Global, European and Belgian pharmaceutical market trends
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Global, European and
Belgian pharmaceutical
market trends
Prepared for CIB
27th February 2019
Patrick Bervelt, Sales Director, Account Management
Patrick Van Dooren, Director Commercial & Technology Services
Copyright © 2019 IQVIA. All rights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States and various other countries.
Agenda
Patrick Van Dooren, Principal, Director Commercial & Technology Services IQVIA
Global and European pharmaceutical market trends
Patrick Bervelt, Sales Director, Sales, BEL & LUX, IQVIA
Belgian pharmaceutical market trends
1
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2
+ Global and European pharmaceutical market trends
+ Belgian pharmaceutical market trends
3
Global and European pharmaceutical
market trends
4
Global growth is forecast at 4.8% per annum, led by developing markets and
the US in particular
Sales Evolution and Forecast - Global
1.600 (2016-2022) 8%
1.447
1.373 Forecasted annual
1.400 1.304 7%
growth 2017-2022
1.245
1.205
1.200 1.139 6%
Sales ($US bn)
Annual growth
1.108 +4.8%
1.000 5%
+5,5%
800 4%
600 3% +3.9%
400 2%
200 1%
0 0%
2016 (a) 2017 (a) 2018 (f) 2019 (f) 2020 (f) 2021 (f) 2022 (f)
Global sales Global growth US growth Europe growth
IQVIA Health Market Prognosis Q3 2018
6
In Europe, growth will be more modest and in Belgium slightly weaker still
Sales Evolution and Forecast - Europe
350 (2016-2022) 10%
300 Forecasted annual
300 290
279 growth 2017-2022
269 8%
259
248
Sales (US$ bn)
250 238 +3.9%
Annual growth
227
6%
200
+2.9%
150
4%
100
2%
50
0 0%
2015 (a) 2016 (a) 2017 (a) 2018 (f) 2019 (f) 2020 (f) 2021 (f) 2022 (f)
Europe sales Europe growth Belgium growth
IQVIA Health Market Prognosis Q3 2018
7
Global growth is expected to be primarily driven by developed markets, and
to a lesser extent by expanded access and use in pharmerging markets
Contribution to Global Sales by Region
(2017-2022)
+5.5% +5.0% +7.4% +3.8% +3.6% +5.1% +1.6% CAGR % (2017-2022)
1.500
11 1 1.447
57 13
1.400 16
61
149
1.300
Sales (US$ m)
1.200
1.139
1.100
1.000
900
800
2017 sales N. America W. Europe E. Europe & CIS Asia L. America ME & Africa RoW 2022 sales
IQVIA Health Market Prognosis Q3 2018
8The US will continue to be the largest market but we expect to see changes
in rankings lower down the top 20
Source: IQVIA Institute
9By therapy area, oncology, antidiabetics and autoimmune disease products
dominate the global market
Top 15 Therapy area ranked by sales 5 year CAGR
(Global sales, $US bn MAT 11/2018)
Oncologics $103bn 9%
Antidiabetics $92bn 11%
Autoimmune Diseases $69bn 18%
Pain $64bn 1%
Respiratory Agents $46bn 2%
Antihypertensives $43bn -6%
Antibacterials $38bn -2%
Anticoagulants $37bn 6%
Mental Health $34bn -6%
Antivirals $30bn 9%
Multiple sclerosis $28bn 13%
Nervous system disorders $27bn 5%
Other cardiovasculars $25bn 2%
Viral hepatitis $24bn 27%
Lipid regulators $22bn -9%
Source: IQVIA MIDAS
10The current drug pipeline reflects this emphasis on oncology
Top 10 Therapy Areas by Molecule Count
10.000 315
Number of Molecules in Development
8.000
6.000
186
222
4.000
150 107
2.000 47 100 82 92 66
0
Discovery Clinical Phase 1 Clinical Phase 2 Clinical Phase 3 Clinical
IQVIA Market Analytics and ReSearch, IQVIA Institute
11Over the past five years there has been a significant increase in the number
of and spending on new active substances
12Fewer than half of the world’s top 20 pharmaceutical companies generated
>15% of their 2018 sales from products launched in the last 5 years
Global – Top 20 refreshment index
Total absolute growth Q3MAT 2012-2018 (Bn LCUS$)
22
J&J Abbvie
20 Gilead
16 BMS
14
12 Novo Nordisk
Roche GSK
10
Amgen
8 Novartis Merck & Co Lilly
Sanofi
6
Bayer Pfizer
4
Allergan Boehringer Ingelheim Takeda
2
Mylan Bubble size represents recently
-4 Astrazeneca launched* product sales in Q3MAT 2018
Teva
-6
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 19 20 21 27 28 29 30 31 69 70 71
Share of Q3MAT sales from recent launches* (%)
Notes: Recent launches: Innovative branded products launched in the last 5 years.
