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Brazils Pharmaceutical Industry.


Opportunities for Swiss Suppliers osec.ch

Branchenbericht Brasilien.

Titel. Sprache. Umfang. Inhalt.

Brazils Pharmaceutical Industry. Opportunities for Swiss Suppliers.

Englisch

69 Seiten, Stand Juni 2010

Brasilien ist nicht nur ein grosser Absatzmarkt fr die Pharmaindustrie, sondern zunehmend auch ein bedeutender Produktionsstandort. Neben den multinationalen Firmen sind mit staatlicher Untersttzung und auf dem Nhrboden des schnell wachsenden Generikamarktes zahlreiche brasilianische Unternehmen entstanden. Diese investieren in den Aufbau von Labors und Produktionsanlagen fr Pharmazeutika und Impfstoffe. Daraus ergeben sich Marktchancen auch fr kleine und mittlere Schweizer Firmen, die sich bereits als Lieferanten der Pharmaindustrie etabliert haben. Der Bericht analysiert die treibenden Krfte, die fr das Wachstum der brasilianischen Pharmaindustrie verantwortlich sind, stellt die wichtigsten Hersteller und Forschungslabors vor und untersucht, welche Chancen fr auslndische Zulieferer bestehen.

Autoren.

Martin Matter (Redaktion) Swiss Business Hub Brazil c/o Consulado Geral da Sua Av. Paulista, 1754, 4 andar, Edifcio Grande Avenida BR-01310-920 So Paulo SP Phone +5511 3372 8200 sbhbrazil@sao.rep.admin.ch www.osec.ch/sbhbrazil Ricardo C. Mendes / Hlio Camargo / Ivan Marcos Milano dos Santos / Anselmo Takaki Prospectiva Consultoria Rua Diogo Moreira, 135, Pinheiros BR-05423-010 So Paulo SP Phone +5511 3816 3636 www.prospectivaconsultoria.com.br

Titelbild.

Copyright F. Hoffmann-La Roche AG, Basel

Table of Contents
Executive Summary..........................................................................................................1 1. About this report ..........................................................................................................3 2. Brazils Pharmaceutical Market...................................................................................4
2.1. 2.2. 2.3. 2.4. 2.5. 2.6. 2.7. Retail Market Size and Trends ...............................................................................4 Ethical, OTC and Generic Segments .....................................................................5 Therapeutic Classes Market Share ........................................................................7 Non-Retail Demand................................................................................................7 Foreign Trade ........................................................................................................9 Geographical Distribution of Demand and Production ..........................................12 Regulatory Framework.........................................................................................14

3. The Pharmaceutical Industry in Brazil......................................................................16


3.1. Overview..............................................................................................................16 3.2. Government Industrial Policies.............................................................................18 3.3. The Growth of Domestic Laboratories..................................................................19 3.4. Market Shares by Company.................................................................................21 3.5. Major Competitors Profiles...................................................................................23 3.6. State-Owned Laboratories ...................................................................................32 3.7. Compounding Pharmacies...................................................................................36 3.8. Manufacture Outsourcing.....................................................................................37 3.9. Research & Development ....................................................................................40 3.10. Biotechnology Companies....................................................................................45

4. Special Segments Highlights ....................................................................................48


4.1. 4.2. 4.3. 4.4. Herbal Medicines .................................................................................................48 Homeopathy ........................................................................................................49 Vaccines ..............................................................................................................50 Diagnostic Medical Devices .................................................................................52

5. The Pharmaceutical Industrys Supply Chain..........................................................54


5.1. Raw Materials ......................................................................................................54 5.2. Machines & Equipment ........................................................................................58 5.3. Services...............................................................................................................61

6. Conclusion and Recommendations..........................................................................63 Annex 1 Events and Publications of Interest ............................................................64 Annex 2 Industry Associations ..................................................................................66 Annex 3 Main Sources Consulted for This Study .....................................................68

EXECUTIVE SUMMARY
With total revenues exceeding USD 26 billion per year, Brazil is an emerging pharmaceutical market: Demand for pharmaceutical products grows approximately 10% per year. Thanks to better income distribution and social programs, more and more of Brazils 191 million people are getting access to health services and medicines. On this breeding ground, the country has developed its pharmaceutical industry. There are 270 private and 20 state-owned pharmaceutical laboratories in business. Multinational companies (including Novartis and Roche) are using Brazil as a production platform, exporting to Latin America, North America and Europe. At the same time, the domestic laboratories, both private (like EMS, Ach, Eurofarma) and public (like Fiocruz and Butantan), have gained sophistication and market share in recent years. The rise of domestic laboratories was mainly driven by three factors: the Brazilian governments industrial policy, new regulations, and the introduction of generics. The development of a national health industry complex is a priority for the government. It supports investments and exports by providing special credits (USD 300 million per year), through the Profarma program, operated by the national development bank BNDES. It also stimulates innovation through subsidies and a solid IP protection. Regulations and technical standards enforced by the national health surveillance agency (ANVISA) keep the industry under pressure to adjust their plants in Brazil to the state of the art and thus to improve its competitiveness. Growing demand for generics offered another growth opportunity for domestic laboratories over the past decade. They came to dominate this market segment and are expanding and modernizing production capacities. The pharmaceutical industry in Brazil has increased its production by 50% within 5 years. While overall capacity usage stands at 74% (2009), foreign and state-owned laboratories present relatively high levels of idle capacity, as some of their production lines are outdated. They sometimes resort to manufacture outsourcing. The demand for pharmaceutical production machines is estimated in the range from USD 50 million to USD 100 million per year. Almost all process equipment is imported; packaging machines, however, are manufactured in the country. Brazil still relies on foreign raw materials and imports more than USD 2 billion worth of active pharmaceutical ingredients per year, since there are only a few local producers. It is a net exporter of excipients, though. Research and innovation are concentrated at public institutions. There are more than 100 small biotech companies, most of them located in clusters linked to public universities and research centers. Private laboratories spend a small (6%), but growing part of their revenue on R&D. They still lack infrastructure for pre-clinical tests. Certain toxicology studies and special chemical tests are not available in Brazil yet.

Osec Market Report: Brazils Pharmaceutical Industry

Brazils amazing biodiversity has been little exploited so far, but might attract more investment in research centers if registration procedures were facilitated. The domestic market for herbal medicines (currently USD 1 billion) already sustains some Brazilian companies specialized in phytotherapy. Brazil also produces 260 million doses of (human and veterinary) vaccines per year. These are mainly supplied to the government by the big state-owned laboratories, sometimes with technology transferred under agreements with multinationals. The Brazilian way of doing business is peculiar, requiring a local market expertise for a successful entry.

Osec Market Report: Brazils Pharmaceutical Industry

1. ABOUT THIS REPORT


This market report introduces the Brazilian Pharmaceutical Industry to Swiss companies active in the pharmaceutical supply chain. It is meant to assist them in identifying new business opportunities. The domestic market is the cradle of Brazils pharmaceutical industry. To understand this industrys characteristics, it is necessary to first take a closer look at the demandside (Chapter 2). Subsequently, the report analyzes the major players, including both multinational and domestic laboratories, public and private, and how the Brazilian government acts to develop a health industry complex (Chapter 3). It then highlights some special segments (Chapter 4) and finally shows which business opportunities can be identified in the pharmaceutical supply chain (Chapter 5). The annexes list relevant trade shows, congresses, business associations, and specialized media, as well as the main sources consulted for this report. Data for this report were collected and interviews conducted in early 2010. Some of the statistics presented were expressed in Brazilian Real (R$). An exchange rate of R$ 1.75 was used to convert Brazilian currency values to USD, where appropriate. The report has been elaborated by Prospectiva, a local consulting firm, and edited by the Swiss Business Hub Brazil. Companies interested in following-up on business opportunities identified through this report are invited to contact the Swiss Business Hub Brazil through Osec.

Osec Market Report: Brazils Pharmaceutical Industry

2. BRAZILS PHARMACEUTICAL MARKET


Among the major pharmaceutical markets in the world, Brazil is one of the fastest growing. It belongs to the Pharmerging Group (along with China, India, Mexico, Turkey, Korea, and Russia), which is expected to account for three quarters of world market growth in the period 2009-2013. The Brazilian market has 191 million consumers with a per capita income of roughly USD 8000, while per capita consumption of medicines is still relatively low. Compared to other emerging markets, Brazil also boasts an effective patent protection regime, consistent with TRIPS rules, and a relatively low incidence of falsified drugs. The main drivers for the market expansion are: General economic expansion : The Brazilian economy was little affected by the international recession and resumed growth in mid 2009 already. The financial industry estimates a 6% increase in 2010, and a growth rate over 4.5% in the following years; Increase of purchasing power: In Brazil, medicines are mostly bought by the citizens themselves, since most health insurance schemes do not reimburse patients for the purchase of drugs. Under such circumstances, 15% of the population still account for 50% of consumption. This will change as income keeps increasing steadily and the gap between rich and poor narrows: Nearly 20 million Brazilians moved upwards from the lowest income classes (D/E) to the middle class (C) between 2002 and 2007, largely due to public policies and social programs sponsored by the federal government. Increasing life expectancy: In 2000, there were 13.9 million people above age 60. By 2020, this figure is expected to reach 30 million. As a consequence, chronic diseases will become more widespread. Phasing out similar drugs: Similar drugs are medicines with formulations identical to branded medicines, but without proven bioequivalence (as in the case of generics). These were introduced before 1996 (when Brazil did not recognize patents on pharmaceutical products) but must be phased out by 2014, leaving a market of USD 2 billion p.a. to generics, phytotherapics and homeopathy.

2.1. Retail Market Size and Trends The Brazilian pharmaceutical retail sales reached R$ 31 billion in 2009. The global economic crisis had no negative impact. Indeed, the sales reported a remarkable CAGR (Compound Annual Growth Rate) of 13.5%, as shown in Chart 1.

Osec Market Report: Brazils Pharmaceutical Industry

Chart 1 Brazilian Pharmaceutical Retail Market in R$

Source: IMS Health * Projection (10% p.a. rate)

Demand in 2013 is projected to reach R$ 45 billion, based on an expected growth rate of 10% per year. However, this value is expressed in nominal currency, including the inflation effect. In real terms, it would correspond to R$ 38 billion of 2009 (equivalent to USD 22 billion). In terms of sales units, the past CAGR reached 6.6%, as shown in Chart 2.

Chart 2 Brazilian Pharmaceutical Market in Units

Source: IMS Health; * Linear Projection

2.2. Ethical, OTC and Generic Segments The growth rate presented above for the entire retail market applies to both the Ethical (mandatory prescription) and the OTC (over-the-counter) markets, since their market
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share has remained almost stable for the last few years.

Chart 3 Ethical x OTC Retail Market

Source: IMS Health - R$ values in nominal currencies

Generics were first introduced in 2001, and reached R$ 4.6 billion annual income in 2009, equivalent to 15% of the retail market. A linear projection of the generics sales evolution is presented in Chart 4.

Chart 4 Brazilian Generics Market Evaluation

Source: IMS Health * Prospectivas Linear Projection

This market segment may grow even stronger, considering the number of patents that shall expire over the next few years, and the phasing-out of similar medicines. On the other hand, laboratories in the OTC segment have begun to react, spending more on advertising to enhance brand loyalty. The rise of generics has changed the industrys profile, as it gave Brazilian laboratories an opportunity to seize a share of the market. In 2009, the share of medicines produced
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by Brazilian laboratories came close to that of multinational laboratories (see Chapter 3.3 The Growth of Domestic Laboratories).

2.3. Therapeutic Classes Market Share The 20 major therapeutic classes are responsible for nearly 40% of the share in the retail market, in R$. Table 1 Top Therapeutic Classes in the Retail Market 2009

Source: IMS Health

2.4. Non-Retail Demand Whereas retail sales account for approximately 70% of the total pharmaceutical market, the remaining 30% fall to state, hospitals and clinics purchases, as shown in Chart 5. Brazilian health plans do not buy drugs.

