Brazil Healthcare Report 2012 v.final

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country report brazil

OVERVIEWpopulation: 205,716,890*

Life expectancy: 70 years (men); 77 years (women)

GDp: $2.1trn

GDp per capita: $11,127

percentage of GDp spent on health: 9

GnI per capita: $9,390

capital: Brasilia

president: Dilma Rousseff

Health Minister: Alexandre Padilha

Language: Portuguese

currency: Real (BRL). Exchange rate: US$1 = R$1.72341

(Source: World Bank, 2010-11), *est. July CIA

EXECUTIVE SUMMARY• BrazilhadahealthcareexpenditureofUS$222.71bn in2011;and was the number one pharmaceutical market in LatinAmericaandthirdinAmerica,withamarketvalueof$25.60bnin2011

• Themedicaldevicesmarketrepresented$4.68bnin2011• Brazil was the largest generic market, at $3.25bn in 2010.Despitethegovernment’sattemptsto increasegenericsuse,patientsandphysiciansstilldonottrustitsquality

• Intellectual property laws remainweak,with the consequentcommercialisationoflegallyambiguousproductsonthemarket

• Highenrolmentrates,lowerlabourcostsandimprovingregulationarecreatinganattractivecentreofR&D;therearecurrentlymorethan2,000clinicaltrialsbeingconductedinBrazil

• Corruptionscandalscontinuetoscarthepoliticallandscape,butthegovernment’santi-corruptiondrivehaspopularsupport

• Thereisstrongfinancialconfidencelinkedtothecentralbankanditsresponsetoshiftingeconomicdynamicsandalsointhegovernment’scommitmenttofiscalsurpluses.

COUNTRY REPORT

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Macro operating environMent GoldmanSachsbelievesthatBrazilcouldbeoneofthefourleadingeconomiesin2050,becauseofagrowthofalmost140percentoverthepastfiveyears,ahugeterritory(26statesandonefederaldistrict),vastpopulation,economicstabilityandpoliticalcertainty.Today,theBrazilianpharmaceuticalmarketisthirdinAmericaandranks top in Latin America,with a 38 per cent share, comparedwith21percentforMexicoand16percentforVenezuela.Brazilalsohasahighhappinessquotientandunitespeoplefromaroundtheworldthroughitsannualcarnival.Brazilwill stage the 2014World Cup and 2016 Olympics, both

ofwhich represent a strong growth in infrastructure investment($200bn).

HealtHcare ServiceS In1988,Brazil created theSistemaÚnicodeSaúde (SUS),whichguaranteeshealthcareforeverybodyunderthetermsitsconstitu-tion. In 2007, the Sistema Unificado y Descentralizado de Salud(SUDS), themain agreement between the government and thestates to implement the SUS, was created. The health systemstillshowsinequalitiesbetweenrichandpoor.Specifically,manychronic and critical diseases such as diabetes, as well as manyformsofcancer,gountreatedduetoa lackofpreventativecare.TheSUShasmore than70,000ambulatoryunits,7,000hospitals(private and public) and holds more than 400m consultationsperyear, including100mwithaspecialist,seeingmostlychronicpatients.TheAgênciaNacionaldeSaudeSuplementar(theBrazilianagency that regulateshealthplans)estimated in2008 that 28.6percentofthepopulationusedonlytheSUS,61.5percentusedamixtureand8.7percentdidnotusetheSUSatall.Theprivateinsurance market includes Supplementary Health (45m people)andDirectPaymentSystem(DPS)(120mpeople).Therichest15percentofthepopulationisresponsibleforover

40percentofmedicineexpenditure.Brazil’shealthcarespendingrepresents almost nine per cent of GDP and Swiss businessnetworkOseccalculatesthatdemandforpharmaceuticalproductsgrowsby10percentayear.Almost200mpeople–20percentofthepopulation–haveprivate insurance. In2010,pharmaceuticalexpenditurereached$20.95bn.