14
Source: IQVIA MIDAS MAT Q3 2018Small players, the ‘emerging biopharma companies’, are expected contribute
a larger share of new active substance launches
Source: IQVIA Institute
15Specialty products are accounting for more and more of new active
substance launches and will make up over half of spending
Share of Specialty Launches Specialty medicine share of spending
2004-2008 2009-2013
38% 50%
2014-2018 2019-2023
61% 65%
Source: IQVIA Institute
18Growth in specialty spending will be disproportionately driven by five
therapeutic classes
Source: IQVIA Institute
19Biologics growth continues to outstrip small molecules
Global biologics sales and trends (Bn of US$, MAT 06/2013-06/2018)
300 30%
MAT 06/18 Biologics sales
250
25% (Total 2018: 295 Bn US$)
20%
Sales (Bn US$)
200
12% 17% 19%
Growth
15%
150 7%
10% 5% 42%
18%
100
5%
50 59% 4% 17%
0%
0 -5% EU5 Autoimmune
2013 2014 2015 2016 2017 2018 US Diabetes
Biologics sales Small molecule growth Japan Oncology
Biologics growth Pharmerging MS
RoW Others
21
Source: IQVIA; European Thought Leadership; MIDAS MAT Q2 2018; Rx only; Note: growth in LCUS$Biologics are on the cusp of being shaken up
Global Rx Value (MAT Q2 2018) LCUSD Global Biologics Top 10 (MAT Q2 2018)
Threatened by LOE
$296bn Other Value Added Medicines
3% 3% bn USD
Innovative SM Top 10 biologics
(2018)
Humira 24
Biologics
29% Lantus 11
Enbrel 10
MIDAS
41% Remicade 8
Global Rx
$1.0tn Novorapid 7
Herceptin 7
1% Mabthera 7
Biosimilars
Opdivo 7
22% Avastin 6
Generics Humalog 6
Total threatened: $90bn, 30% of biologics
Notes: Pathway biosimilars only 22
Source: IQVIA MIDAS MAT Q2 2018Originators begin taking back share from certain markets. Adalimumab
latest and most anticipated entrant
Biosimilar penetration – October 2018
insulin
infliximab glargine etanercept rituximab trastuzumab adalimumab
EU5
UK 92.2% 9.0% 82.0% 91.5% 60.7%
Germany 51.3% 13.3% 56.8% 60.9% 28.3% 1.4%
France 59.1% 14.6% 17.9% 63.6% 27.5% 0.08%
Italy 78.5% 19.2% 45.6% 74.5% 9.2% 0.01%
Spain 55.8% 12.0% 30.2% 27.8% 10.6% 0.02%
High
High penetration
uptake
Denmark 98.5% 9.3% 90.6% 67.2% 99.3%
Finland 17.8% 6.0% 6.1% 6.2% -
Netherlands 76.1% 10.8% 24.1% 93.4% 95.0% 3.2%
Norway 97.6% 5.8% 90.1% 0.0% 81.2%
Poland 95.2% 35.6% 36.6% 34.4%
Canada 9.8% 7.8% 11.0% 0.2%
Japan 9.0% 50.2% 6.8% 30.6% 30.6%
USA 6.2% 31.7% Low
uptake
Notes: trastuzumab and rituximab subcutaneous form excluded from calculations 23
Source: IQVIA MIDAS Restricted MTH October 2018Originators use devices as one of their most successful defences
Trastuzumab forms (2014-17) Treatment days Trastuzumab volume share (2018) Treatment Days
SC Herceptin IV Herceptin Biosimilar
5 NL
EU5
Germany UK
Treatment days (Mio.)