Osec Market Report: Brazils Pharmaceutical Industry

Chart 5 Brazilian Market of Medicines in 2008

Sources: IMS Health; Ministry of Health / Portal da Sade Government Purchases

Non-retail sales represented R$ 10.5 billion in 2008. Government purchases amounted to R$ 7.6 billion, of which R$ 5.6 billion was carried out under the Unified Healthcare System (SUS). The SUS program is linked to the Ministry of Health and is meant to coordinate the health-related activities of several government spheres (federal, state and municipal). Nevertheless, state and municipal governments also purchase some medicines without resorting to SUS, mainly vaccines and drugs against some endemic diseases. These medicines are usually supplied by their own laboratories, while the private laboratories catch the lions share (70%) of SUS acquisitions. SUS procurement is divided into 5 categories: basic pharmaceutical assistance (16%), strategic pharmaceutical assistance (neglected diseases and sexually transmitted diseases, 21%), exceptional acquisition of medicines (higher technology drugs, 41%), vaccines and blood derived products (22%). The government procurement is carried out through public tenders (for values above R$ 650.000) or through budgeting procedures (for values below the threshold). Medicines are specified by their active principles and galenical forms. Price is the overriding factor in government purchasing decisions. Foreign companies may participate in public tenders, but must be represented by a subsidiary registered in the country or a Brazilian representative. In case of tied bids the preference is for products manufactured in the country.

Osec Market Report: Brazils Pharmaceutical Industry

2.5. Foreign Trade 2.5.1. Trade Performance The foreign trade figures presented in this chapter include operations with products under HS codes 3003 (pharmaceutical final products not packed for retail) and 3004 (drugs packed for retail). Unpacked products represent only 3% of imports and 1% of exports. Total foreign trade operations of drugs significantly increased in the period from 2003 to 2008, reaching USD 3.5 billion on an average annual growth of 23%, as shown in Chart 6. In 2009, imports registered a 1% reduction in terms of value, while domestic demand still increased 10%. Less affected by the global crisis, Brazilian exports grew 15% in 2009, while the previous annual growth was 27%. In 2010, imports tend to increase again and gradually return to the previous growth pace.

Chart 6 Brazilian Pharmaceutical Foreign Trade Evolution (Value)

Source: Ministry of Development, Industry and Foreign Trade

Generally speaking, exports have been growing at a faster pace than imports, but their overall value remains lower. Therefore, Brazils trade balance continues to post deficits for pharmaceutical products, and remains dependent on imports. The Ministry of Health perceives this dependence as a major vulnerability, and its reduction is one of the main objectives of public policies for the sector (see Chapter 3.2 Government Industrial Policies). In terms of volume, the situation is different. From 2003 to 2007, exports exceeded imports, as shown in Chart 7.

Osec Market Report: Brazils Pharmaceutical Industry

Chart 7 Brazilian Pharmaceutical Foreign Trade Evolution (Volume)

Source: Ministry of Development, Industry and Foreign Trade

Nevertheless, the volume imported exceeded export volumes in 2008, suggesting a significant change in the trade strategy of international laboratories and reflecting the global crisis effects over the exchange rates worldwide, The average price of medicines decreased from USD 118 to 102 per kilogram in a year. Approximately 100 countries exported drugs to Brazil in 2009, although 51% of imports (in value terms) come from the USA, Switzerland and Germany, source countries of major international laboratories, as presented in Chart 8.

Chart 8 Brazilian Imports of Drugs in Terms of Value (HS codes 3003 / 3004)

Source: Ministry of Development, Industry and Foreign Trade

Imports of medicines into Brazil are predominantly carried out by the subsidiaries of international laboratories established in the country. They are also responsible for the biggest part of exports, but the share of domestic laboratories tends to increase.
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Latin American countries are the main foreign destination of Brazilian medicines, as shown in Chart 9, since: The top international laboratories elected Brazil as their production platform for Latin America, on the grounds that Brazil represents approximately 40% of the regional demand (including Mexico); Brazil participates in regional trade agreements that allow local exporters to sell pharmaceutical products under preferential conditions or tariff-free. This network of agreements comprises almost all Latin American countries. Chart 9 Brazilian Exports of Medicines (HS codes 3003 / 3004)

Source: Ministry of Development, Industry and Foreign Trade

2.5.2. Taxes on Imports Although the federal government exempts medicines from the payment of the main taxes in its own sphere (except for import duties), the total tax burden on the importation of medicines to the country is still high. At the same time, the import cost calculation is quite complex, involving an intercorrelated system of federal and state taxes, also taking into account the specific product and the state of disembarkation. Products are identified by their NCM codes (Mercosur Common Nomenclature), which is based on the international HS codes. Table 2 shows the tax values for an imported medicine, compared to the taxes applied to an equivalent domestic product.

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Table 2 Example of Tax Amounts for a Medicine

Source: Prospectiva calculation

On the other hand, the tax burden on the importation of equipment is higher, as shown in Table 3. Table 3 Example of Tax Amounts for Equipment

Source: Prospectiva calculation

Exports from Brazil are made easier by a business friendly drawback regulation. Not only does it exempt the components importation from all taxes, it also provides for a refund of taxes paid on domestic components. The drawback regulation also encompasses re-exportation operations, i.e. without local manufacturing process involved.

2.6. Geographical Distribution of Demand and Production Within Brazil, the demand for medicines is not evenly distributed, since the country is still characterized by significant regional and social disparities: The heavily populated and relatively rich Southeast region (comprising the megacities of So Paulo and Rio de Janeiro) is responsible for 56% of the domestic drugs demand. By contrast, the North region, dominated by the Amazon rainforest, barely represents 5% of the market.

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Table 4 Brazilian Market Regional Distribution 2008 Basis

Sources: (1) IBGE (Brazilian Institute of Geography and Statistics) (2) IMS Health

Following demand, the production of pharmaceutic al products is also concentrated in the Southeast region of the country. The State of the So Paulo headquarters more than 110 laboratories, and Rio de Janeiro 80. However, the State of Gois is in the 3rd biggest manufacturing location, accounting for 33% of medicine production in terms of volume. This position is due to a pharmaceutical industrial cluster located in the city of Anpolis. The Anpolis cluster was launched in 1989, and its development was stimulated by a tax exemption policy implemented jointly by the state and municipal governments. Currently, the cluster gathers more than 20 pharmaceutical and pharmochemical companies, mainly focused on the production of generics, in addition to bioequivalence, bioavailability, and quality control laboratories. The industrial cluster of Gois has already generated over 20,000 jobs, and encouraged other regional governments to start similar projects, aiming at the establishment of new pharmaceutical clusters, such as:
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Goiana, located in the State of Pernambuco, in the Northeast region of the country. Specialized in biotechnology, it has 3 plants under construction: Novartis (vaccines), LAFEPE (Pernambuco state-owned laboratory) and Hemobras, a new federal-owned laboratory that will produce hemotherapeutic products; Eusbio, in the State of Cear (Northeast region) is set to become a location for medicines and health equipment production sites. It already counts on a new biotech plant of FIOCRUZ (see Chapter 3.6 State-Owned Laboratories). The emergence of new regional clusters is expected to reshape Brazils pharmaceutical industry in the future.

2.7. Regulatory Framework Changes in the regulatory framework have contributed to the development of Brazils pharmaceutical industry over the last 10 years. 2.7.1. Intellectual Property Rights The most important change occurred in 1996, when the National Congress approved a new Intellectual Property Law, which for the first time extended patent protection to pharmaceutical and pharmachemical products and procedures. To have intellectual property rights protected in Brazil, it is necessary to register the international patents and trademarks with INPI (National Institute of Industrial Property). INPI is a signatory of the PCT international protocol (Patent Cooperation Treaty). Therefore, the original depositary receipt agency may extend the rights to Brazil. Unfortunately, Brazil has not signed Madrid Protocol yet, which automatically recognizes the registration of trademarks registered at international patent offices.

2.7.2. ANVISA ANVISA (National Health Surveillance Agency) is the regulatory agency that controls the management, imports, storage, distribution and sale of health related products and services in the country. Comparable to Swissmedic, it is an autonomous agency linked to the Ministry of Health, under a delegation contract (see http://www.anvisa.gov.br). The Agencys competences embrace regulation, control and inspection, including the concession of drugs registration permits, which are compulsory for both local production and imports. Since ANVISA was established in 1999, the registration of drugs and the acquisition of manufacturing permits became slower and more expensive. On the positive side, the Agencys high sanitary standards brought about a significant improvement in the manufacturing practices and thus promoted the quality of medicines sold in Brazil. By now, the majority of domestic products can be sold in most Brazilian export markets without adaptation.

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ANVISA has adopted national guidelines for Good Manufacturing Practices (see http://www.anvisa.gov.br/legis/resol/2003/rdc/210_03rdc.pdf) and quality control, which refer to WHO recommendations. There are also Good Laboratory Practice guidelines which follow the OECD standard. The Agencys competence also includes the establishment of rules for labels, direction information, and advertisement materials on medicines and foods. Foreign laboratories usually need to redesign labels, packages, and advertisement materials in order to sell medicines in the Brazilian market. In addition, the Agency regulates the sale of medicines. It currently prepares new rules on the importation of drugs, which are going to oblige importers to have their own quality control laboratories.

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3. THE PHARMACEUTICAL INDUSTRY IN BRAZIL


3.1. Overview In Brazil, there are more than 500 pharmaceutical laboratories registered, but less than 300 private laboratories are in fact operating. In addition, there are approximately 20 state-owned laboratories of different sizes. Only 5 of these produce more than 150 million units of drugs per year.

Table 5 Profile of Pharmaceutical Laboratories Operating in Brazil

Sources: IMS Health; Prospectivas market experts (*) gross value

The industry has been shaped and reshaped by international mergers and acquisitions, the rise of domestic companies, local M&A processes and the entry of new competitors from abroad. At the same time, the Brazilian government has been actively promoting the domestic pharmaceutical sector (see Chapter 3.2 Government Industrial Policies). The growing level of capital assets invested (see Chart 10) reflects the enlargement and modernization of plants by the Brazilian laboratories their investments are focused on manufacturing capacity. At the same time, elevated levels of idle capacity prompted a temporary slump in foreign direct investment after 2004. Recently, multinational companies announced more investments, turning Brazil into a production platform for the Latin American market.

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Chart 10 Pharmaceutical Industry Investments

Sources: Capital Assets - Painel de Empresas (Febrafarma) FDI - Bacen/Conap - Brazilian Central Bank

The volume of pharmaceutical production in Brazil (according to the governments statistical office, IBGE) has steadily increased over the past decade (see Chart 11):

Chart 11 Pharmaceutical Production Index Pharmaceutical Production Index


180 160 140 120 100 80 60 Jan 03 Nov 03 Sep 04 Jul 05 Mai 06 Mrz 07 Jan 08 Nov 08 Sep 09

Source: IBGE Reference year (100%): 2002

In terms of galenical forms, domestic production is concentrated in solids, representing 60% of volume. Of the newly launched products, 80% are in solid form. Oral liquids represent 15 to 20% and the remaining production is distributed along ointments, suppositories, sterile liquids, etc. Regarding production capacity usage, see Chapter 3.8 below.
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3.2. Government Industrial Policies The Brazilian government has a policy to promote the development of a national pharmaceutical industry. It is implemented on the federal level, but supported by the state and municipal government spheres. The federal policy is implemented under the label Health Industry Complex (Complexo Industrial de Sade or CIS) since 2007. It aims at enhancing a national production base of pharmaceutical chemical products, as well as medical equipment. The targets are to reduce the annual foreign trade deficit on health-related goods from USD 7.1 billion to 4.4 billion, and to develop technology in order to produce 20 drugs considered strategic for the Brazilian healthcare system, both up to 2013. The major arm of the Health Industry Complex policy is Profarma (Support Program for the Development of the Pharmaceutical Productive Chain), a federal program to finance investments of companies headquartered in Brazil and inserted in the health industry. Other key elements of the policy are implemented by FINEP (Research and Projects Financing), the Brazilian Agency of Innovation. The policies of the state and municipal governments are focused on the establishment or expansion of regional industrial clusters (see Chapter 2.6 Geographical Distribution of Demand and Production).

3.2.1. Profarma The funds for the Profarma program are provided by the BNDES (National Bank of Social and Economic Development), which offers long-term credits at low interest rates. Profarma funds may be used to acquire equipments and industrial systems made in Brazil, but also to import equipment (unless a similar national product exists), as well as to pay for services (like studies, projects and training) and inter-company technology transfers. The program was launched in 2004 and its first phase, concluded in 2007, leveraged investments of R$ 2 billion, distributed in the following three subprograms: Production (manufacturing improvement) - Directed to the construction, expansion and modernization of production capacity. This subprogram represented R$ 1.3 billion of investments, distributed in 34 diverse projects; Innovation - Related to radical or incremental innovations (products and processes), construction and consolidation of innovation infrastructures, and internalization of competences and activities on R&D (R$ 160 million in 13 projects); Empowerment of National Companies Supporting the incorporation, acquisition, or merger of companies, aiming at the creation of larger enterprises under national control. In its first phase, Profarma financed the acquisitions of Biosinttica by Ach and of Barrene by Farmasa (R$ 560 million).

