Latvia Pharmaceuticals and Healthcare Report Q4 2011

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Latvia Pharmaceuticals and Healthcare Report Q4 2011 Published on August 2011

Report Summary BMI View: Latvia's disease profile and relatively low per-capita consumption of pharmaceuticals (compared with the rest of developed Europe) is a clear illustration of the need for innovative medicines. However, the performance of the pharmaceutical market remains indelibly tied to the country's macroeconomic environment. Having endured a three-year depression, the economy is finally set to return to positive growth in 2011. However, the road back to prosperity will be long, with private consumption still lagging behind the country's broader economic recovery, threatening the return of the predominantly out-of-pocket driven pharmaceutical market.

Headline Expenditure Projections - Pharmaceuticals: LVL267mn (US$500mn) in 2010 to LVL277mn (US$561mn) in 2011; +4.1% in local currency terms and +12.2% in US dollar terms. - Healthcare: LVL915mn (US$1.72bn) in 2010 to LVL936mn (US$1.89bn) in 2011; +2.3% in local currency terms and +10.3% in US dollar terms. - Medical devices: LVL54mn (US$102mn) in 2010 to LVL56mn (US$113mn) in 2011; +2.5% in local currency terms and +10.5% in US dollar terms. Business Environment Rating: Of the 20 markets analysed by BMI in the Emerging Europe region, Latvia has fallen by two places in Q411 to 12th place, down from 10th place in Q311, with an overall score of 51.9.We do not envisage Latvia challenging any of the top five Emerging Europe markets, given the limitations of its population size, among other factors. Key Trends & Developments - In February 2011, the Latvian Ministry of Health and the country's Health Economics Centre launched an information campaign to raise awareness the affordability and effectiveness of genetic medicines. - As stated by the Latvian State Agency of Medicines (SAM), a reduced VAT rate was applied to medical devices for individual use as of June 2011. These include single-use medical devices that are disposed of after use (such as syringes, gloves, catheters), custom-made medical devices (such as spectacles, prosthetics) and self-care medical devices (such as wheelchairs, functional beds, glucose monitors, respiratory monitors). BMI Economic View: The Latvian economy is firing back up. Although deleveraging and fiscal consolidation are major headwinds, the export sector is booming and financial stability has improved significantly. Success in overhauling public finances has not only secured the admiration of other indebted states, but has also resulted in Fitch upgrading Latvia's sovereign debt to investment grade from junk. We believe the progress made in economic and fiscal reform will pave the way for eurozone accession by 2014. BMI Political View: Latvia's economic fortunes have undergone a marked turnaround following its emergence from a three-year depression, with the government proving particularly adept in fiscal reform. However, with the consolidation programme on track, focus will shift towards two major challenges during this parliamentary term: reducing double-digit unemployment and securing membership to the eurozone.

Table of Content Executive Summary 5

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>> Get this Report Now by email! SWOT Analysis 7 Latvia Pharmaceuticals And Healthcare Industry SWOT . 7 Latvia Political SWOT .. 8 Latvia Economic SWOT 9 Latvia Business Environment SWOT ... 10 Pharmaceutical Business Environment Ratings 11 Table: Emerging Europe ' Regional Pharmaceuticals Business Environment Ratings, Q411 ... 11 Rewards .. 12 Risks ... 12 Latvia ' Market Summary .. 14 Regulatory Regime 15 Regional Collaboration .. 15 Corruption .. 16 Intellectual Property Developments 17 Pricing Regime ... 18 Pricing Changes . 18 Reimbursement Regime ... 20 Table: Latvia - Number of Pharmaceutical Products*** 21 Industry Developments. 22 Epidemiology .. 22 Communicable Disease ... 23 Healthcare Sector ... 24 Healthcare Provision .. 25 Biotechnology . 26 Clinical Trials . 28 Medical Devices.. 28 Industry Forecast Scenario ... 30 Overall Market Forecast. 30 Table: Pharmaceutical Sales, Historical Data and Forecasts . 31 Key Growth Factors ' Industry... 32 Table: Latvia Healthcare Expenditure, Historical Data and Forecasts ... 33 Key Growth Factors ' Macroeconomic .. 35 Table: Latvia ' Economic Activity .. 38 Prescription Market Forecast . 39 Table: Prescription Drug Sales, Historical Data and Forecasts . 40 Table: Latvia - Medicines Consumption by ATC Groups (LVLmn)* 41 Patented Drug Market Forecast . 42 Table: Patented Drug Sales, Historical Data and Forecasts ... 43 Generic Drug Market Forecast ... 44 Table: Generic Drug Sales, Historical Data and Forecasts ... 45 OTC Medicine Market Forecast . 46 Table: Over-The-Counter (OTC) Medicine Sales, Historical Data and Forecasts .. 47 Medical Device Market Forecast 48 Table: Medical Device Sales, Historical Data and Forecasts .. 49 Pharmaceutical Trade Forecast . 50 Table: Exports, Imports and Balance . 52 Other Healthcare Data Forecasts ... 53 Key Risks To BMI's Forecast Scenario ... 54

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>> Get this Report Now by email! Competitive Landscape 55 Pharmaceutical Industry . 55 Table: Medicines Consumption According to Marketing Authorisation Holders (turnover in LVL) in 2009 ... 56 Recent Pharmaceutical Company Developments 57 Pharmaceutical Wholesale . 59 Table: Latvia - Wholesale Mark-Up Scheme for Reimbursable Pharmaceuticals, 2008 .. 60 Pharmaceutical Retail 60 Table: Latvia - Pharmacy Mark-Up scheme for Reimbursable Pharmaceuticals, 2008 .. 60 Table: Latvia Pharmacies And Pharmacy Market Ratios, 2004-2009 . 62 Company Monitor .. 63 Indigenous Company Profiles .. 63 Grindeks (includes Tallinn Pharmaceutical Plant) . 63 Olainfarm ... 67 Multinational Company Profiles .. 70 Pfizer .. 70 GlaxoSmithKline . 72 Sanofi-Aventis . 74 Novartis .. 76 Merck & Co 78 Country Snapshot: Latvia Demographic Data. 80 Section 1: Population .. 80 Table: Demographic Indicators, 2005-2030 ... 80 Table: Rural/Urban Breakdown, 2005-2030 .. 81 Section 2: Education And Healthcare . 81 Table: Education, 2002-2005 . 81 Table: Vital Statistics, 2005-2030 ... 81 Section 3: Labour Market And Spending Power . 82 Table: Employment Indicators, 2001-2006 . 82 Table: Consumer Expenditure, 2000-2012 (US$) ... 83 Table: Average Annual Wages, 2000-2012 . 83 Pharmaceutical And Healthcare Glossary ... 84 BMI Methodology .. 86 How We Generate Our Pharmaceutical Industry Forecasts ... 86 Risk/Reward Ratings Methodology . 87 Ratings Overview 87 Table: Pharmaceutical Business Environment Indicators .. 88 Weighting 89 Table: Weighting Of Components ... 89

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