4
3
2
1
0
Q2/14 Q4/14 Q2/15 Q4/15 Q2/16 Q4/16 Q2/17 Q4/17
Reformulated Subcutaneous injection: less invasive,
Original faster administration
28
Source: IQVIA European Thought Leadership; IQVIA MIDAS Restricted MTH July 2018Defences hold strong: no significant switch from SC -> IV
Rituximab Subcutaneous share Treatment days Trastuzumab Subcutaneous share Treatment days
Biosim Launch May-17 Biosim Launch May-18
35% 80%
30% 70%
60%
25%
50%
20%
40%
15%
30%
10%
20%
5% 10%
0% 0%
France Germany Italy Spain UK France Germany Italy Spain UK
29
Source: IQVIA European Thought Leadership; IQVIA MIDAS MTH December 2018What to watch 2019 to 2023
Next-generation Biotherapeutics: expanding use and new approvals
30
Source: IQVIA European Thought LeadershipBelgian pharmaceutical
market trends
31Recent measures impacting the Belgium market
• Easing of conditions for reimbursement of hep C
drugs (Jan 2019)
• Incentivization of biosimilar prescription (Jan 2019)
• Liberalization of the distribution network for medical 2019
devices in Belgium (Feb 2019)
• Elections (May 2019)
• Creation of the Federal Observatory
of Biopharmaceutical sector
2018 • Belgian Medicines Verification
• Low Variable Care System goes Live
• Hospital Networks
• BeNeLuxA – initiative to
facilitate information sharing
and streamline Health
Technology Assessments
2017
• Agreement to boost uptake of biosimilars
• Introduction of patent cliff system for medicines in cat A, B, C, Cs,and Cx
2016 • Reduction of the security margine
• Application of patent cliff
• Implementation of the “180 + 1” measure
32The hospital channel has made the strongest contribution to Belgian
pharmaceutical market growth
Total Pharmaceutical market – Belgium
(MNF Euro value; MAT December 2018)
Total Pharmaceutical Market €5.401m
Delta Absolute growth +€357m 1yr growth +7.1% 5yr CAGR +4.2%
Hospital €2.321m Rx bound sales €2.618m
+€346m abs value +0.3% 1y growth
+17.5% 1y growth
43%
+10.9% 5y CAGR
57% 85% Non Rx bound €462m
Retail €3.081m 15% +0.5% 1y growth
+€10m abs value
+0.3% 1y growth
+0.4% 5y CAGR
Source: IQVIA Retail & Hospital audits
33Hospital sales growth is led by original products, whilst in the retail channel
generics are performing best
Total Pharmaceutical market – Belgium
(MNF Euro value; MAT December 2018)
Total Pharmaceutical Market €5.401m
Hospital €2.321m Generic €107m
5% +11.0% 1yr growth Protected
88
Original €2.208m %
+17.9% 1yr growth
12% Unprotected
95%
Retail €3.081m Generic €506m Protected
+5.9% 1yr growth 40
17% %
Original €2.572m
60% Unprotected
-0.7% 1yr growth
83%
Source: IQVIA Retail & Hospital audits
34Retail
35In retail, immunotherapy and haematology are the best performing
categories, whilst angiotensin products have seen the greatest decline Retail
Top 10 ATC2 classes in values with growing and declining – Retail
(MNF Euro Value (Mio.); MAT December 2018)
Immunosuppressants (L04) Humira, Stelara, Psycholeptics (N05)
330 +9,3% Cosentyx, Cimzia 163 -2,7%
Antithrombotics (B01) 226 +9,3% Eliquis, Lixiana, Brilique Analgesics (N02) 140 -4,4%
Antihistamines and COPD
177 +5,1% Inuvair, Revlar Elipta, Xolair Renin-Angiotensin agents (C09) 119 -3,8%
products (R03)
Antidiabetics (A10) 148 +5,3% Toujeo, Trulicity, Jardiance Lipid modifying agents (C10) 117 -25,6%
Systematic antivirals (J05) 146 +6,2% Genvoya, Tivicay, Odefsey Psychoanaleptics (N06) 94 -3,8%
Sex hormones and modulators of
Other nervous system drugs (N07) 100 +1,4% Tecfidera, Aubagio 76 -0,9%