HealtHcare policy & expenditure In 2010, spending on healthcare reached $178.98bn, with anexpected compound annual growth rate (CAGR) of 10.04 percent by 2015, reaching $355.14bn in value at consumer prices.Governmentexpenditureonhealth,whichaccountedfor46.4percentoftotalhealthexpenditurein2010,isforecasttoincreaseinrelative terms to 50.27 per cent of total healthcare spending by2015.InSeptember2011,thegovernmentannouncedthefundingof programmes that prevent, diagnose and treat cervical andbreast cancer.Nearly$5.6mwill be invested tomanagebothoftheseleadingcausesofdeathinBrazilianwomen.InFebruary2011,HealthMinisterAlexandrePadilhaannounced

thatmedicines forhypertensionanddiabeteswouldbesuppliedfreethroughanationwidenetworkofpublicpharmacies–FarmáciaPopular–andalsothroughprivatepharmacychainsthatsubscribeto thegovernment’spopularpharmacyprogramme.Thepopularpharmacyprogrammeworkswith1.5mpatientseverymonth,ofwhich700,000havehypertensionand400,000havediabetes. InBrazil,therearearound32mdiagnosedcasesofhypertensionandapproximatelyeightmillioncasesofdiabetes.Thesefigurescoveronly the diagnosed patients; it is likely that there are actually30-40percentmorecases.While80percentofpatientsrelyonpublichealthcarefordiagnosis,mostpayfortreatmentsfromtheirownpocket.The Brazilian government finances 90 per cent of medicines

to treat other conditions, including asthma, allergic rhinitis,Parkinson’s disease and osteoporosis. This measure is part ofa campaign to cut extreme poverty, as statistics show that thepoorestof thepopulationspend12percentof their incomesonpharmaceuticals. The flagship programme is called PROFARMA,led by the Brazilian Development Bank (BNDES), with a budgetof$1.5bn.Itsmaingoalistocreateagroupofcompetitivephar-maceutical companies to reduce the country’s big pharma tradedeficit.PROFARMArepresentsthefutureoflocalpharmacompanies.

HealtHcare reforM In January 2009, the World Bank approved a $235m loan toBrazil’s Health Network Formation and Quality ImprovementProject (QualiSUS). It focuses on improving healthcare servicesprovidedbySUS,deliveringsystemsfortheprevention,diagnosisandtreatmentofpriorityhealthconditions,withanemphasisonnon-communicablediseases.Theestimatedcostoftheproject is$677m.ThecontinuedgrowthoftheBrazilianeconomyhasmadeprivatehealthcare(DPS)moreaffordable.

pricing and reiMburSeMentThe pricing system is faced with two conflicting forces. Onone side, the goverment is trying to keep prices low in a bidto provide unrestricted healthcare, while on the other is anindustry that wants higher prices to increase its profit levels. InOctober2003,anewagencywascreated–CMED– chargedwithsettingretaildrugpricesandanotherconsumerprice indexwascreated:theproductivityfactor.Theagencyadoptedarefer-encepricingsystemofsorts,whichformulatesitsestimatesonan‘adequatepricecoefficient’basedoneachdruginabasketofnineWesterncountriesandtheproduct’scountryoforigin.Brazilhasabasicreimbursementsystem,restrictedtothepublic

sector, reflecting themarket’s developing nature and traditionalheritage of private provision. The public healthcare system islimited to medicines on the National List of Essential Drugs(RENAME).Governmentpurchasesandreimbursementofso-called‘high-priced medicines’ in 2007 were reportedly budgeted at

