimentary tract and metabolism 186B: Blood and blood-forming organs 186C: Cardiovascular system 186D: Dermatologicals 187G: Genitourinary system and sex hormones 187H: Systemic hormonal preparations 187J: General anti-infectives systemic 187K: Hospital solutions 187L: Antineoplastic and immunomodulating agents 187M: Musculoskeletal system 188N: Nervous system 188P: Parasitology 188R: Respiratory system 188S: Sensory organs 188T: Diagnostic agents 188V: Various 189Forecast factors 189Glossary 190Index 191

List of FiguresFigure 1.1: GDP composition by sector in key Middle East countries, 2008 32Figure 1.2: Comparison of healthcare expenditure across major Middle Eastern countries 39Figure 3.3: Middle East pharmaceutical market share by countries, 2008 79Figure 3.4: Top 10 drug classes in the Egyptian pharmaceutical market, 2008 ($m) 85Figure 3.5: Top 10 drug classes in the Turkish pharmaceutical market, 2008 ($m) 87Figure 3.6: Top 10 drug classes in the Saudi Arabian pharmaceutical market, 2008 ($m) 90Figure 3.7: Top 10 drug classes in the Israel pharmaceutical market, 2008 ($m) 92Figure 3.8: Top 10 drug classes in the Jordanian pharmaceutical market, 2008 ($m) 94Figure 3.9: Top 10 drug classes in the UAE pharmaceutical market, 2008 ($m) 97Figure 3.10: Top 10 drug classes in the Lebanese pharmaceutical market, 2008 ($m) 100Figure 3.11: Top 10 drug classes in the Kuwaiti pharmaceutical market, 2008 ($m) 102Figure 4.12: Market share of top 10 and other players in the Middle East pharmaceutical market, 2008 132Figure 4.13: Novartis’ Middle East pharmaceutical market sales by therapy area, 2008 134Figure 4.14: GSK’s Middle East pharmaceutical market sales by therapy area, 2008 143Figure 4.15: Sanofi-Aventis’ Middle East pharmaceutical market sales by therapy area, 2008 151Figure 4.16: Pfizer’s Middle East pharmaceutical market sales by therapy area, 2008 158Figure 4.17: Ibrahim’s Middle East pharmaceutical market sales by therapy area, 2008 166

List of TablesTable 1.1: Demographic profile of key Middle East countries 23Table 1.2: Forecast epidemiology of common risk factors in Egypt, 2008–14 25Table 1.3: Forecast epidemiology of common risk factors in Turkey, 2008–14 25Table 1.4: Forecast epidemiology of common risk factors in Saudi Arabia, 2008–14 26Table 1.5: Forecast epidemiology of common risk factors in Israel, 2008–14 27Table 1.6: Forecast epidemiology of common risk factors in Jordan, 2008–14 27Table 1.7: Forecast epidemiology of common risk factors in UAE, 2008–14 28Table 1.8: Forecast epidemiology of common risk factors in Lebanon, 2008–14 29Table 1.9: Forecast epidemiology of common risk factors in Kuwait, 2008–14 30Table 1.10: Key economic metrics of Middle East countries, 2008 31Table 3.11: Pharmaceutical sales in major Middle East countries, 2008 78Table 3.12: Middle East pharmaceutical sales by therapy area, 2008 81Table 3.13: Middle East pharmaceutical market sales forecast by ATC code, 2008–14 82Table 3.14: Egypt’s pharmaceutical market by therapy area sales, 2008 83Table 3.15: Turkey’s pharmaceutical market by therapy area sales, 2008 86Table 3.16: Saudi Arabia’s pharmaceutical market break-down by therapy area sales, 2008 89Table 3.17: Israel’s pharmaceutical market by therapy area sales, 2008 91Table 3.18: Jordan’s pharmaceutical market breakdown by therapy area sales, 2008 93Table 3.19: UAE’s pharmaceutical market by therapy area sales, 2008 96Table 3.20: Lebanon’s pharmaceutical market by therapy area sales, 2008 98Table 3.21: Kuwait’s pharmaceutical market by therapy area sales, 2008 101Table 3.22: Leading brands in the Middle East pharmaceutical market, 2008 103Table 3.23: Leading brand sales forecast, 2008–14 109Table 3.24: Leading brands in the Egyptian pharmaceutical market, 2008 110Table 3.25: Leading brands in the Turkish pharmaceutical market, 2008 112Table 3.26: Leading brands in the Saudi Arabian pharmaceutical market, 2008 115Table 3.27: Leading brands in the Israeli pharmaceutical market, 2008 117Table 3.28: Leading brands in the Jordanian pharmaceutical market, 2008 119Table 3.29: Leading brands in the UAE pharmaceutical market, 2008 121Table 3.30: Leading brands in the Lebanese pharmaceutical market, 2008 123Table 3.31: Leading brands in the Kuwaiti pharmaceutical market, 2008 125Table 4.32: Leading companies in the Middle East pharmaceutical market, 2008 130Table 4.33: Novartis’ leading brands in the Middle East market, 2008 136Table 4.34: GSK’s leading brands in the Middle East market, 2008 145Table 4.35: Sanofi-Aventis’ leading brands in the Middle East market, 2008 152Table 4.36: Pfizer’s leading brands in the Middle East market, 2008 159Table 4.37: Ibrahim’s leading brands in the Middle East market, 2008 168Table 4.38: Leading companies in the Egyptian pharmaceutical market, 2008 171Table 4.39: Leading companies in the Turkish pharmaceutical market, 2008 173Table 4.40: Leading companies in the Saudi Arabian pharmaceutical market, 2008 175Table 4.41: Leading companies in the Israeli pharmaceutical market, 2008 177Table 4.42: Leading companies in the Jordanian pharmaceutical market, 2008 179Table 4.43: Leading companies in the UAE pharmaceutical market, 2008 181Table 4.44: Leading companies in the Lebanese pharmaceutical market, 2008 182Table 4.45: Leading companies in the Kuwaiti pharmaceutical market, 2008 184  For More information please contact :

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