the genital system (G03)
Antiinflammatory and
60 +13,4% Xeljanz, Olumiant Urology (G04) 68 -4,1%
antirheumatic products (M01)
Vaccines (J07) 56 +10,3% Gardasil, Bexsero Systematic antibacterals (J01) 58 -3,4%
Cough medications (R05) 55 +2,6% Bronchosedal, Toularynx Nasal preparations (R01) 46 -4,8%
Antiepileptics (N03) 53 +2,6% Vimpat Antihemorrhagics (B02) 45 -8,9%
Source: IQVIA Retail Audit
36In retail, immunotherapy and haematology are the best performing
categories, whilst angiotensin products have seen the greatest decline Retail
Top 10 ATC2 classes in values with growing and declining – Retail
(MNF Euro Value (Mio.); MAT December 2018)
Immunosuppressants (L04) Risperdal, Zolpidem, Psycholeptics (N05)
330 +9,3% 163 -2,7%
Lormetazepam, Abilify
Antithrombotics (B01) 226 +9,3% Dafalgan, Durogesic, Perdolan Analgesics (N02) 140 -4,4%
Antihistamines and COPD
177 +5,1% Coversyl, Preterax, Exforge Renin-Angiotensin agents (C09) 119 -3,8%
products (R03)
Antidiabetics (A10) 148 +5,3% Crestor, Inegy, Ezetrol Lipid modifying agents (C10) 117 -25,6%
Systematic antivirals (J05) 146 +6,2% Sipralexa, Cymbalta Psychoanaleptics (N06) 94 -3,8%
Sex hormones and modulators of
Other nervous system drugs (N07) 100 +1,4% Mireva, Nuvaring, Yasmin 76 -0,9%
the genital system (G03)
Antiinflammatory and
60 +13,4% Vesicare, Tamsolisine SDZ, Cialis Urology (G04) 68 -4,1%
antirheumatic products (M01)
Vaccines (J07) 56 +10,3% Amoxicilline EG, Amoclane EG, Tetralysal Systematic antibacterals (J01) 58 -3,4%
Cough medications (R05) 55 +2,6% Otrivine, Sofrasolone, Rhinospray Nasal preparations (R01) 46 -4,8%
Antiepileptics (N03) 53 +2,6% Refacto AF, Benefix Antihemorrhagics (B02) 45 -8,9%
Source: IQVIA Retail Audit
37The top 20 companies account for 63% of the market share
and display variable performances over the last year Retail
Top 20 companies performances and growth – Retail Growth since last MAT Market growth
(MNF Euro Value (Mio.); MAT December 2018) 0.2%
EG GENERICS 219,3 1,4%
PFIZER 164,4 Enbrel -7,5%
ABBVIE 140,8 +1 Humira 9,1%
NOVARTIS PHARMA 131,3 +1 4,9%
GLAXOSMITHKL.PHARM 125,3 +1 2,3%
SANDOZ 122,8 +1 3,1%
BRISTOL-M. SQUIBB 114,6 +3 Eliquis, Orencia 7,3%
MSD BELGIUM 113,7 -1 Inegy, Ezetrol -6,8%
JANSSEN-CILAG 113,7 +1 Stelara 20,0%
BAYER PHARMACEUTIC 106,2 +1 -1,9%
SANOFI BELGIUM 101,7 -2,8%
ASTRAZENECA 92,0 -9 Crestor -33,3%
BOEHRINGER INGEL. 73,9 5,0%
GILEAD SCIENCES 68,8 +1 Genvoya, Odefsey 10,6%
TAKEDA BELGIUM 63,8 -1 Pantomed Nycomed -6,7%
TEVA PHARM.BELGIUM 62,1 6,6%
J&J CONS. 22,1 -2,2%
VIIV HEALTHCARE 49,1 2,0%
NOVO-NORDISK 47,3 -0,1%
SERVIER 47,2 +1 0,1%
Source: IQVIA Retail Audit
38On the Belgian market, 162 retail products have been launched between
January 2017 and September 2018 Retail
In total, 162 products were launched on the Belgian market between
162 January 2017 and September 2018
Influenza vaccines, Imported products, Generics
139 Original products with monthly sales below €30k
Original products with monthly sales above €30k recorded at least once
23
39HIV drugs, biologics in psoriasis, rheumatics and diabetes markets, and
respiratory products show the fastest growth Retail
Original products launched between January 2017 and September 2018
with monthly sales above 30,000 EUR recorded at least once
(Value (MNF/EUR); 24 months as of launch)
1.400.000
1.200.000
J05C - ODEFSEY - 201701
1.000.000
Sales (MNF/EUR)
J05C - SYMTUZA - 201804
800.000
600.000
400.000
200.000
0
MONTH 1
MONTH 2
MONTH 3
MONTH 4
MONTH 5
MONTH 6
MONTH 7