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At the end of 2007, a second phase of Profarma was launched, which runs up to 2012. It foresees a R$ 3 billion investment, with R$ 1.5 billion earmarked for innovation. The new Profarma puts a special emphasis on improving the competitiveness of exporters and of state-owned laboratories. For the latter, the national development bank BNDES will finance 80% of investments, and the remaining 20% shall be disbursed by the federal, state or even municipal governments. Foreign companies operating in the country may benefit from Profarma, but projects in the initial period were mainly from Brazilian capital companies (85% of projects).

3.2.2. FINEP FINEP is linked to the Ministry of Science and Technology and manages the federal government funding for scientific and technological development. The agency provides non-reimbursable funds for research projects of non-profit institutions, such as universities and research centers, as well as low interest rate loans for projects of private companies established in the country. It supports every stage of the scientific and technological development cycle: basic research, applied research, and innovation on products, processes, and services. The Health Industry Complex is one of FINEPs priorities. From 2002 to 2009, FINEP investments in this sector exceeded R$ 600 million (i.e. R$ 75 million per year). The Eurofarma laboratory, for example, obtained an R$ 11 million loan to develop 5 generic medicines, while EMS Pharma was granted funds to implement a R&D center to develop formulations and carry out validation and stability tests. This center employs 200 technicians. Similarly, Ach financed the development of a new phytotherapic medicine based on a Brazilian herb.

3.3. The Growth of Domestic Laboratories The big multinational laboratories have been present in Brazil since the government started to attract them in the 1940s. They came to dominate the Brazilian market first through imports (70% of national consumption in 1953) and then by setting up their own manufacturing capacities (80% of national production in the late 1960s). They were later joined by smaller companies and by competitors from emerging markets, notably after 1990, when import restrictions were lifted, price controls eased, and patent protection extended to pharmaceutical products. Nevertheless, Brazil had domestic laboratories throughout this period. Industrial scale production began in the 1930s, and Brazilian pharmaceutical companies mushroomed after 1970, as they were allowed and indeed encouraged to produce similar medicines, i.e. copies of drugs patented abroad, using active ingredients imported from Italy or Spain. An attempt by the government to stimulate national production of pharmaceutical chemicals through import restrictions failed in the 1980s, not least because it was

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accompanied by severe price controls. In the 1990s, market liberalization and the strength of the Brazilian Real took their toll on domestic laboratories. Domestic laboratories have gained market share in the past decade, though. This trend was driven by the governments Profarma program and by the rise of generics. With a new legal and regulatory framework, and without demanding large R&D investments, generics now offered a relatively low-risk opportunity to grow. When the sale of generics effectively started in Brazil in 2003, the domestic laboratories overall market share stood at 37%. It has now reached 52% in terms of units, as shown in Chart 12. In terms of value, the market share of international laboratories still remained 10% higher than domestic laboratories, mainly due to the smaller unit price of generics.

Chart 12 Domestic Laboratories Market Share Evolution

Source: IMS Health

Thus far, the generics sold in the country are largely produced by Brazilian capital companies (80% in terms of value). Some international competitors retreated soon after market entry. But the rapidly evolving market scenario proved to be testing for domestic companies, too. The local generics market leader, Medley, ran into heavy debts and was then sold to Sanofi-Aventis in 2009. The prices of generics in Brazil are usually just 35% lower than branded ones a relatively small discount by international standards. These circumstances allow wellmanaged companies to earn profits and increase their investment power. Nevertheless, since most domestic laboratories are still family-owned, their capacity to actively engage in mergers and acquisitions (and innovation) remains limited. The major laboratories, notably Ach, Eurofarma and EMS, now consider going public in order to improve their access to the capital market. The smaller and medium companies, on the
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other hand, face the risk of being taken over.

3.4. Market Shares by Company

3.4.1. Retail Market The retail market is mature and extremely competitive; the leaders share was approximately 7% and the share difference among the 3 major players was just 1% in 2009, as shown in Table 6.

Table 6 Laboratories Share in the Retail Market

Source: IMS Health * Domestic companies ** Domestic company acquired in 2009 by Sanofi-Aventis

Table 6 data do not consider the acquisition of Medley by Sanofi-Aventis. SanofiAventis including Medley will be the market leader. Likewise, Novartis and Sandoz are ranked as two different manufacturers. Jointly, they are the third biggest player in the Brazilian pharmaceutical retail market. The market shares in the Ethical (mandatory prescription) and OTC sub-segments are presented in Table 7, reflecting values in R$ million.

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Table 7 Ethical and OTC Retail Shares

Source: IMS Health * Domestic companies ** Domestic company acquired by Sanofi-Aventis

Table 8 shows the market sub-segment of generics. It is highly concentrated and dominated by Brazilian laboratories. Table 8 Generics Retail Shares

Source: IMS Health * Domestic companies ** Domestic company acquired by Sanofi-Aventis

3.4.2. Non-Retail Market The non-retail market segment is not as competitive as the retail market and is more
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concentrated. The seven major players detained nearly 50% of the market in 2008, as shown in Table 9. Though they do not show up in the top 10, it is in this market segment that state-owned laboratories are particularly active.

Table 9 Shares in the Non-Retail Market

Source: Grupemef * Domestic companies

3.5. Major Competitors Profiles The competitors profiles are presented according to their positions in the retail market ranking. 3.5.1. EMS Pharma

Sources: IMS Health; Grupemef

EMS Pharma laboratory is a family-owned domestic company founded in 1964 as a small drugstore in the metropolitan region of So Paulo. In 1999, EMS began to operate its first pharmaceutical plant near So Paulo, after an investment of R$ 100 million. Today, EMS has two plants in the state of So Paulo, with an output capacity of 360 million units per year, and more than 4,500 employees, including 1,500 sales
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representatives. EMS has expanded its operations by acquiring smaller laboratories and investing in their plants. Over 6% of EMS revenues are applied to R&D activities. Its portfolio has 1,500 products, distributed into 5 divisions: EMS Hospital with 27 products and 40 presentations; EMS Consumption, which has an extensive portfolio of products divided into categories such as vitamin C, antiflu, antacid, contusion medicines and menstrual regulator; EMS Sigma Pharma, having a segmented portfolio of products that cover analgesics, antibiotics, anti-inflammatories, antihypertensive, antianemics, immunosuppressants, contraceptives, etc; EMS Generics offering over 500 product presentations, including anti-inflammatory, painkillers, antibiotics, antiulcer, anti-hypertensive, antimalarial, antidiabete, topic corticoids, and generics against flu and cold; EMS Similar: Gerovital (Multivitamin), Apevitin BC, Naridrin, Sominex, Complexo B (B Complex), EMS Expectorante (Expectorant) and Allexofedrin, etc. Website: www.ems.com.br

3.5.2. Sanofi-Aventis

Sources: IMS Health; Grupemef

Combined with Medley (acquired in 2009, see below Chapter 3.5.4.), Sanofi-Aventis now leads all retail market segments, presenting:

Sanofi-Aventis is in Brazil since 1959, established in the city of So Paulo. Today, Brazil is the companys second most important production platform (after France), and its 7th most important market. Sanofi has a manufacturing plant in Suzano (state of So Paulo), with an output capacity of 200 million units per year and 630 employees. This unit is said to be the
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companys biggest pharmaceutical plant worldwide. Nevertheless, Sanofi keeps adding more production capacity: It invests roughly USD 100 million (from 2009-2012) to bring the joint output of the Suzano and Campinas plants (acquired from Medley, see below) to 450 million units. It also operates development centers at both locations. Sanofi-Aventis delivers: Ethical Drugs for cardiovascular/thrombosis (15), dermatology (8), metabolic diseases (10), internal medicine (71) and central nervous system (18); Generics: 23 products OTC: 27 products Vaccines: 18 products, from preventive to therapeutic uses. Sanofi-Aventis and Medley are both manufacture outsourcing providers. Website: http://www.sanofi-aventis.com.br

3.5.3. Ach

Sources: IMS Health; Grupemef

Ach Laboratrios Farmacuticos S.A. is a domestic company founded in 1966, in the metropolitan region of So Paulo, controlled by the Brazilian families Dellape Baptista, Siaulys and Depieri. However, they are planning an IPO for 2010. Ach has two pharmaceutical plants in the metropolitan region of So Paulo, which employ over 3,000 workers and produce over 160 million units per year. Since 2008, it has been investing R$ 75 million to update and enlarge the output capacity of its main plant, located in Guarulhos. Currently, the company exports 24 medicines and 36 presentations to 12 countries: Argentina, Bolivia, Canada, Colombia, Chile, Ecuador, USA, Mexico, Peru, Cape Verde, Dominican Republic, and Venezuela. Ach invests R$ 120 million in 2010 to launch similar and generic medicines, which patents are about to expire. It is also investing R$ 70 millions in the R&D of new medicines, including in the biotech area. Achs portfolio includes 250 products and 600 presentations, distributed in the following classes: Ethical 135 products in diversified presentations for arthrosis, infection, inflammation, cardiology, dermatology, endocrinology, gastroenterology, oncology, respiratory diseases, womens health and neurological drugs;
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OTC 35 products; Generic 83 products; Dermocosmetics 15 products. The main therapeutic classes of the laboratory are Cardiovascular System (20%); Respiratory System (18%); Musculo-Skeletal System (16%); Genito Urinary System (11%); Alimentary Tract Metabolism (11%); Nervous System (9%), and Dermatology (4%). Website: http://www.ache.com.br

3.5.4. Medley

Source: IMS Health

Medley was founded in 1932 as a local family-owned company, located in upstate So Paulo. The laboratory has been a pioneer in the production of generic drugs, becoming later the leader of this segment. In 2009, the company encountered severe liquidity problems, which prompted its sale to Sanofi-Aventis, but it continues to be managed as an independent unit. The acquisition was approved by competition regulators in May 2010, under certain restrictions. At the time of its acquisition, Medley already operated two pharmaceutical plants in So Paulo, with a combined output capacity over 180 million units per year, employing 1,550 people (incl. 500 sales representatives). Sanofi-Aventis approved the construction, for USD 45 million, of a new plant in Brasilia to produce generic hormones for the Latin American market. This facility is expected to become operational by 2012. Products from the laboratory have been exported to 15 Latin American countries. Sanofi-Aventis is opening new fronts in Europe. Medley operates in the segments of Ethical, OTC and Generic drugs, offering 127 different products. Website: http://www.medley.com.br

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3.5.5. Eurofarma

Sources: IMS Health; Grupemef

Eurofarma is a Brazilian pharmaceutical laboratory founded in 1972, as the first Brazilian manufacture services provider. In this field, it is still one of the major Brazilian players. Laboratory services range from single manufacture up to full services, covering all type of galenical forms. Since its foundation, the company has grown, acquired other companies, and started to manufacture and sell its own brands and other brands under international license. The company has now 3,300 employees; 1,900 involved in the sales force. Eurofarma is headquartered in the city of So Paulo. In 2007, it began transferring production blocks from its 5 different plants to a new industrial complex located in the city of Itapevi, near So Paulo, to be concluded in 2010. The new plant required an investment of approximately R$ 450 million. Eurofarma exports to a few Latin American countries and intends to cover 90% of the Latin American market by 2015. In order to achieve this objective, it acquired a small Argentine laboratory in 2009, Quesada Farmacutica. It also has a project to build a new plant in Venezuela. In recent years, Eurofarma has been investing 5 to 6% of its revenues in R&D projects, including in the biotechnology area. It is working on two radical innovation projects in collaboration with universities: the first is to develop a new treatment for diabetes type 2 and degenerative neurological diseases, and the second is a new phytotherapic drug with anti-inflammatory and analgesic effects. The company operates eight business divisions: Pharma Business Unit: Responsible for the sales of branded drugs (158 products); General Practice, Gynecological, Pediatric, Psychiatric, Urological, Gastroenterological, Dermatologic, Neurologic, Orthopedic, Rheumatologic, and Otorhinolaryngologic. Generic Drugs Unit: has 140 products, predominantly antibiotics, antidepressants and tranquilizers. Hospital Unit. It offers a complete portfolio comprising reference, similar and generic drugs of the following therapeutic classes: antibiotics, anti-inflammatory drugs, antiulcer agents, anesthetics and others. In addition to the private segment, Eurofarma has the Bidding Unit, which supplies public hospitals and the SUS program. Oncology Unit. Currently, it has the largest volume of cancer products in the Brazilian market.
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Pearson Unit (Veterinary Unit), with 34 products. It is launching a new plant in 2010, where it shall produce foot-and-mouth disease vaccines (biotech). Export Division, which manages the commercialization of Eurofarma drugs in the external market. Services to Third Part. It coordinates Eurofarmas outsourcing services. Euroglass Unit. It offers containers to store drugs. Website: http://www.eurofarma.com.br