Sources: Adapted from Brazilian Pharmaceutical Industry Federation (Febrafarma), Group of Executives of the Pharmaceutical Market (Grupemef), IMS Health, BMI

pHarMaceutical expenditure

BrL29.10bn$16.55bn

over the counter

BrL7.75bn$4.41bn

BrL 36.85bn

prescription

79%

21%



$700m. Total state spending and reimbursement of medicinesstoodat12.3percentofthetotalcentralhealthcarebudget,witharound 70 per cent spent on imported products. Brazil directlyreimbursesmedicinesusedintheSingleHealthSystem(SUS)statehospitalsfor inpatients,aswellasforessentialand‘exceptional’medicines for outpatients in targeted disease groups, includingHIV/AIDS, cancer, diabetes and less common conditions such asChagas disease and endometriosis, covering around 400,000people.InApril2008,afurther225typesofpharmaceuticalingredients

wereexemptedfromPISandCOFINS(federaltaxes).InJuly2010,theCommissionforSocialSecurityandFamilyapprovedproposalsfornewlegislationexemptingdrugsforthetreatmentofdiabetesandhypertensionfromallfederaltaxes.Around51millionpeoplesufferfromthesediseasesinBrazil.TheBraziliangovernmentandpharmaceuticalindustryhaveresumednegotiationsoverreducingICMS (Brazilian sales tax) rates. According to calculations by theBrazilian Institute of Tax Planning, ICMS accounts for 17.5 of thetotal35.7percentaveragetaxcurrentlyaddedtomedicineprices.

diSeaSe burdenNon-communicable chronic diseases were the primary cause of67 per cent of all deaths in the country in 2007. Cardiovasculardiseases, chronic respiratory diseases, cancer anddiabeteswerethe main causes, accounting for a total of 705,500 deaths. Theneed for anti-depressants is increasing rapidly in emergingmarkets, includingBrazil,where theprevalenceofDSM-IVmajordepressiveepisodeswas10.4percentina12-monthperiod.The rapid economic development of Brazil has led to consider-

able transformations in epidemiological trends. The governmentis increasing its efforts to reducemortality rates and prevent anepidemic of chronic non-communicable diseases, mainly throughinvestment in education and prevention. This means there areconsiderablegrowthopportunitiesinthemarketforchronicdiseasemedicinesanddiagnostics.

pHarMaceutical MarketBrazilisrankedtopofthepharmaceuticalmarketsinLatinAmericaand third inNorthAmerica,with amarket valueof $25.60bn in2011.• The government has moved to align the drug regulatoryenvironmentwithinternationalstandards,includingsignif-icantIntellectualProperty(IP)reforms

• Higher government spending on public provision isimprovingaccesstomedicines

• The low-cost generic and biosimilars sectors will play anever greater role as the government seeks to find cost-effectivetreatmentsandsuppresscounterfeitdrugs

• Exports will continue to grow as both local and foreigncompanieslooktoexpandactivityandfocusonBrazilasaregional hub

• As happens in other markets, the rise of generics coulderode growth of patentedmedicines.

Between2010and2015theBrazilianpharmaceuticalmarkethasa predicted CAGR of 7.85 per cent and 10.25 per cent, in localcurrencyandUSdollar terms, respectively.TheUS is the leadingsourceof imports,accounting for22.6per cent in2010.WesternEuropean countriesmadeup a further 44.2 per cent of imports.Brazilhaspassedalawtoreducetheimportofgoods–includingpharmaceuticals – produced outside Mercosur (the commonmarket of Brazil, Argentina, Paraguay and Uruguay). Mercosurmarkets will benefit because, even if their prices exceed thoseofferedbyforeignfirmsbyupto25percent,theywillbechosenasproviders.Tobeincludedinthebasicpharmaproductslist,theyhavetobelaunchedpreviouslyinothercountries(branded–OTCorgenerics). Thisbasic list isupdatedevery twoyears,as is thecasewiththeexceptionallist,whichincludesrare,nicheandhigh-costtreatments.Theproductsonthebasic listaremorelikelytobegenerics,whilethoseontheexceptionallistusuallycomefromtechnologytransferdeals.