MONTH 8
MONTH 9
MONTH 10
MONTH 11
MONTH 12
MONTH 13
MONTH 14
MONTH 15
MONTH 16
MONTH 17
MONTH 18
MONTH 19
MONTH 20
MONTH 21
MONTH 22
MONTH 23
MONTH 24
Source: IQVIA LMPB data
40HIV drugs, biologics in psoriasis, rheumatics and diabetes markets, and
respiratory products show the fastest growth Retail
Original products launched between January 2017 and September 2018
with monthly sales above 30,000 EUR recorded at least once
(Value (MNF/EUR); 24 months as of launch)
600.000
M01C - XELJANZ - 201712
M01C - OLUMIANT - 201711
500.000
Sales (MNF/EUR)
400.000
300.000
200.000
100.000
M01C - KEVZARA - 201803
0
MONTH 1
MONTH 2
MONTH 3
MONTH 4
MONTH 5
MONTH 6
MONTH 7
MONTH 8
MONTH 9
MONTH 10
MONTH 11
MONTH 12
MONTH 13
MONTH 14
MONTH 15
MONTH 16
MONTH 17
MONTH 18
MONTH 19
MONTH 20
MONTH 21
MONTH 22
MONTH 23
MONTH 24
Source: IQVIA LMPB data
41HIV drugs, biologics in psoriasis, rheumatics and diabetes markets, and
respiratory products show the fastest growth Retail
Original products launched between January 2017 and September 2018
with monthly sales above 30,000 EUR recorded at least once
(Value (MNF/EUR); 24 months as of launch)
250.000
A10C - FIASP - 201809
200.000
A10C - XULTOPHY - 201808
Sales (MNF/EUR)
150.000
100.000
50.000
0
MONTH 1
MONTH 2
MONTH 3
MONTH 4
MONTH 5
MONTH 6
MONTH 7
MONTH 8
MONTH 9
MONTH 10
MONTH 11
MONTH 12
MONTH 13
MONTH 14
MONTH 15
MONTH 16
MONTH 17
MONTH 18
MONTH 19
MONTH 20
MONTH 21
MONTH 22
MONTH 23
MONTH 24
Source: IQVIA LMPB data
42HIV drugs, biologics in psoriasis, rheumatics and diabetes markets, and
respiratory products show the fastest growth Retail
Original products launched between January 2017 and September 2018
with monthly sales above 30,000 EUR recorded at least once
(Value (MNF/EUR); 24 months as of launch)
250.000
R03L - TRIMBOW - 201804
200.000
Sales (MNF/EUR)
150.000 R03L - TRELEGY ELLIPTA - 201807
100.000
50.000
0
MONTH 1
MONTH 2
MONTH 3
MONTH 4
MONTH 5
MONTH 6
MONTH 7
MONTH 8
MONTH 9
MONTH 10
MONTH 11
MONTH 12
MONTH 13
MONTH 14
MONTH 15
MONTH 16
MONTH 17
MONTH 18
MONTH 19
MONTH 20
MONTH 21
MONTH 22
MONTH 23
MONTH 24
Source: IQVIA LMPB data
43HIV drugs, biologics in psoriasis, rheumatics and diabetes markets, and
respiratory products show the fastest growth Retail
Original products launched between January 2017 and September 2018
with monthly sales above 30,000 EUR recorded at least once
(Value (MNF/EUR); 24 months as of launch)
1.400.000
1.200.000
J05C - ODEFSEY - 201701
1.000.000
Sales (MNF/EUR)
J05C - SYMTUZA - 201804
800.000 D05B - TREMFYA - 201807
M01C - XELJANZ - 201712
600.000 D05B - TALTZ - 201704
M01C - OLUMIANT - 201711
400.000
R03M - FASENRA - 201809
A10C - FIASP - 201809 R03L - TRIMBOW - 201804
200.000 A10C - XULTOPHY - 201808
R03L - TRELEGY ELLIPTA - 201807
D05B - KYNTHEUM - 201809 M01C - KEVZARA - 201803
0
MONTH 1
MONTH 2
MONTH 3
MONTH 4
MONTH 5
MONTH 6
MONTH 7
MONTH 8
MONTH 9
MONTH 10
MONTH 11
MONTH 12
MONTH 13
MONTH 14
MONTH 15
MONTH 16
MONTH 17
MONTH 18
MONTH 19
MONTH 20
MONTH 21
MONTH 22
MONTH 23
MONTH 24
Source: IQVIA LMPB data
44Specific patterns cannot be traced when looking at generic products
separately Retail
Generic products launched between January 2017 and September 2018
with monthly sales above 30,000 EUR recorded at least once
(Value (MNF/EUR); 24 months as of launch)
500.000
450.000
Gx launched betwen Jan17 & Dec18 = 18,9M€
400.000
350.000
Sales (MNF/EUR)
75% coming from 4 molecules :
300.000 - Tadalafil
250.000 - Rosuvastatine
- Ezetimibe
200.000