3.5.6. Novartis

Sources: IMS Health; Grupemef

Sandoz do Brasil, which is not included in the above figures, presented the following performance in the same period:

Source: IMS Health

Of the two Novartis predecessor companies, Sandoz had been active in Brazil since 1941, and Ciba-Geigy had arrived in 1971. Novartis do Brasil has over 2,200 employees. From 2007-12, it invests R$ 233 million to expand the capacity of its plants in Resende (RJ) and Taboo da Serra (SP), which it uses as production platforms for both the domestic and export markets. It synthesizes its own pharmaceutical ingredients there. By 2012, Novartis will install in the State of Pernambuco (Northeast region) a new plant to produce vaccines. The drugs portfolio of Novartis in Brazil comprises: Ethical 110 products for cardiovascular diseases, metabolic diseases, oncology, hematology, respiratory diseases, neurosciences, arthritis and bones, infectious diseases/ transplant/ immunology (IDTI), ophthalmology, dermatology, and gastrointestinal and urinary diseases;
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OTC 26 products; Vaccines against several viruses and bacteria; Veterinary products for a wide range of animals. Website: http://www.novartis.com.br Sandoz do Brasil has 800 employees. The plant located in Camb (Paran state) manufactures drugs for the Brazilian market, but also for export to Europe and North America. The product range includes generics, OTC, and drugs for medical specialties, such as oncology, central nervous system, urology, and gynecology. Growth hormones will be added in the second half of 2010. The plant output capacity is 1 billion tablets, 60 million blisters and 46 million packed units per year. Website: http://www.sandoz.com.br

3.5.7. Pfizer

Sources: IMS Health; Grupemef

In 1952, Pfizer started its operations in Brazil, trading imported products. In 1960, the company launched its first industrial plant in the country. Pfizer has a plant in the metropolitan region of So Paulo, with an output capacity of 170 million units per year. Headquartered in the city So Paulo, it has 1,800 employees. The local portfolio includes: Drugs for human use - approximately 110 products, mainly Ethical, for cholesterol, depression, neuropathic aches, arterial hypertension, pulmonary hypertension, oncology, central nervous system, and gynecology; Veterinary drugs - for cattle, birds, pigs, and pets, including anti-inflammatory, antiparasitic, products for the reproductive process and vaccines. Pfizer is planning to enter the Brazilian segment of generics. In 2009, it tried to acquire Neo Qumica, but the company was sold to the Hypermarcas domestic group (D M Ind. FTC). Pfizer continues to look out for acquisition targets. Website: http://www.pfizer.com.br/

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3.5.8. Bayer Schering Pharma

Source: IMS Health

Bayer Schering Pharma figures do not consider the Bayer Consumer Care area. Together, they would form the 7th major player in the Brazilian pharmaceutical retail market. Bayer Consumer Care presents the following performance record:

Bayer Schering has been in Brazil for a long time: Bayer for more than 110 years and Schering since 1950, having launched a local production unit in 1959. The group has local operations in four areas: Pharma (Ethical drugs); Consumer Care (OTC); Diabetes Care and Animal Healthcare, besides drugs for diagnosis. The company is headquartered in So Paulo and has more than 1,600 employees. Their main industrial sites are in So Paulo city, dedicated to human health, with an output capacity of 130 million blisters per year, and in Porto Alegre (Rio Grande do Sul State, South region) producing 150 million units of animal healthcare products. Bayer Schering Pharma produces over 46 Ethical drugs for: Andrology; Anti-infective; Cardiovascular; Dermatology; Diagnosis; Gynecology; Neurology; Oncology and Primary Care. Website: http://www.bayerscheringpharma.com.br

3.5.9. AstraZeneca

Source: IMS Health

Before their international merger in 1999, Astra had been active in Brazil for two decades, and Zeneca for one.

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AstraZeneca is currently headquartered in Cotia (metropolitan region of So Paulo), where it also operates an industrial plant with an output capacity over 38 million units per year. It has 1,200 employees in Brazil. AstraZenecas product mix comprises drugs for Anesthesiology, Cardiovascular, Infectious diseases, Gynecology, Mastology, Neuropsiquiatry, Oncology, Urology, and Respiratory diseases. Website: http://www.astrazeneca.com.br

3.5.10.

Boehringer Ingelheim

Source: IMS Health

Boehringer Ingelheim started in Brazil in 1953, through a pharmaceutical importer. In 1976, it installed a manufacturing plant in Itapecerica da Serra, in the metropolitan region of So Paulo. The plant, located in Itapecerica da Serra, has 27,700 square meters and an output capacity of more than 120 million units per year. The company is headquartered in the city of So Paulo and has approximately 1,000 employees in the country. Boehringer Ingelheim do Brasil offers manufacture outsourcing services, including full services. Outsourcing accounts for 8% of the production in Itapecerica da Serra. The company locally produces drugs for exportation to Europe, Asia and all Latin America. Export revenues represent 25% of companys revenue in Brazil. Its mix comprises: Ethical 31 products OTC 11 products Veterinary 8 products Website: http://www.boehringer-ingelheim.com.br/

3.5.11.

Roche

Roche is the non-retail market leader in Brazil. Overall, with gross revenue of R$ 1.5 billion in 2008, it ranked third in Brazil, behind Sanofi-Aventis and Novartis. Headquartered in Sao Paulo, Roche do Brasil has 1,375 employees. Production is concentrated at its site in Jacarepagu (near Rio de Janeiro), refurbished
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in 2002-04 for USD 70 million. A new quality control laboratory was added in 2008. In its plant, Roche manufactures solid forms, oral liquids, and sterile liquids for the Brazilian and Latin American markets (export value was USD 82.2 million in 2008). To make use of idle capacity, Roche also offers manufacturing services to third parties. The companys pharmaceutical division in Brazil sells 51 brands in 110 presentations. Website: http://www.roche.com.br/

3.6. State-Owned Laboratories In Brazil, there are 18 state-owned pharmaceutical laboratories affiliated to ALFOB (Brazilian Official Laboratories Association) and a few vaccine producers, such as Biomanguinhos, Butantan Institute and Tecpar. They produced 30% of drugs purchased by the SUS program in terms of value (See Chapter 2.4 Non-Retail Demand), from basic OTC medicines to vaccines. ALFOB laboratories are linked to the federal and state governments, to public universities, to the Armed Forces or to the Ministry of Health. The main ones are listed in Table 10. Together the ALFOB laboratories have an installed production capacity of 14 billion units of medicines per year, but they present an average idle capacity of 66%. Table 10 Major ALFOB Laboratories Output and Idle Capacity in 2008

Source: ALFOB (Brazilian Official Laboratories Association)

Idle capacity is especially high in smaller laboratories. This is primarily due to: the difficulty to adapt production plants to sanitary regulations from ANVISA only the four laboratories presented in Table 10 already had GMP certificates in 2008; difficulties to purchase new equipment, hire qualified professionals, and develop manufacturing technology; raw material shortages due to delays in public tender procedures. The main government strategy to strengthen state-owned laboratories is to develop business partnerships with private laboratories. In 2009, there were eight business agreements entered into by the Brazilian Ministry of Health, involving 9 state-owned laboratories and 11 private companies, being 4 foreign and 7 domestic.
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Biomanguinhos, a state-owned laboratory not affiliated to ALFOB, for instance, signed a business agreement with GlaxoSmithKline comprising the technology transfer of a pneumococcal vaccine and the installation of an R&D center for neglected diseases (malaria, dengue and yellow fever). The improvement of state-owned laboratories also goes through investments into their technological development and output capacity, in addition to R&D projects. From 2000 to 2009, the Ministry of Health invested over R$ 400 million in state-owned laboratories. The second phase of the Profarma program (see Chapter 3.2 Government Industrial Policies) also benefits the improvement and expansion of state-owned laboratories. However, the release of funds is contingent on an audit of the laboratories operating and administrative processes, and a commitment to eventual changes recommended by the BNDES. This procedure tends to favor the bigger state-owned companies, promoting a concentration process within the segment. Hence, the government expects the largest state-owned laboratories to become more competitive, reducing its expenses for the acquisition of drugs, and possibly reducing the share of private laboratories in SUS program purchases. In the mid to long term, state-owned laboratories may dispute the retail market to keep their growth pace. The major stated-owned laboratories are:

3.6.1. FIOCRUZ - Fundao Oswaldo Cruz FIOCRUZ is a Brazilian centenary institution linked to the Ministry of Health and headquartered in Rio de Janeiro. It has over 7,500 employees and health professionals working in 15 institutes, including Farmanguinhos, Biomanguinhos, 7 R&D units, 2 health schools, and a reference hospital. FARMANGUINHOS Institute of Medicines and Drugs Technology Farmanguinhos is part of the federal government policy for the control of medicine prices, mainly through the production of generics for use in the treatment of AIDS. It also produces medicines against tuberculosis, malaria, leprosy, hypertension, and several kinds of cancer. Farmanguinhos quintuplicated its production capacity in 2005, by acquiring from GlaxoSmithKline a pharmaceutical plant located in the metropolitan region of Rio de Janeiro, for an amount of US$ 6 million. Website: http://www2.far.fiocruz.br/farmanguinhos

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Biomanguinhos - Immunobiologicals Technology Institute . It is the largest producer of vaccines and kits for diagnosis of infectious and parasitic diseases in Latin America. It is also the worlds largest producer of vaccines against yellow fever, supplying up to 100 million doses per year to the SUS program and for exportation. The product range includes vaccines against measles, poliomyelitis, meningitis meningococcal A/C and by Haemophillus influenzae type B, diphtheria, tetanus, pertussis, and MMR triple vaccine. In a joint venture with GlaxoSmithKline (GSK), at a cost of 35 million, Biomanguinhos develops a new vaccine against dengue (endemic in Brazil). Annual output exceeds 100 million doses of concentrated viral and around 60 million vaccine doses, catering for 47% of the vaccines demand of the National Program of Immunizations (PNI). Furthermore, Biomanguinhos supplies up to 2.5 million kits of reagents for diagnosis of infectious and parasitic diseases, such as AIDS, leishmaniasis, Chagas disease, dengue fever, hepatitis, and rubella. Website: http://www.fiocruz.br/bio

3.6.2. FURP FURP, or Fundao para o Remdio Popular (Popular Medicine Foundation), is linked to the So Paulo State government and headquartered in the So Paulo metropolitan region. It was the first state-owned laboratory to produce generics in the country. It is the major Brazilian state-owned laboratory, having 2 pharmaceutical plants located in Guarulhos and in Amrico Brasiliense. The Amrico Brasiliense unit is the newest, having demanded up to now an investment of R$ 240 million. Its yearly output shall reach 21.6 millions of ampoules and 1.2 billion capsules after reaching its full production capacity. In 2008, FURP produced almost 2 billion units of drugs, comprising antibiotics, antiretrovirals, antihypertensives, dermatological, immunosuppressors, and medicines for treatment of diabetes and mental health. Website: http://www.furp.sp.gov.br

3.6.3. Butantan Institute Butantan Institute, founded in 1901, belongs to the State of So Paulo, and is currently located in the city of So Paulo. Today it is one of the five major vaccine producers in the world and the largest supplier for the domestic market. It is responsible for 80 vaccines distributed through the SUS program and for 65 anti-snake venom serums. The Institute supplies approximately 80% of the sera and vaccines used in the country. In addition to anti-venin sera, Butantan Institute produces other sera such as antitetanus, anti-rabic, anti-diphteric, antibotulinic "A", antibotulinic "B", antibotulinic "ABE", and anti-thymocytic serums. Its serum output capacity reaches 600 thousand ampoules
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per year. The vaccines produced by the Institute are Tetanic Toxoid, Double vaccine (dT) for prevention against diphtheria, Triple vaccine (DTP) for prevention against diphtheria, tetanus and pertussis, Intradermic BCG, and against rabies (human use). Butantan Institute produces 500 thousand doses of BCG per year. With new packing and lyophilization techniques, the production is set to increase 50%. It is currently developing a vaccine against meningitis A, B and C, and a new vaccine against pertussis. Butantan Institute developed the first recombinant vaccine in Brazil (using the genetic engineering techniques) against hepatitis B, with a production capacity of 50 million doses per year. Research and genetic engineering are also being conducted for the development of vaccines against dengue fever and schistossomosis (together with FIOCRUZ). In 2007, the Institute inaugurated a R$ 70 million plant for flu vaccines, with technology transferred from Sanofi Pasteur. The start of production has been delayed due to compliance issues. Butantan will be able to manufacture over 40 million doses per year and become the first Latin American laboratory to produce vaccines against influenza A (H1N1). Another big project planned by Butantan Institute is a blood derived products plant with a processing capacity of 150 thousand liters of plasma per year. Website: http://www.butantan.gov.br