Pharmaceuticalsales($bn),LHS PharmaceuticalsalesatCER(US$bn),LHS Pharmaceuticalsales,%ofGPD,RHS

pHarMaceutical Market forecaSt (2007-2021)

70.00 2.5

2.0

1.5

1.0

0.5

0.0

60.00

50.00

40.00

30.00

20.00

10.00

0.002007 2008 2009 2010 2011f 2012f 2013f 2014f 2016f2015f 2017f 2018f 2019f 2020f 2021f



reSearcH & developMentBrazil’scentralgovernmentremainsaprimarysponsorofresearch,seekingtoincreasethecountry’sdrugdevelopmentandmedicalresearch capacity, foster its domestic industry and reduce thecurrent trade deficit. In September 2011, theMinistry of Healthannounced itwould invest $881m in the research and develop-ment(R&D)sectorbytheendof2014.Thefundsaretobeallo-cated to ‘neglecteddiseases’ suchasdengue fever,malariaandtuberculosis.InadditiontoincreasingitsR&Dcommitments,thegovernment

has promised to introduce twonew clinical trial programmes. AlawapprovedinNovember2005providesincentivesforinnovativeprivatesectorcompanies,withfirmsoffereda50percentreduc-tionontheIndustrialisedProductstaxoninputsforR&D,aswellasazero-rateexemptionforallcostsrelatingtotheprotectionofintellectualpropertyrightsoutsideBrazil.The biotechnology industry is experiencing faster growth and

offering a number of opportunities for international players.Guided by the desire to develop a world-class biotechnologysector,Brazil’sgovernmenthaspushedthroughaseriesofscienceandeducationreformsdesignednotonlytoestablishnationalR&Dcentres,butalsotodeveloptheskilledlabourtostaffthem.Overthecourseof2010,eightnational laboratoriesweregivenpublicfunding to develop stem cell research projects. Despite the factthat prescriptions for biomedicines are rising in Brazil and thatmoreandmoreBraziliancompanieswanttobecomeinternationaldruginnovatorsratherthanregionaldrugproducers,awarypublicsuggests that biotechnology has a longway to go before beingbroadlyaccepted.However,Brazil’simportsofmedicinalbiologicsroseto$1,589min2009.Despite the expansion of multinational drugmakers in the

country, 10 out of the largest 21 pharmaceutical companies areBrazilian, highlighting strong competition fromdomestic genericdrugmakers. There are some 550 pharmaceutical firms in thecountry,employingaround23,000staffandmeetingthebulkof

MarketingAnewraftofrestrictiverulesonadvertisinghasbeenintroduced.These affect the communication of safety/product informa-tion, requiring that television and radio adverts verbalise suchwarnings,while text sizes forwarningsmust be at least 35 percentof the sizeof the largest fontused inanadvert. Televisioncommercials formedicines canonlybebroadcastwhen childrenoradolescentsarenotlikelytobewatching.Samplesofover-the-counter(OTC)medicinescannotbeoffered.

In the case of antibiotics or oral contraceptives, samples areallowedonlyiftheyofferafulltreatmentperiod.Inmedical education, the rules state that if a companywishes

toofferanunrestrictedacademicsponsorship,itmustsubmittheagenda and content to the national health surveillance agencyAgência Nacional de Vigilância Sanitária (ANVISA) at least threemonthsbeforethemeeting.Picturesofpeopleingestingproductsareprohibitedandtheuseofcelebritiesisheavilyrestricted.

ToapplyforOTCstatus,adrugmustdemostratethatithasbeenavailable OTC for aminimum of five years in the US or Europe.The OTC product must exhibit a mandatory red stripe on itspackaging.All registereddrugsareofficially limitedtopharmacysale,althoughsomesupermarketssellalimitednumberofOTCs.Thebestgrowthareasinrecentyearsincludetopicalpainkillers,vitaminsupplements,oralhygieneandappetitestimulants.