- Ethinylestradiol
150.000
100.000
50.000
0
MONTH 1
MONTH 2
MONTH 3
MONTH 4
MONTH 5
MONTH 6
MONTH 7
MONTH 8
MONTH 9
MONTH 10
MONTH 11
MONTH 12
MONTH 13
MONTH 14
MONTH 15
MONTH 16
MONTH 17
MONTH 18
MONTH 19
MONTH 20
MONTH 21
MONTH 22
MONTH 23
MONTH 24
Source: IQVIA LMPB data
45Hospital
46On the hospital market, Antineoplastic drugs lead in sales and growth,
adding €229m additional sales for the period Hospital
Top 10 ATC2 classes in values with growing and declining – Hospital
(MNF Euro Value (Mio.); MAT December 2018)
Antineoplastic agents (L01) Opdivo, Keytruda, Systemic antivirals (J05)
908 +35,4% Revlimid 83 -22,9%
Immunosuppressants (L04) 123 +8,7% Remsima, Inflectra Systematic antimycotics (J02) 20 -3,1%
Antihemorrhagics (B02) 104 +19,6% Novoseven, Advate, Kovaltry Psycholeptics (N05) 17 -1,3%
Ophthalmologicals (S01) 84 +12,8% Lucentis, Eylea Analgesics (N02) 17 -8,1%
Antiseptics and disinfectants
Immunoglobulins (J06) 79 +10,7% Multigam, Privigen 15 -2,3%
(D08)
Antianemics (B03) 78 +10,9% Aranesp, Injectafer Other gynecologicals (G02) 11 -0,7%
Drugs for acid related disorders
Other nervous system drugs (N07) 75 +15,6% Gilenya, Lemtrada, Bridion 10 -5,2%
(A02)
Imaging diagnostics (T01) 74 +16,3% Iomeron, Dotarem, Visipaque Psychoanaleptics (N06) 7 -1,1%
Piperacilline/Tazobactam,
Systematic antibacterials (J01) 65 +6,5% Plasma expensers (K02) 4 -14,4%
Meropenem Fresenius Kabi
Hormono therapy (L02) 63 +26,8% Xtandi, Zytiga Lipid modifying agents (C10) 4 -21,6%
Source: IQVIA Hospital Audit
47On the hospital market, Antineoplastic drugs lead in sales and growth,
adding €229m additional sales for the period Hospital
Top 10 ATC2 classes in values with growing and declining – Hospital
(MNF Euro Value (Mio.); MAT December 2018)
Antineoplastic agents (L01) Epclusa, Viekirax, Systemic antivirals (J05)
908 +35,4% Daklinza 83 -22,9%
Immunosuppressants (L04) 123 +8,7% Cancidas Systematic antimycotics (J02) 20 -3,1%
Antihemorrhagics (B02) 104 +19,6% Xeplion Psycholeptics (N05) 17 -1,3%
Ophthalmologicals (S01) 84 +12,8% Paracetamol Fresenius Kabi, Dafalgan Analgesics (N02) 17 -8,1%
Antiseptics and disinfectants
Immunoglobulins (J06) 79 +10,7% Iso-Betadine 15 -2,3%
(D08)
Antianemics (B03) 78 +10,9% Syntocinon, Prostin E2, Dostinex Other gynecologicals (G02) 11 -0,7%
Pantomed Nycomed, Nexiam, Drugs for acid related disorders
Other nervous system drugs (N07) 75 +15,6% Losec Mups
10 -5,2%
(A02)
Imaging diagnostics (T01) 74 +16,3% Sipralexa, Cymbalta Psychoanaleptics (N06) 7 -1,1%
Systematic antibacterials (J01) 65 +6,5% Volulyte, Voluven, Geloplasma MRX Plasma expensers (K02) 4 -14,4%
Hormono therapy (L02) 63 +26,8% Crestor, Inegy, Ezetrol Lipid modifying agents (C10) 4 -21,6%
Source: IQVIA Hospital Audit
48The leaders on the hospital market remain consistent compared
to last period Hospital
Top 20 hospital companies sales and annual growth Growth since last MAT Market growth
(MNF Euro Values (Mio.); MAT December 2018) 19%
ROCHE 233,5 15%
MSD BELGIUM 185,8 +2 Keytruda 37%
NOVARTIS PHARMA 170,6 -1 12%
BRISTOL-M. SQUIBB 164,9 -1 Opdivo, Sprycel 20%
JANSSEN-CILAG 138,8 Imbruvica, Darzalex, Zytiga 34%
CELGENE 104,0 +1 Revlimid 25%
AMGEN 90,8 -1 3%
PFIZER+PFE BE 87,5 +9 Ibrance, Inflectra, Sutent, Ecalta 85%
SANOFI BELGIUM 75,2 -1 5%
TAKEDA BELGIUM 66,4 +3 Entyvio 34%
BAYER PHARMACEUTICALS 63,6 -1 9%
FRESENIUS KABI 59,9 -1 7%
ABBVIE 56,6 Maviret 32%
BAXTER 43,9 5%
CSL BEHRING 42,0 15,7%
GILEAD SCIENCES 40,3 -7 -38%
NOVO-NORDISK 38,5 +1 Novoseven 36%