3.6.4. FUNED - Fundao Ezequiel Dias Fundao Ezequiel Dias is linked to the State of Minas Gerais. Located in the capital Belo Horizonte, it was founded in 1907. Currently, FUNED supplies anti-venin and antitoxic serums that represent around 35% of the national demand. Beyond, the laboratory produces over 30 diverse drugs, comprising analgesics and antipyretics, antibacterials, anti-secretives, antianemic, broncho-dilators, cardiovasculars, antiparasitics, antidepressants, antiinfeccios and antiinflammatories, antiretrovirals, immunosuppressors, and medicines for treatment of diabetes and for mental health. The laboratory also produces vaccines and others biological and prophylactics products. FUNED signed in 2009 a technology transfer agreement with Novartis, focused on a vaccine against meningitis C. The transfer process is expected to be concluded in five years. Website: http://www.funed.mg.gov.br/

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3.7. Compounding Pharmacies Brazil has the largest market of compounding pharmacies in the world, with approximately 7,000 establishments, supplying to more than 60 million people per year. Almost 70% of these establishments are located in the Southeast region; the State of So Paulo alone has over 3,500 compounding pharmacies. The Brazilian compounding pharmacies revenue is estimated at 8% of the domestic retail sales of regular medicines, that is, near USD 1.4 billion based on the current exchange rate. Compounding pharmacies are very important in the homeopathic market. Over 2,000 compounding pharmacies work with homeopathies. The impressive number of Brazilian compounding pharmacies is mainly due to: Price. The compounded medicine is usually cheaper than industrialized ones; Physicians. The compound prescription is a subject present in almost all academic medical schools and many doctors prefer to prescribe compounded medicines, especially homeopathic practitioners; Pharmacists. There are over 120,000 pharmacists in the country, much more than the employer capacity of pharmaceutical manufacturers and drugstores. Thus, many pharmacists start their own business, often compounding pharmacies. However, this scenario is changing, primarily due to strict regulations implemented by Anvisa: Since 2005, compounding pharmacies are prohibited from producing products with presentation and concentration equivalent to industrialized medicines; In 2006, ANVISA introduced the "Good Compounding Practices" guide, with strict demands on the production and quality control of medicines in compounding pharmacies, and quickly started inspections to check its application; The rules for the labeling of compounded medicines were modified by ANVISA in 2008, compelling pharmacies to include new information on labels, such as the identification of the physician responsible for the medicine prescription and the pharmacist that compounded it. Thus, smaller independent establishments tend to disappear, since the first regulation restricted the market and the others increased the production costs. ANFARMAG, the National Association of Compunding Pharmacists, is promoting among its 5,000 affiliates the creation of pharmacy chains as an alternative way to survive. While these are not yet significant market players, their number and size is growing. Chains of compounding pharmacy stores, mainly those specialized in homeopathy, usually also sell phytotherapics, food supplements, holistic products, vitamins, and sometimes, industrialized homeopathic medicines.

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3.8. Manufacture Outsourcing The Brazilian pharmaceutical industry has gradually improved its production capacity usage, as shown in Chart 13.

Chart 13 Manufacturing Capacity Usage in the Pharmaceutical Industry

Source: FGV NUCI

As a consequence, there is a growing market for manufacture outsourcing which was estimated at R$ 250 million in 2008. The demand for manufacturing services stems both from some domestic laboratories, whose investments to expand production capacity have not kept pace with growing demand, and from a few foreign companies having deactivated outdated or unprofitable production lines of their own. There are also companies facing exceptional demands (e.g. due to a successful public bid) or those whose production facilities do not meet the requirements of sanitary authorities (mainly state-owned laboratories). The demand for manufacturing services shows where companies need extra capacities, a situation which may result in future investments. Of course, the scenario is different for each galenical form and different pharmaceutical specialties. As shown in Chart 14, the solid forms account for almost 50% of the outsourcing demand. The share of sterile liquids accounts for almost 20% of the total manufacture outsourcing market, despite of smaller product quantities. Unit prices are higher and few companies have production lines for vials. The market segment of lyophilized sterile liquids, in particular, is characterized by the highest unit prices, although it barely represents 5% of the market.

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Chart 14 Manufacture Outsourcing Demand in Value Terms

Source: Prospectiva elaboration

In the future, the outsourcing of lyophilized sterile liquids will be much greater, as biotech products shall dominate the market, especially proteics that should be lyophilized in order to increase products stability. The lines of semi-solids and oral liquids account for 15% of the market and present the idlest production capacity, since they have the smallest technological complexity and require lower amounts of investments. Thus, there shall be no new outsourcing needs for those production lines, except large volume contracts. The other category congregates a set of diversified forms, including creams, ointments, aerosols, etc, besides packing services for all galenical forms. Almost all the current outsourcing contracts comprise single manufacturing services, without packaging and raw materials, or even quality control services, but there is a clear demand for improvement in the service level towards full-services or, at least, complementary services, such as the supply chain.

3.8.1. Manufacture Service Providers The Brazilian pharmaceutical outsourcing market is very competitive. There is a large number of players with different profiles, ranging from small sized service providers to large multinational companies. At the same time, a competition analysis shows a high level of concentration, with the 5 major providers accounting for approximately 60% of revenues. The top providers are listed in Table 11.

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Table 11 Major Suppliers in the Brazilian Pharmaceutical Outsourcing Market

Source: Prospectiva researches

In order to map this market, we can distinguish three groups according to the importance they give to outsourcing services in their overall activities. Group A - Companies to which outsourcing is their only business. There are more than 25 in this group, mainly small companies that offer a smaller range of services; Group B - Companies committed to outsourcing, even though it is not their core business. The group comprises 5 to 10 companies, usually large domestic and international laboratories that offer outsourcing services for diverse galenical forms and pharmaceutical specialties; Group C - Companies that sell their idle capacity, without focus on outsourcing. This group comprises the largest number of companies and is the most heterogeneous. The market share in terms of value of each class of provider is presented in Chart 15.

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Chart 15 Analysis of Outsourcing Services Providers (*)

Source: Prospectiva researches (*) Does not consider cosmetics

3.9. Research & Development 3.9.1. Overview The R&D investment from Brazilian private laboratories has traditionally been very low, since patent protection was only extended to pharmaceutical products in 1997. While it still remains low by international standards, R&D spending in Brazil shows a tendency of consistent growth, as shown in Chart 16, and has reached R$ 500 million in 2008.

Chart 16 R&D Investments from Brazilian Private Laboratories

Source: Febrafarma report Brazilian Pharmaceutical Innovation

In 2008, R&D investment by foreign companies in Brazil represented 56% of the total
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amount. It was applied mainly to clinical research of new products developed abroad. R&D investments from domestic laboratories amounted to R$ 218 million in 2008, a significant increase over previous years. Major companies now invest more than 6% of their revenues on research projects. A big part of this effort was directed at incremental research. It appears that Brazilian companies are changing their business strategies. They are coming to perceive innovation and the development of new medicines as essential to sustain and increase their market share. Apart from collaboration with universities and other external research institutions, they are setting up and improving their own research centers. Eurofarma and Biolab together founded Incrementha PD&I, a joint venture which started by performing incremental researches and went on to develop radical innovations (http://www.incrementha.com.br). Another example is Cristlia, the domestic laboratory that possesses the largest number of patents. It recently invested R$ 30 million to install a new R&D center. Cristlia is conducting 29 medicine research projects, of which 14 are incremental and 15 radical (http://www.2cristalia.com.br). A few medium size laboratories are going the same path, such as Almeida Prado (presented in Chapter 4.2 Homeopathy), which is installing a new research center in the North region of the country, considering new phytotherapics based on Amazonian herbs. There are no accurate data concerning R&D investments from state-owned laboratories, but the amount is likely to have exceeded R$ 80 million in 2008, considering that FIOCRUZ alone spent R$ 46 million. The major state-owned laboratory research centers belong to FIOCRUZ and Instituto Butantan, which are mainly focused on the immunization and treatment of neglected diseases and sexually transmitted diseases / Aids (see Chapter 3.6 State-Owned Laboratories). Very often, they act throughout the entire research cycle, from basic research to the final clinical test, usually relying on academic or other public research institutions, and even on private laboratories. Altogether, Brazil already has the capacity and expertise to do basic research and clinical tests. However, it still needs pre-clinical development, due to the lack of infrastructure, particularly in the biotech area. A recent study carried out by Prospectiva identified a lack of the following: Companies specialized in toxicology studies; CROs (Contract Research Organizations) certified with GLP/GMP as bioteries and recombined protein manufacturers; Laboratories for special chemical tests. In the biotech sector, the most complex tests are currently carried out abroad; Equipment for biotech tests of new products; Experts for the development of biotech pharmacos.
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That need for pre-clinical development represents the best business opportunity for international CROs and equipment suppliers in the short and medium term.

3.9.2. Public Institutions Research The innovation activities are highly concentrated in public universities in Brazil, and 75% of the Brazilian researchers are linked to universities. The five major universities have almost 1,000 PhD researchers dedicated to the life sciences. Their productivity is large, having published over 10.000 scientific papers in 2007. Until a few years ago, almost all academic researchers from Brazil performed scientific studies without worrying about their practical application. That posture has been changing, especially in the healthcare area. Today many researchers collaborate with projects proposed by public institutions or private companies. The Innovation Law, adopted in 2004, contributed to this change of mind. It allowed the application of public funds to industrial projects and stimulated business partnerships between public institutions and private companies. At the same time, this law enabled the commercialization of intellectual rights arising from publicly sponsored inventions. In 2006, 60% of the patents deposited with INPI (National Industrial Property Institute) belonged to public universities. The Acheflan medicine is an interesting case on public-private interaction. Its active principle derives from a native herb (Cordia verbenacea) found on the coastline of So Paulo. The success in the development of Acheflan by Ach laboratory was due to the collaboration with four public universities: USP (Universidade So Paulo), UNICAMP (Universidade de Campinas), UFRJ (Universidade Federal do Rio de Janeiro), and UFSC (Universidade Federal de Santa Catarina). The most remarkable Brazilian universities are: USP - Universidade de So Paulo. USP is linked to the government of the State of So Paulo, being the largest university and research institution in Brazil. Radical biotechnological and biomedical researches are carried out by several institutes inside the university, especially the Institute of Biomedical Science, the Institute of Chemistry, the Structural Molecular Biotechnology Center (CBME-USP), and the Luiz Queiroz School of Agriculture. Performance: 332 patents deposited in the period between 1992-2008; 4,809 scientific papers published in 2007; 509 PhD researchers in the healthcare area in 2008. Website: http://www.usp.br/prp

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UNICAMP - Universidade de Campinas Unicamp is also linked to the government of the State of So Paulo, being one of the top research universities in the country. It is the major Brazilian depositor of patents, most of them in Chemistry and Agribusiness. Performance: 548 patents deposited in the period 1992-2008; 1,723 scientific papers published in 2007; 115 PhD researchers in the healthcare area in 2008. Website: http://www.unicamp.br/unicamp/ensino-pesquisa-e-extensao/pesquisa UFRJ - Universidade Federal do Rio de Janeiro UFRJ is one of the oldest universities in Brazil and has great relevance in biotechnology research, housing eight academic biotech research centers like the Vegetal Biotechnology Center, the Biochemistry Institute, and the Natural Food Center. Performance: 186 patents deposited in the period 1992-2008; 1,506 scientific papers published in 2007; 106 PhD researchers in the healthcare area in 2008. Website: http://www.pr2.ufrj.br UFMG - Universidade Federal de Minas Gerais UFMG is the second largest Federal University in Brazil and has expertise in the biotechnology area; 55% of its patents deal with biotech and it detains technology for diagnosis, vaccines, and treatment of a wide range of illnesses, from cancer to neglected infectious diseases. The university has some experience in technology transfer in the biotech area. Performance: 258 patents deposited in the period 1992-2008; 936 scientific papers published in 2007; 115 PhD researchers in the healthcare area in 2008. Website: http://www.ufmg.br/pesquisa/areas_saude.shtml Besides the universities, Brazil has some public research institutions, such as: Evandro Chagas Institute (Biomedical Research - http://www.iec.pa.gov.br); INCA (Brazilian National Cancer Institute - http://www1.inca.gov.br/english); INCT-INOFAR (National Institute of Science and Technology of Pharmochemicals and Medicines http://www.inct-inofar.ccs.ufrj.br); Ludwig Institute for Cancer Research (http://www.ludwig.org.br); and Royal Institute (Main areas: Toxicology and Genotoxicology - http://www.institutoroyal.com.br). However, only FIOCRUZ and Butantan Institute (see Chapter 3.6 State-Owned Laboratories) have a performance comparable to the major Brazilian universities.