Source: Melhores & Maiores, BMI

“Brazil’s central government remains a primary sponsor of research, seeking to enlarge the country’s drug development and medical research capacity”

Headquarters 2008 sales ($m) 2009 sales ($m) 2010 sales ($m)

pfizer US 666.1 1,932.2 2,160.7

novartis Switzerland 1,115.5 1,603.7 1,949.7

Sanofi France 1,228.9 1,583.9 1,900.0

roche Switzerland 734.8 1,174.2 1,884.3

Medley Brazil 243.1 918.8 1,607.7

astraZeneca UK-Switzerland 584.4 899.5 1,088.9

eMS Sigma Brazil 445.0 727.2 903.6

eurofarma Brazil 423.6 696.3 839.8

aché Brazil 455.8 683.7 823.9

Merck Germany 332.3 501.7 576.9

eli lilly US 545.2 819.0 560.6

tortuga Brazil - 391.9 522.8

laboratório cristália Brazil 254.9 347.1 396.6biolab Sanus farmacéutica Brazil 211.1 313.2 380.9

bristol-Myers Squibb US 253.1 365.3 333.4

top 15 pHarMaceutical and HealtHcare coMpanieS in braZil by revenue (2010)



demand inunit terms.Of the top10 firmsby sales in2009, thefirstfourareallforeignmultinationals.Pfizer,NovartisandSanofiare clear leaders, followedbyRoche, theBraziliangenerics firmMedley(recentlyacquiredbySanofi),AstraZeneca(AZ)andEliLilly.In 2008, the median return on investment percentage figures

stood at 9.1 per cent. Companies that achieved double-digitpercentage returns included AZ (31.4 per cent), Biolab SanusFarmacêutica(22.6percent),NeoQuímica(14.3percent),Bristol-MyersSquibb(11.2percent)andRoche(10.2percent).ThelargeconcentrationofpharmaceuticalmanufacturinginBrazilismainlyattributed to strong domestic demand, particularly formanufac-turers of generics. The market share of the domestic manufac-turingsectorisstrong,beingestimatedat70percentingenerics,withlocalfirmsdominantintermsofvolumegrowth.

genericS Brazil’sgenericsmarketisthebiggestinLatinAmerica,valuedat$3.25bn in 2010, and has been the fastest-growing drug sectorsince2000:almost25percentofmedicinessoldinBrazilin2011weregenerics. Itsgenericdrugmarketgrewby24.8percent inreal terms during 2010, marking another year of rapid marketsharegainsfortheindustry.Whiledoctorscontinuetoresistprescribinggenericmedicines(44

percentofthembelievetheyaremoresusceptibletocounterfeitingthan patented medicines and 46 per cent are dissatisfied withBrazilianbioequivalencestandards),mostof thepatients–almost80 per cent – have confidence in them, which is not a surprisebecausetheyalreadypayforpatentedproducts.The increasingly regulated pharmacy retail environment means

that pharmacists have greater influence over dispensed drugsandpricinghasagreatereffectontheconsumer’schoiceofdrug.Retailoutletsarerequiredtostockaround70percentofallgenericproductsonthenational listandtomakeappropriate information

onthedrugsavailabletoconsumers.Since2002,thegovernmenthaspermitted,butnotmandated,genericsubstitutionbypharma-cistsfilingprescriptionsunderRegulation135/3.Moreimportantly,doctors are required to use the active pharmaceutical ingredient(API)orinternationalnon-proprietaryname(INN)ofthedrugwhenwritingprescriptions.Bioequivalent generic drugs represent a fast-growing sector; by

value,theyaccountfor20percentoftotalprescriptiondrugsales,or15.5percentoftotaldrugexpenditure.

counterfeiting CounterfeitdrugscomingfromParaguayarestillamajorprobleminBrazil.AccordingtoANVISA,20percentofmedicinessoldinBrazilarecounterfeits.However,thatpercentageisoneofthelowest inLatin America, compared with Argentina, Colombia and Mexico,whichhavemore than40percent,accordingto theUSFoodandDrugAdministration(FDA).Therearea lotofpossible causes for the constantpresenceof

fakemedicines inBrazil. These includeaweakgovermentstruc-turetomonitorimports,corruptionandalowstaffingbudgetforANVISA.