ASTELLAS 32,5 -2 12%
ASTRAZENECA 32,0 Iressa, Lynparza, Tagrisso, Faslodex 19%
SHIRE PHARMACEUT. 29,4 +1 14%
Source: IQVIA Hospital Audit
49Consumer Health
50The Consumer Health market grew by 1.1% in the past year, driven by the
performance of the patient care category Consumer
Health
Consumer Health market – Belgium
(PUB Euro value; MAT December 2018)
Total Consumer Health Market €1,997m
Delta Absolute growth €21m 1yr growth +1.1% 5yr growth +1.8%
OTC €1,340m Registered €823m
15% +0.8% 1y growth +0.4% 1y growth
+1.4% 5y CAGR
18% PEC €354m
Non registered €517m
67% +0.4% 1y growth
+1.6% 1y growth
+2.1% 5y CAGR
PAC + NTR €302m
+2.8% 1y growth
+3.8% 5y CAGR
Source: IQVIA Consumer Health Services
51Most of the biggest Consumer Health classes are OTC but are
experiencing mixed performances Consumer
Health
Top 10 OTC classes in values with growing and declining – Consumer Health
(PUB Euro Value (Mio.); MAT December 2018)
01 Cough Cold 253 +4,3% Rhinathiol, Medica, Physiomer 02 Pain Relief 268 -0,3%
Promagnor, Tribvit,
04 Vit/Minerals/Nutrit.Suppl 194 +1,0% Folavit 82 Beauty Product For Women 116 -0,2%
03 Digestive/Oth Intest Rems 189 +1,0% Imodium, Movicol, Buscopan 10 Circulatory Products 81 -6,8%
06 Skin Treatment 90 +1,7% Iso-Betadine, Bepanthol, Cremicort H 07 Eye Care 62 -0,2%
83 Unisex Beauty Products 87 +7,1% Cicaplast LRP, Anthelios, Mouskito 35 Baby Foods 61 -1,5%
13 Calm Sleep Mood Enhancing 46 +5,7% Sedistress, Sediplus, Metasleep 86 Hair Products 46 -0,7%
56 Tests & Measuring Instr. 28 +1,1% One Touch Verio, Bayer Contour Next 12 Urinary And Repruduct Car 44 -2,5%
30 Spec Enteral Nutrition Pr 27 +4,1% Fortimel Com.Prote, Fresubin 2 Kcal 85 Personal Hygiene 44 -1,9%
47 Advanced Dressings 24 +8,8% Flaminal, Flamigel, Opsite 05 Tonics/Other Stimulants 42 -0,4%
57 Medical/Surgical Aids 23 +8,3% Krober Oxycure, Nexcare Coldhot 93 Oral Hygiene & Care Acce 17 -3,7%
Source: IQVIA Consumer
Health Services
52Most of the biggest Consumer Health classes are OTC but are
experiencing mixed performances Consumer
Health
Top 10 OTC classes in values with growing and declining – Consumer Health
(PUB Euro Value (Mio.); MAT December 2018)
01 Cough Cold 253 +4,3% Dafalgan, Voltaren Emulgel 02 Pain Relief 268 -0,3%
04 Vit/Minerals/Nutrit.Suppl 194 82 Beauty Product For Women 116 -0,2%
+1,0% Widmer Visage, Remederm, Widmer Yeux
03 Digestive/Oth Intest Rems 189 +1,0% Arterin, Cardioaspirine 10 Circulatory Products 81 -6,8%
06 Skin Treatment 90 +1,7% Preservision 3, Hyabak, Systane 07 Eye Care 62 -0,2%
83 Unisex Beauty Products 87 +7,1% Nutrilon (2), Nan Optipro HA, Nan 35 Baby Foods 61 -1,5%
13 Calm Sleep Mood Enhancing 46 +5,7% Nizoral-JPB, Dercos Shamp 86 Hair Products 46 -0,7%
56 Tests & Measuring Instr. 28 +1,1% 12 Urinary And Repruduct Car 44 -2,5%
Ymea, Canestene Gyn Clo., Prevalon
30 Spec Enteral Nutrition Pr 27 +4,1% Saforelle, PH5-Eucerin 85 Personal Hygiene 44 -1,9%
47 Advanced Dressings 24 +8,8% Biocure, A.Vogel (5), Tonixx 05 Tonics/Other Stimulants 42 -0,4%
57 Medical/Surgical Aids 23 +8,3% Corega, Protefix 93 Oral Hygiene & Care Acce 17 -3,7%
Source: IQVIA Consumer
Health Services
53Johnson & Johnson retains its leadership in Belgium Consumer
Health but the top 10 have overall seen negative performance Consumer
Health
Top 20 Consumer Health Companies Ranked by Sales Growth since last MAT Market growth
(PUB Prices €m, MAT December 2018) 1.1%
J&J CONS. 87,7 1,3%
GSK 75,8 -6,3% Voltaren Emulgel, Voltapatch Tissugel