3.9.3. State Support to Innovation Innovation in the healthcare sector is the subject of several government initiatives and
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policies, with biotechnology as a priority. The aforementioned Innovation Law is an example. It stimulates research through tax exemption, encourages the participation of ICTs (Scientific and Technological Institutions), and regulates the payment of royalties for technology transfer. However, in the federal sphere, the main tools to promote innovation are: Production Development Policy for the CIS (Health Industry Complex, introduced in Chapter 3.2 Government Industrial Policies); Profarma program (Support Program for the Development of the Pharmaceutical Productive Chain). It finances investments associated to incremental researches and to the development of new pharmaceutical chemicals and medicines, having spent for this R$ 160 million from 2004 to 2007; FINEP (Research and Projects Financing). It aims at the health industry\s technological qualification in the SUS areas of interest, and the stimulation of private innovative investments. From 2002 to 2009, it spent over R$ 600 million; Production Innovation Program of BNDES (National Bank of Social and Economic Development). It finances projects of incremental innovations and technological qualification, and the installation of research centers; CNPq (National Council for Scientific and Technological Development). It is dedicated to the promotion of scientific and technological research and to the development of human resources for research in the country. In addition to the federal initiatives, there are others in the state governments sphere, such as FAPESP (So Paulo State Research Foundation), the largest one. FAPESP is a funding agency for scientific and technological research linked to the government of the State of So Paulo. It grants funds and loans for academic and applied researches, in addition to scholarships for researchers. The agency also supports some special research programs as SMOLBnet (Structural Molecular Biology Network), Virtual Institute of Biodiversity (Biodiversity and environment protection investigation), and Genoma (Molecular Biotechnology investigation). 3.9.4. Regulatory Issues In Brazil, all clinical researches must be previously approved by ANVISA. ANVISA requires that clinical researches approval include GLP (Good Laboratory Practice) certificates and the CEP (Committee of Ethics in Research) evaluation, apart from technical reports and corporate documents. ANVISA GLP guidelines follow the OECD (Organization for Economic Co-Operation and Development) standard. In the pre-clinical research, all the laboratories must have GLP certificates. ANVISAs GLP certification process requires that research laboratory facilities are previously approved by INMETRO (National Institute of Metrology, Standardization, and Industrial Quality - http://www.inmetro.gov.br/) or by an institution accredited by
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INMETRO. INMETROs approval comprises physical inspection. The basic points for equipment are adequacy for the operation, reproducibility of the experiments, and stability of the results. INMETROs approval process follows the ILAC standards (International Laboratory Accreditation Cooperation).

3.10. Biotechnology Companies The biotechnology industry is relatively recent in Brazil. However, the country has already established a global presence in important areas, such as stem cell research, genomic studies, vegetable biotechnology, and vaccines. Overall, the Brazilian biotech industry is still in the research phase, and the activities concentrated in clusters are linked to the major universities and research institutions (see Chapter 3.9 Research & Development). These clusters host a large part of the 110 biotech companies operating in the country, without considering foreign companies, most of which maintain a purely commercial presence, and companies mainly focused on other areas, such as pharmaceutical laboratories. Over 73% of biotech companies have formal business partnerships with universities or research centers. They are small to medium sized companies, which presented the following profile in 2008: 40% had been in operation for less than 6 years; 25% from 6 to 10 years, and barely 15% over 15 years; 50% had up to 10 employees, 27% from 11 to 20, and only 8% over 50; 50% report annual revenues lower than R$ 1 million. In the human health sector, there were 22 biotech companies. This was the second most important sector in 2008, as presented in Chart 17.

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Chart 17 Brazilian Biotech Companies Distribution by Sector in 2008

Source: Biominas database (http://www.biominas.org.br)

Revenues reported in 2008 from biotech companies operating in the human health sector reached USD 210 million, arising from a diverse portfolio of products and services. The largest concentration was on manufacturing of in vitro diagnosis kits (10 companies), followed by CRO (6 companies). At the same time, the sector of inputs comprised 41 companies operating also with a diverse portfolio of products, including the manufacture of reagents for in vitro diagnosis, biopolymers, vegetable extracts, recombinant proteins, etc. In addition to these companies, there are a few foreign biotech companies in the Brazilian market, such as Genzyme, Actelion, Shire, Biogen and Biomarin, none of them producing locally. The domestic biotech companies are the quickest, simplest, and cheapest gateway for the entry of foreign companies into the Brazilian biotech market, through business agreements or even acquisitions. The Danish New Nordisk, for example, although it had been in Brazil since 1990, only consolidated its local presence in 2002, when it acquired Biobrs laboratory, a national pioneer in biotechnology, and the only producer of insulin at that time. Currently, the Biobrs plant is the largest Latin American manufacturer of insulin (http://www.novonordisk.com.br) The government plays an important role in the biotech area, through funding programs, regulations and policies. Almost 70% of all Brazilian biotech companies benefit from government incentives, mainly non-reimbursable funds (48.4%), followed by low interest rate loans (9.5%) and tax exemptions (5.3%). A National Policy for Biotechnology Development was launched in 2007. Its goal is to lead Brazil to figure among the top five countries in biotechnology in 15 years, based on
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an investment of approximately R$ 10 billion for that purpose, 60% public and 40% private. The main regulation on biotech, the National Biosafety Law, was introduced in 2005. This law provides for safety norms and inspection mechanisms for biotech activities and allows the production of genetically modified organisms. However, its guidelines are rather generic. The Biosafety Law is under review in order to contemplate different requirements for distinct categories of biologic products, establishing specific regulatory issues for manufacturing, quality control, non-clinical and clinical tests. The review also includes the simplification of the research and commercial use approval.

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4. SPECIAL SEGMENTS HIGHLIGHTS


4.1. Herbal Medicines Revenues from the Brazilian herbal medicines segment are expected to exceed USD 1 billion in 2010. This segment has seen above average growth (+20%) driven by the the distribution of phytomedicines through the SUS program, their affordable prices, and by the dissemination of phytotherapy among general practitioners. Many traditional recipes are now applied on an industrial scale. There are more than 200 companies active in the segment, but the major 6 hold approximately 60% of the market share. Table 12 Herbal Medicines Major Players in 2007

Source: Manufactures and Distributors Pharmaceutical Yearbook

The evolution of this market is attracting investments from both Brazilian and foreign companies. While native herbs have been used to a lesser degree up till now, this may change soon, as Brazils biodiversity starts to be exploited. There are already a few scientific and technological institutions specialized in this area. However, the implantation of foreign-owned research centers in the Amazonian and Northeast region of the country may stir controversies about biopiracy. It is thus recommended to act in close collaboration with domestic companies and institutions. These may also benefit from financial support by Profarma and FINEP (see Chapter 3.2 Government Industrial Policies) for research and development of phytoterapics.
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While medicinal plants and their parts are not subject to registration, herbal medicines have to be registered with ANVISA. The procedure is similar to OTC medicines, but it may take from 5 to 10 years to register a product based on herbs not yet catalogued by ANVISA.

4.2. Homeopathy The Brazilian market of industrialized homeopathic medicines is relatively small (ca. USD 120 million), but it experiences a strong growth trend, mainly driven by the phasing out of similar drugs by 2014 and the expected reduction in the number of compounding pharmacies. It is safe to forecast that in the medium term the Brazilian market of industrialized homeopathic medicines will reach USD 400 million, excluding export revenues. There are only a few laboratories of significant presence in this market (see Table 13). The market leader is Almeida Prado, a local laboratory that holds approximately 60% of the market share. Table 13 Industrialized Homeopathic Medicines Laboratories in Brazil

Source: Prospectivas research

The common history of domestic laboratories is: founded as a compounding pharmacy by a specialized physician or pharmacist; evolved with manufacturing of homeopathic ready products (ready to consume in the POS Point Of Sale); previously focused on the manufacture business and then increased the distribution coverage. Industrialized homeopathic medicines need to be registered with ANVISA, which will ask for a GMP certificate in the process.

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4.3. Vaccines The market segment of human vaccine reaches R$ 1.2 billion per year, equivalent to USD 690 million based on the current exchange rate. Government purchases exceed 90% of the demand in volume. A considerable part of vaccines is supplied by state-owned laboratories, making Brazil the major manufacturer of vaccines in Latin America, with an output of 260 million doses per year.

Table 14 Market Share of Brazilian Vaccine Suppliers in 2009 (USD values)

Source: Prospectiva researches

The domestic laboratories are in a dominant position, thanks to good quality R&D, low production costs, and substantial financial resources from the government. They are competitive enough to export to developing countries. Domestic laboratories mainly produce vaccines against the endemic diseases covered by the National Program of Immunization (PNI), which currently consists of: 1. BCG (against tuberculosis); 2. Hepatitis B; 3. DTP (against diphtheria, tetanus, and pertussis); 4. DTP + Hib (diphtheria, tetanus, pertussis, and Haemophilus influenzae type B); 5. DT (against diphtheria and tetanus); 6. Haemophilus influenzae type B; 7. Poliomyelitis; 8. Rotavirus; 9. Yellow fever; 10. Triple vaccine (DTP) against diphtheria, tetanus, and pertussis;
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11. Influenza; 12. Pneumococcal vaccine (meningitis, pneumonia, sinusitis, ear inflammation, bacteremia); 13. Anti-meningococcal vaccine. Private manufacturers tend to focus on vaccines of more restricted use, such as the most modern vaccines or those not directly related to local endemic diseases, in addition to filling gaps in the supply of governmental laboratories. Brazilian imports of human vaccines reached USD 290 million in 2009 (see Chart 18).

Chart 18 Brazilian Vaccine Foreign Trade Evolution (HS code 3002.20)

Source: Ministry of Development, Industry and Foreign Trade

The main private suppliers were GlaxoSmithKline and Sanofi Pasteur (Sanofi-Aventis vaccine division), followed by Wyeth (Pfizer), Merck Sharp & Dohme, and Novartis. The main source countries of imports are shown in Chart 19:

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Chart 19 Sources of Brazilian Imports of Vaccines (HS code 3002.20)

Source: Ministry of Development, Industry and Foreign Trade

More and more international companies have come to consider Brazil as a production platform, as locally manufactured vaccines may be included in the National Program of Immunization. Production licensing and technology transfer to state-owned laboratories are determining factors in negotiations with the government. The Novartis deal for Menjugate (vaccine against meningitis C) is a case in point. The laboratory will first supply the vaccine to the PNI and then gradually transfer the technology to FUNED (Minas Gerais State-owned laboratory).