Medical deviceSANVISA controls the registration of medical devices, requiringcompaniestoestablishalocalofficeorfactory,oralocaldistributorinordertoaccessthemarket.ANVISAhasitsownregulatorystand-ards;internationalcertificationisnotacceptedwithouttheagency’squality assurance inspections. Approval of medical devices couldbecomesubjecttogreaterrisk-baseddifferentials,iftwoproposalsfromANVISAareimplemented.Underthesenewmeasures,afour-tiersystemcouldbeintroduced,similartothesystemusedintheEU, inwhich low-riskhealthproductsareallowedeasieraccesstomarket,whilehigher-riskproductsrequiresuitablegoodmanufac-turingpractice(GMP)certification.Proposed legislation would allow low-risk health products, in

classesIandII,moresimplifiedmarketaccessbystreamliningtheapprovalsprocessandmakingproduct information requirementsmoresuitedto thetechnicalnatureofaproduct.Thenewregis-trationwouldbevalid for fiveyears. In vitrodiagnosticproductswouldbeexemptfromthesimplifiedprocedure.RegistrationforequipmentandmaterialsclassifiedinhigherriskgroupsIIIandIVwould requireGMPcertification. For in vitro diagnosticproducts,thiswouldapplytogroupsII,IIIandIIIa.Examplesofproductsinthesegroupsaremagneticresonanceimagingequipment,ortho-paedicimplantsandglucoseself-testingdevices.The registration process is already relatively swift, taking an

averageof10months.Productregistrationsarevalidforfiveyearsand classified according to Law9.782/99,which dividesmedicaldevicesintothreeriskclasses(1,2and3).Thecostofregistrationofadevicevariesaccordingtotheannualrevenueofthecompanyand is generally in the range $1,187-$11,877. The private sectoraccountsforthemajorityofmedicaldevicesalesinBrazil(68percent), followed by the public sector (21.5 per cent) and exports(8.8percent).

HealtHcare coMMunicationS As the focus on healthcare continues to grow, so too do thefortunes of the main worldwide agencies based in Brazil. Withan investment of nearly $100m, the number of professionalsspecialisinginhealthandpharma(physicians,engineers,editors,app developers) is rising. There are nowmore than 140 health-

Source: Brazilian Pharmaceutical Industry Federation (Febrafarma), Group of

Executives of the Pharmaceutical Market (Grupemef), IMS Health, BMI

pHarMaceutical Market by Sub-Sector

3,248

4,409

13,297

otc patentedGeneric

$bn (2010)



careagenciesfocusingonthisfield,about100ofwhicharesmallagencies.Againstabackgroundoftighterregulation,collaborationamong

pharma and healthcare agencies has increased. There are a lotofnewservices, includingdigitalchannels,plusclosescrutinyofcertification procedures for campaigns, medical writing and soon. Also, there is an increased collaboration in the digital arenabecause of complex and incomplete government regulations. Atthesametime, therearemoreprogrammesbeingdevelopedtoimprovepatients’adherencetodrugs,promotingbetterconsumerloyalty, even inmassmarkets.With niche or high priced drugs,suchprogrammesareessential.Brazilianpharmaceuticalcompaniesspendalmost$700mannually

promoting their products. The investment in sampling, details,journalsandgiftsisgoingdown,whileatthesametimeinvestmentin digital,mobile and adherence strategies is increasing.Medicaleducation investment is expected to grow, because the agenciesare changing and looking for more return on investment (ROI).Physicians say that they need to understand all the key featuresof theproducts, so that they can improvepatients’ qualityof lifeultimately.

Medical education programmes aimed at key opinionleaders (KOL) are really expanding the reach of impact, andKOL speaker tours reinforce the main marketing campaigns inBrazil. Unlike the situation in the US, direct-to-consumer (DTC)advertising of prescription drugs is illegal, with only dermo-cosmetics, OTC and phytotherapeutic products able to use thismethod.Brazilisexperiencingnewchallengesaswellasopportunitiesfor

increasingprofitability.Pharmaceuticalcompanieshavetoadoptanaggressive medical education approach and new communicationtechnologies(digitalmedia)alongsidetheirconventionalsalesforceofmedicalrepresentativesiftheywantbetterROI.Astherearelikelytobefewerblockbusterdrugsinfuture,multi-