BMS 66,2 +1 -2,4% Dafalgan, Sedergine, Niflugel
OMEGA PHARMA 63,0 -1 -7,9% XLS Medical, Arterin, Davitamon
SANOFI CHC 62,3 1,2%
RECKITT BENCKISER 58,8 -0,7%
TAKEDA BELGIUM 57,1 -2,8% Asaflow, Steovit, Magnecaps
MERCK CONS.HLTH 54,9 -2,3% Omnibionta
SMB LABORATOIRE 49,4 Algostase Mono, Neo-Golaseptine, Afebryl 4,6%
MEDA PHARMA 47,0 -0,4%
MELISANA 45,5 -0,2%
NUTRICIA 44,2 -2,1%
EG 40,3 Cetirizine
+1 EG, Paracetamol EG, Ibuprofen EG 11,2%
QUALIPHAR 39,7 +2 Medica, Toularynx, Mouskito 7,9%
TILMAN 39,6 -2 2,7%
LA ROCHE POSAY 39,0 -1 1,7%
METAGENICS 35,7 Probactiol, Curcudyn, Metasleep 5,5%
LOUIS WIDMER 29,8 -2,7%
NESTLE BELGILUX 29,1 OTC PEC 0,0%
VICHY 25,8 PAC NTR -4,3%
Source: IQVIA Consumer Health Services
54Biosimilars
552019 is expected to be the biggest year yet for biosimilars
Share of Sales in Belgium – Originators and Biosimilars
(MNF Euro Value (Mio.); MAT December 2018)
Therapy Area Molecule Product Share of sales Biosimilar Share of sales
Adalimumab Humira 100% Imraldi, Amgevita 0%
Etanercept Enbrel 94% Benepali 6%
Infliximab Remicade 71% Remsima, Inflectra, Flixabi 29%
Antineoplastic & Filgrastim Neupogen 73% Tevagrastim, Nivestim 27%
Immunomod. Trastuzumab Herceptin 100% Herzuma 0%
Rituxumab Mabthera 100%
Bevacizumab Avastin 100% Expected EU 2022
Nivolumab Opdivo 100% Expected in EU 2024
Insulin Glargine Toujeo, Lantus, Suliqua 98% Abasaglar 2%
Alimentary
Insulin Aspart Novorapid, Novomix 100% Expected in EU 2022
Blood Epoetin Alfa Eprex 88% Binocrit 12%
Genito, sex
Follitropin Alfa Gonal-F 76% Bemfola 24%
hormones
Hormonal Somatropin Genotonorm, Norditropin 82% Omnitrope 18%
Source: IQVIA MIDAS
56HCPs
57Amongst the General Practitioners, 4,545 of them are
responsible for 70% total market potential Prescriptions
Decile analysis
(Active GPs and Occupational GPs; prescription value (millions); MAT December 2018)
15,155 physicians
600 50%
45%
500
Prescription value (millions)
40%
35% 35%
400
Market share
30%
300 25%
555
20% 15% 20%
200 11%
15%
312
8%
228 10%
100 5%
169 3%
124 2% 1% 0% 5%
86 54 8 1
0 27 0%
D1 D2 D3 D4 D5 D6 D7 D8 D9 D10
AVERAGE prescription
value per doctor per year 366 206 151 112 82 57 36 18 6 1
(in thousands euro)
Source: IQVIA Xponent
58Digital promotional spending has slowly grown compared to traditional
spending, but levelled off in 2018 at 5%
Corporate website and mailing represent over 80% of digital spending
Digital vs. Traditional promotional Total Digital Spending
spend EU5
Total €m 144 136 137 130 116 Web advertising
GPs/Primary care Meetings
100% Detailing
4% 5% 6% 6% 5% 5% 0%
2%
Social Apps
media 1%
80% 11%
60% Mailing
20%
96% 95% 94% 94% 95%
40%
Corporate
website
20% 61%
0%
FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 € 9m
Traditional Spending Digital Spending
Source: IQVIA ChannelDynamics
59When including Digital channels in the mix, it is important to target the
HCP’s who are receptive to these channels
60CONCLUSIONS
Hospital market is the key driver of the market growth, and
potentially as large as the Retail in a few years’ time
Despite the slow down and stability of the Retail market, the launch
performance and uptake will be an important driver for the Primary Care drugs
Biosimilars are part of the market pictures, with some of them
launched lately and a few others to come in the next years
Use of the Digital channels in the promotion mix will also require a
good tactical plan to be successful
61Thank you
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