4.4. Diagnostic Medical Devices The market segment of diagnostic medical devices comprises kits of reagents, equipment, and services. It has experienced more than 10% annual growth for a number of years, and the total sales revenues are now estimated at R$ 2 billion. Sales of reagents for diagnosis, in particular, is estimated between R$ 400 and R$ 500 million per year, including drugs for diagnosis by image (less than 10%). Clients are clinical laboratories (90%) and blood banks (10%). The governments annual purchases reach approximately R$ 400 million, through public tenders. Supply largely depends on imports: Over 95% of the reagents are imported and 80% comes from European or NAFTAs countries. The Brazilian output is limited and has low technological content. Domestic manufacturers in this segment are mainly small size companies that work in the final phases of the elaboration of kits for diagnosis. Roche Diagnostic is the market leader, but the competition scenario is complex, with 40 players accounting for 70% of the market. The most prominent domestic manufacturer is Biomanguinhos (see Chapter 3.6. State-Owned Laboratories) which, in addition to producing over 2 million kits every year, also makes a few reagents such as monoclonal antibodies, human conjugated anti-Ig, panels and reference sera for quality control.
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Other local players are Quibasa Qumica Bsica (www.bioclin.com.br) and Laborlab (www.laborlab.com.br). Diagnostic devices are covered by the Health Industry Complex policy (see Chapter 3.2. Government Industrial Policies). The governments investment target in this area is the technological development and production of inputs, equipment, and reagents for enzymatic tests, molecular tests, and quick diagnostic tests, regarding: neglected diseases: dengue, tuberculosis, cutaneous leishmaniasis, visceral leishmaniasis, leptospirosis, and malaria; diseases that represent large expenses for the SUS program: AIDS, citomegalovirus, hepatitis B, hepatitis C, toxoplasmosis, rubella, and syphilis. Manufacturers will also face new compliance issues, as ANVISA reviews the sanitary regulation which held clinical laboratories responsible for the quality of the devices used in diagnostic tests. Manufacturers or importers will need to regularize their devices at the agency in order to sell them in the domestic market. Such regularization will be a single record of technical features in ANVISAs database of products that present low risk to human health, but will require a complete registration process (including a GMP certificate) for higher risk products. This may result in special opportunities for foreign biotech companies willing to enter into business partnerships, e.g. production technology licensing for private or stateowned domestic laboratories.

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5. THE PHARMACEUTICAL INDUSTRYS SUPPLY CHAIN


5.1. Raw Materials 5.1.1. Market Overview The Brazilian market of pharmaceutical raw materials reached nearly R$ 3 billion in 2009, indicating a 16% CAGR over the last 5 years, as shown in Chart 20:

Chart 20 Brazilian Pharmaceutical Raw Material Market Evolution

Source: ABIQUIF (Brazilian Association of Pharmochemical Industries)

Most Brazilian pharmaceutical laboratories lack the know-how and scale to produce their own pharmaceutical ingredients. Apart from a few synthetic products (like paracetamol and vitamin C) and fermentation products (like antibiotics and enzymes), production is usually limited to the final synthesis, using fine chemistry ingredients from external sources. Among the few more vertically integrated pharmaceutical manufacturers are Novartis and Cristlia (www.2cristalia.com.br), which has a chemical plant in Itapira, in the State of So Paulo. As a consequence, almost 80% of the demand in terms of value is covered by imports (down from 94% back in 2003). The remainder is supplied by local producers: foreign companies operating in Brazil, like the market leader BASF, or domestic companies like Globe Qumica (www.globequimica.com.br) and Nortec Qumica (www.nortecquimica.com.br). Brazils dependence on imports and the impact of pharmaceutical chemicals purchases on the Brazilian foreign trade balance have been sources of concern for the Brazilian government. The strengthening of local production thus became an important objective of the Health Industry Complex policy (see Chapter 3.2. Government Industrial Policies). This represents an opportunity for Swiss companies interested in the sale and

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transfer of manufacturing technologies. APIs (Active Pharmaceuticals Ingredients) represent the overwhelming part of pharmaceutical chemicals imported, as shown in Chart 21. Chart 21 Brazilian Pharmaceutical Raw Material Trade Composition

Source: ABIQUIF (Brazilian Association of Pharmochemical Industries)

The sources of Brazilian imports are shown in Chart 22. Chart 22 Brazilian Importation of Pharmaceutical Raw Materials
Source: ABIQUIF (Brazilian Association of Pharmochemical Industries)

Exports are modest, corresponding to just 20% of the importation expenses in 2009.
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The destination of exports is shown in Chart 23.

Chart 23 Brazilian Exportation of Pharmaceutical Raw Materials


Source: ABIQUIF (Brazilian Association of Pharmochemical Industries)

5.1.2. Competitive Environment In Brazil, there are 660 companies operating in the area of importation, production, fractionizing, and distribution of medicines raw materials. It is a very competitive and scattered market. The majority of these companies also supplies inputs for the food and cosmetic industries. International laboratories import almost all their inputs directly. For distributors, 60% of sales are directed to compounding pharmacies and the remaining 40% to domestic pharmaceutical laboratories. State-owned laboratories carry out procurement through conventional or electronic public tenders; price is the overriding factor for the purchase decision. It is not rare that state-owned laboratories purchase low quality inputs produced in China or India, having to discard them or hire companies to refine them. The major suppliers are affiliated to ABRIFAR (Brazilian Association of Distributors and Importers of Pharmaceutical Inputs, Cosmetic, Veterinary, Food and Supplement). It has 30 affiliates that represent 95% of the market, the most important are:

BASF BASF is the leading supplier, offering its own products, imported or manufactured at the companys plant in Guaratinguet, State of So Paulo. It holds a near 10% share of the market. The laboratory is practically the only domestic supplier accepted by major
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foreign companies. Website: http://www.basf.com.br SELECTCHEMIE Brasil Under Swiss management, Selectchemie represents more than 50 suppliers from Europe, North America, and Asia. It distributes both active ingredients and excipients, as well as blister films. Website: http://www.selectchemie.com.br M. CASSAB Comrcio e Indstria M. Cassab imports and distributes products to different industries. In the pharmaceutical market, it also offers services on laboratorial tests for raw materials and medicines. The company is headquartered in So Paulo. Website: http://www.mcassab.com.br GALENA Qumica e Farmacutica Galena imports and distributes raw materials for the pharmaceutical, food, and veterinary industries. The company also manufactures cosmetics and food supplements. It fractionizes products for the compounding pharmacies market, being one of their major suppliers. The company is headquartered in Campinas, in the State of So Paulo. Website: http://www.galena.com.br BRANFAR - Brandlis Farmacutica Apart from APIs, Branfar imports and trades products destined to animal nutrition and health. The company is headquartered in Campinas, in the State of So Paulo. Website: http://www.brandolis.com.br DENVER FARMA Denver imports and distributes APIs for the pharmaceutical and cosmetic industries. The company is headquartered in the city of So Paulo. Website: http://www.denverfarma.com.br DINALAB Comrcio, Importao e Exportao Dinalab imports and distributes pharmaceutical ingredients, and is headquartered in the city of So Paulo. Website: http://www.dinalab.com.br COLORCON do Brasil Colorcon is a foreign company, leading the development, supply, and technical support of formulated coatings and other excipients for the pharmaceutical industry worldwide. It produces pharmaceutical excipients in Cotia, close to the city of So Paulo. Website: http://www.colorcon.com COSMOQUIMICA Indstria e Comrcio Cosmoqumica imports and distributes chemical products to different market sectors. The company is headquartered in Barueri, close to the city of So Paulo. Website: http://www.cosmoquimica.com.br GENIX Indstria Farmacutica Genix distributes and fractionizes inputs for the pharmaceutical, chemical, and cosmetic industries. The company also supplies gelatin capsules produced in its own plant located in the Anpolis pharmaceutical cluster (State of Gois). The company is headquartered in the city of So Paulo. Website: http://www.genix.ind.br
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MAKENI CHEMICALS Indstria e Comrcio de Produtos Qumicos Makeni imports and distributes chemical and petrochemical products. The company is headquartered in the metropolitan region of So Paulo (Diadema). Website: http://www.makeni.com.br PHARMASPECIAL Especialidades Qumicas e Farmacuticas Pharmaspecial imports and distributes pharmaceutical and cosmetic ingredients. It is the exclusive representative of Clariant S/A, Alban Muller International, CLR Chemisches Laboratorium Dr.Kurt Richter, Aloe Corp, Juste SAQF, etc. The company is headquartered in Santana do Parnaba, in the State of So Paulo. Website: http://www.pharmaspecial.com.br HENRIFARMA Produtos Qumicos e Farmacuticos Henrifarma distributes, fractionizes, imports and exports pharmaceutical ingredients. The company is headquartered in So Paulo. Website: http://www.henrifarma.com.br

5.1.3. Regulatory Issues The current sanitary regulation implies that each shipment of ingredients imported for medical production must be previously approved by ANVISA (see Chapter 2.7 Regulatory Framework). On arrival, the shipment is sampled and confined by ANVISAs technicians. Then, samples are sent for analysis to laboratories accredited by ANVISA. The shipment is released only after the agencys approval. Sanitary regulations also require a certificate of Good Practices of Distribution and Fractionizing of Pharmaceutical Inputs for every establishment active in the import, export, distribution, transport, storage, fractionizing and packaging of medical inputs. This certificate is also issued by ANVISA. However, ANVISA is preparing a new regulation which determines that foreign manufacturers or importers will need to have their APIs approved by the agency before shipment. This includes the previous registration with ANVISA of the products to be imported and a manufacturers GMP certificate, similarly to the medicines requirements described in Chapter 2.7. The product registrations will be valid for 5 years. For domestic manufacturers, the registration of each ingredient with ANVISA is already required, apart from the GMP certificate.

5.2. Machines & Equipment 5.2.1. Production equipment market The Brazilian market of production equipment for the pharmaceutical industry is highly volatile. In recent years, sales volume ranged between USD 50 and USD 100 million p.a. Currently, the sales indicate a growth trend, due to the increase of investments from domestic, private (see Chapter 3.3. The Growth of Domestic Laboratories) or stateOsec Market Report: Brazils Pharmaceutical Industry

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owned companies (see Chapter 3.6. State-Owned Laboratories). The main private domestic laboratories are quite conservative regarding the acquisition of new equipment, given that many of their production executives previously worked in multinational companies, even abroad. The key decision factors of private domestic companies purchases are price, delivery term, and particularly technical reliability, including the availability of technical support, and production reproductiveness. As a rule, purchases are preceded by a visit to plants that operate similar machines. State-owned laboratories acquire equipment through public tenders, where price is the most important factor. However, the profile of production executives from major stateowned laboratories is similar to private laboratories, and they set forth rigorous quality clauses on the auction announcements. Foreign companies may participate through a subsidiary registered in the country or a Brazilian official representative. There is generally no restriction on foreign equipment, such as a minimum national content. However, in case of tied bids the preference is for equipment manufactured in the country, and foremost by a national manufacturer. Subsidiaries of major international laboratories acquire machines according to their worldwide directions, being more flexible for packaging equipment. However, they have been operating under a high idle capacity, with only limited investments in production expansion since 2005. The production machine demand is largely concentrated on the solid galenical forms (see Chapter 3.8. Manufacture Outsourcing), whereas non-sterile liquids and ointments have idle production capacity over 50%. Sterile liquids have a reduced share in the market, being predominant in the veterinary segment. Libbs and Eurofarma recently invested in sterile liquid plants. Eurofarma now indicates a 40% idle production capacity on its sterile liquid line. The injectable liquids market has been stimulated by the purchases of the state-owned laboratories (Biomanguinhos, Butantan, FURP, etc.) and this is a trend in the Brazilian market. Few private laboratories are investing in this area.

5.2.2. Production equipment suppliers There are practically no national manufacturers of process equipment for the pharmaceutical industry. Almost all such equipment imported, mainly from Germany, USA and UK. The combined sales of Glatts, Diosnas, and Boschs German products account for 70% to 80% of the Brazilian pharmaceutical process machines market segment. Glatt is represented in Brazil by Almapal (http://www.almapal.com.br), Diosna by Codipar Brazil (http://www.codipar.com.br), and Bosch has a subsidiary in the country. These representative companies also work with other manufacturers. Almapal, for instance, represents Bauch + Strbel (German) and P + Am (Indian).