channelmarketingstrategies,usingdigitalmedia,whichischeaper,can bring the pharmaceutical companies greater ROI. Brazil hasalmost76millionpeopleconnected to the internet,equivalent to37.4per centof thepopulation. In addition, doctors’ behaviour ischanging quickly. Doctors are busier seeing increasing number ofpatients,sotheyhavelittletimetoseemedicalrepresentativesandtheyaremoreinclinedtoobtaintherelevantinformationonline.Sopharmaceuticalcompaniesneedtobuildtheirmarketingstrategiesaround digitalmedia. KOL platforms,webcasts, onlinemarketing,blogs,socialmedia,forums,chatroomsandanyothersuchmediacan be effective means to present the company’s products andoffersthroughopinionleaders.Thedigitalworldcannotbeignored.Forexample,usingavisual

aid for iPad can increase the contact time of presenting detailsto the target consumer from less thanaminute to3.5minutes.Companiesareusingmuchofthetechnologyattheirdisposaltogoodeffect,developingonlinedetailaidsandapps.Increasingly,theyarecreatingwebsitesthatincludepassword-protectedportals

forphysicians,whilee-detailsareimprovingengagement.Patientsandcaregiversareadoptingmoreproactiveapproaches,

leading to better doctor-patient communications. Health informa-tion is becoming ever more specialised and there is an urgentneed to fulfil this unmet requirement inBrazil. Theuseof digitalchannelsincreatingincreasedengagement,eitherwithhealthcareproviders(HCP)inaneducationalsettingorthroughdiseaseaware-nesscampaignsaimedat thepublicandpatients, isapriority forpharmainBrazil.Specialists are more technology-focused and have been early

adoptersofiPadsandelectronicmedicalrecords,andthenumbersofprimarycareprovidersadoptingtechnologyande-healthpracticearegrowingquickly.MoreandmoreHCPsaregoingonlinetofindinformationaboutclinicaltrials,diagnosticpathwaysandtreatmentalgorithms,aswellasdrugsinformation.

outlook PrescriptionandOTCdrugsalesperformancereflectBrazil’soverallmarkettrends,whichresultfromthelackofreimbursementmech-anismsandhighrelianceonout-of-pocketspending.Nevertheless,the burgeoning middle class will sustain consumer spending inthemediumterm,anditislikelythattheprescriptionmarketwillreach a value of around $29.64bn in 2015, up from$16.55bn in2010,whenitrepresentedalmost79percentofthetotalmarket.Increasingly,moresophisticatedmedicinesarelikelytodominate

theprescriptiondrugmarketinvalueterms,alongwithmorewidelyavailable bioequivalent genericmedicines. In general, alimentaryandmetabolismproductswillremaintheleaddrugcategoriesinthemediumterm,althoughasustained increase inpurchasingpowerandaccesstohealthcarewouldseesolidgrowthincentralnervoussystem,cardiovascularandrespiratorymedicines.

The potential for more expensive patented products remainshigh,giventhecountry’sunderdevelopedR&Dsectorand itshighreliance on imported innovative drugs. Sales of patented drugscouldreachingavalueof$21bnin2015.Theprojectedcontinuationof sales expansions is one of the key reasons that multinationalresearch-baseddrugmakerscontinuetoinvestinBrazil.

TheAuthorsWritten by AMK Healthcare Communications – McCann Health. Contacts: JD Puentes (left), President & CEO, AMK Healthcare Communications Latin America and John Cahill, CEO, McCann Health. Emails: [email protected] and [email protected]

“If pharma companies want to improve their return on investment, they have to adopt an aggressive medical education approach and new communication technologies”

For comprehensive reports on other countries, go to www.pmlive.com/countryreports

“The potential for more expensive patented products remains high, given the country’s underdeveloped R&D sector and reliance on imports”

Health & Medicine

Brazil Healthcare Report 2012 v.final