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In the packaging segment, however, there are significant local manufacturers. The major suppliers are: FABRIMA Fabrima, the market leader, is part of the German Oystar Group. It is the leading manufacturer of packaging machinery in the South American market, catering for the pharmaceutical, cosmetic, and food industries. The Fabrima plant, located in Guarulhos (metropolitan region of So Paulo), delivers services and products worldwide. Website: http://www.oystar.fabrima.com/ IMAUTOMATICHE Maquinas de Embalagens Trading company owned by IMA (Industria Macchine Automatiche, Italian). Headquartered in the city of So Paulo, it is the second market leader in the packaging segment. Website: http://www.ima.it EGBERTO HEIN Packing Technology Egberto Hein is a representative of several foreign manufacturers of process and packaging equipment for the pharmaceutical (70%), cosmetic, chemical, and alimentary industries. It represents Becomix Mischtechinik, Harro Hfliger, Seidenader, L. B. Bohle, Holland, Tecmar, CSAT, Korsch, Fedegari, and Pester Pack Automation. The company is headquartered in the city of So Paulo. Website: http://www.egbertohein.com.br CARLOS A. WANDERLEY Carlos A. Wanderley is a representative of international manufacturers of packaging machinery for the pharmaceutical, cosmetic, chemical, and alimentary industries. It is headquartered in the city of So Paulo. Website: http://www.carloswanderley.com.br BOSCH - Robert Bosch Tecnologia de Embalagem Brazilian subsidiary of Bosch Packaging Technology. It manufactures packaging machines for solids (encapsulement) and liquids, in addition to trading Boschs imported process machines. It operates in Barueri, located in the metropolitan region of So Paulo. Website: http://www.bosch.com.br

5.2.3. Research laboratory equipment The demand for research laboratories equipment is increasing, due to the investment growth in R&D, mainly in the biotech area (see Chapter 3.9. Research & Development). Customers range from university laboratories and other technological and scientific institutions to public and private pharmaceutical manufacturers. On the supply side, there are small domestic equipment manufacturers as well as distributors offering products of foreign biotech companies and representatives of the major international manufacturers of production machines. Still, this market offers good opportunities for international suppliers, from direct exportation to partnership agreements with local manufacturers. The following domestic companies work in the equipment segment: Biosystems Equipamentos para Laboratrios
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Imports and distributes equipment for research laboratories - www.biosystems.com.br Hipperqumica Manufactures equipment for research laboratories under the Sppencer trademark www.hipperquimica.com.br Loccus Biotecnologia Develops, projects and http://www.loccus.com.br manufactures equipment for research laboratories -

Terroni Equipamentos Manufactures equipments that involve vacuum, cold or heat, mainly lyophilizators http://terroni.com.br Uniscience Trades equipment, accessories, http://www.uniscience.com.br. and reagents for research laboratories -

5.2.4. Regulatory Issues Pharmaceutical production machines do not have a specific sanitary regulation. The responsibility for their performance is attributed to drug manufacturers. In order to acquire and renew the GMP (Good Manufacturing Practices; see Chapter 2.7 Regulatory Framework) every year, the drugs production lines must go through a formal inspection, which includes an equipment efficiency qualification through the collection and tests of samples. ANVISAs GMP guidelines, however, only contain generic rules for the equipment qualification. For an autoclave, for instance, ANVISAs rules specify that the product should be sterile when leaving the equipment, requiring that no cold point exist in the autoclave chamber. The qualification can be performed by the internal staff, when technically qualified, but laboratories prefer to hire external verification from companies accredited by ANVISA. For research equipment, ANVISA follows the OECD principles of Good Laboratory Practice. ANVISAs GLP certification process requires that all equipment used in the research laboratories is previously approved by INMETRO (National Institute of Metrology, Standardization, and Industrial Quality- http://www.inmetro.gov.br/) or by an institution accredited by INMETRO. INMETROs basic points for approval are equipment adequacy for the operation, reproducibility of the experiments, and stability of the results.

5.3. Services The Brazilian pharmaceutical industry counts on a broad offer of specialized services that cover practically the whole value chain. However, there are still a few gaps in specific areas with more refined technologies, in addition to unattended demand due to
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the rapid increase of the domestic market. CROs (Contract Research Organizations) will find good business opportunities in the pre-clinical research (see Chapter 3.9 Research & Development). This applies to almost all areas, from information technology to toxicology tests. In the project engineering area, opportunities for foreign companies seem to be more restricted, because competition is tighter and knowledge of Anvisas regulations is a prerequisite. The best path in this case is the partnership with a domestic company. Numerous companies provide support to obtain product and equipment registration with ANVISA. This is an extremely scattered market, where both foreign companies and independent consultants are active. Among the main competitors are the Canadian MarcM Consulting (www.marcmconsulting.ca), and the Brazilians BAP Consult (www.bapconsult.com.br) and Platinum Consultoria (www.platinumconsultoria.com.br). In logistics, there is an unattended demand for low cost services. Still, companies will need to have ANVISA certification and some security expertise to face the risk of robbery. Unidocks is the logistic services market leader, located in the city of So Paulo; it was recently acquired by the British group Exel.

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6. CONCLUSION AND RECOMMENDATIONS


The Brazilian pharmaceutical market is among the worlds top 10 markets, registering annual revenues of more than USD 25 billion, and a sustained growth trend exceeding 10% per year. Subsidiaries of the top worldwide groups compete with domestic private and state-owned laboratories, medium sized foreign companies, etc. Pharmaceutical production in Brazil remains heavily dependent on importation of key ingredients. The sectors foreign trade balance presents deficits that already surpassed USD 7 billion per year. This prompted the government to devise industrial policies and spend billions of dollars to enhance domestic production and innovation. The growing use of Brazil as a production platform for Latin America and the growth of domestic laboratories, along with the effective enforcement of production standards by the authorities, generate business opportunities for Swiss biotech companies, especially for the development and transfer of modern manufacturing technologies. In this context, opportunities in the segments of herbal medicines, vaccines and immunologic drugs, diagnostics, cosmetics, and veterinarian products should not be neglected. Brazil has a formidable capacity and expertise for basic research and clinical tests. However, it still needs to build capacity for pre-clinical development, which represents a good business opportunity for Swiss equipment manufacturers and CROs operating in almost all areas, from information technology to toxicology tests. On the other hand, the Brazilian market is complex, mature and very competitive; new entrants are faced with a number of obstacles. The space to export equipment, products or services on a sporadic basis is restricted, even considering that the Swiss quality and expertise are respected in the domestic market. Swiss companies willing to enter the Brazilian market may choose different paths: Business partnership with a local service provider or manufacturer; Business agreement with a trade representative company; Establishment of a local sales office, to develop an own distribution chain. Of course, the best option needs to be analyzed case by case. The careful selection of business partners is essential. Furthermore, the regulatory environment in Brazil is strict and not entirely transparent, and the Brazilian way of doing business is peculiar. In order to enter the market successfully, it is recommended to make use of local experts. Their services are available through Osec and the Swiss Business Hub Brazil.

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ANNEX 1 EVENTS AND PUBLICATIONS OF INTEREST


Major Exhibitions, Fairs, and Conferences in Brazil Abradilan Farma. Important national fair of the pharmaceutical sector http://www.abradilan.com.br Analitica Latin America. International fair of laboratory technology, biotechnology and quality control - http://www.analiticanet.com.br/ BIOLATINA. Latin Americas largest biotech exhibition and trade event (biannual) http://www.biolatina2008.com/ BioPartnering Latin America - http://www.techvision.com/bpl/ CBAC. Brazilian Congress of Clinical Analysis - http://www.qeeventos.com.br/ Congresso Brasileiro de Biotecnologia. Brazilian Biotechnology Congress http://www.sigaeventos.com.br/apresenta%E7%E3o.htm CPhI. International fair of ingredients for the pharmaceutical industry http://www.cphi-sa.com.br/ Econofarma. Meeting and fair of products and services for pharmacies and drugstores - http://www.econofarma.com.br/ Encontro FEBRAFAR. Pharmacy chains meeting - http://www.febrafar.com.br/ Expo Farmcia. Annual fair of suppliers of the pharmaceutical segment http://www.expofarmacia.com.br/ Expo Pharma. Fair of the pharmaceutical business sector in Rio de Janeiro http://www.expopharma.com.br/ FCE Pharma / Pharma Congress. International Exhibition of Technology for the Pharmaceutical Industry - http://www.fcepharma.com.br/ FEIRAFARMA. Fair of products and services for the pharmaceutical retail market http://www.abcfarma.org.br/ HOSPITALAR. International fair of products, equipment, service and technology for hospitals, laboratories, clinics and physicians - http://www.hospitalar.com/ P-MEC. International fair of equipment suppliers for the pharmaceutical industry http://www.pmec-sa.com.br/ Publications and Websites of Interest Biotec AHG. Website, provides information on the biotechnology market http://www.biotec-ahg.com.br/ Guia da Farmcia. Magazine and Website driven to drugstores and pharmacies http://www.guiadafarmacia.com.br/ GuiaPharma do Brasil. Products, equipment and services for the pharmaceutical industry (Website) - http://www.guiapharma.com.br/ HVB. Brazilian Virtual http://www.hospvirt.org.br/ Hospital Companies and Products -

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Pharmaceutical Technology Brasil. Brazilian bi-monthly edition of international magazine - http://www.edicoesvr.com.br/ Revista + Sade. Healthcare http://www.cns.org.br/#inicio sector news (Magazine) -

Revista ABCFARMA. ABCFARMA Magazine (Brazilian Association of the Pharmaceutical Commerce) - http://www.portalabcfarma.com.br/ Revista Biotecnologia e Desenvolvimento. Biotechnology and Development Magazine - http://www.biotecnologia.com.br Revista Frmacos & Medicamentos. Marketing, scientific, and technical publication driven to the professionals of the pharmaceutical industry; RCN Publisher (group Racine) - www.rcneditora.com.br Revista Fornecedores Hospitalares. http://www.revistafh.com.br/ Hospital Supplying Magazine -

Revista GRUPEMEF. Grupemef Magazine; data and news of the pharmaceutical market - http://grupemef.com.br/ Revista Qumica e Derivados. ABIQUIM magazine (Brazilian Association of Pharmochemical Industries) - http://www.quimica.com.br/quimicaederivados.htm Sade Business Web. Healthcare http://www.saudebusinessweb.com.br/ sector news website -

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ANNEX 2 INDUSTRY ASSOCIATIONS


ABIFINA Associao Brasileira das Indstrias de Qumica Fina, Biotecnologia e suas Especialidades (Brazilian Association of the Industries of Fine Chemistry, Biotechnology and its Specialties) http://www.abifina.org.br/ ABIFISA Associao Brasileira das Empresas do Setor Fitoterpico, Suplementos Alimentares e de Promoo da Sade (Brazilian Association of Phytotherapic, Food Supplement and Companies Related to Health Promotion) http://www.abifisa.org.br/ ABIQUIF Associao Brasileira da Indstria Farmoqumica (Brazilian Association of Pharmochemical Industries) - http://www.abiquif.org.br/ ABIQUIM Associao Brasileira da Indstria Qumica (Brazilian Association of the Chemical Industry) - http://www.abiquim.org.br/ ABRABI Associao Brasileira das Empresas de Biotecnologia (Brazilian Association of Biotech Companies) - http://www.abrabi.org.br/ ABRAFITO Associao Brasileira de Fitoterapia (Brazilian Association of Phytotherapy). Linked to IBPM - http://www.ibpm.org.br/ ABRIFAR Associao Brasileira dos Distribuidores e Importadores de Insumos Farmacuticos, Cosmticos, Veterinrios, Alimentcios e Aditivos (Brazilian Association of the Distributors and Importers of Pharmaceutical Inputs, Cosmetic, Veterinary, Food and Supplement) - http://www.abrifar.org.br ALANAC Associao dos Laboratrios Farmacuticos Nacionais (Brazilian Association of the National Laboratories) - http://www.alanac.org.br/ ALFOB Associao Brasileira dos Laboratrios Oficiais (Association of the Brazilian Official Laboratories) http://www.alfob.com.br/ ANFARMAG Associao Nacional dos Farmacuticos Magistrais (National Association of Magistral Pharmacists) - http://www.anfarmag.com.br BIOMINAS Fundao Biominas (Biominas Foundation; dedicated to the Brazilian Biotechnology industry) - http://www.biominas.org.br/ CBDL Cmara Brasileira de Diagnstico Laboratorial (Brazilian Chamber of Laboratory Diagnosis) - http://www.cbdl.com.br/ IBPM Instituto Brasileiro de Plantas Medicinais (Brazilian Institute of Medicinal Plants) - http://www.ibpm.org.br/ INTERFARMA Associao da Indstria Farmacutica de Pesquisa (Association of the Research Pharmaceutical Industry) - http://www.interfarma.org.br/ SBAC Sociedade Brasileira de Anlises Clnicas (Brazilian Society of Clinical Analyses) - http://www.sbac.org.br/ SBIM Associao Brasileira de Imunizaes Immunizations) - http://www.sbim.org.br/ (Brazilian Association of

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SINDUSFARMA Sindicato da Indstria de Produtos Farmacuticos no Estado de So Paulo (Union of the Pharmaceutical Products Industry in the State of So Paulo) http://sindusfarma.org.br/ SSBIOTEC Sociedade Brasileira de Biotecnologia (Brazilian Biotechnology Society) - http://www.sbbiotec.org.br/

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ANNEX 3 MAIN SOURCES CONSULTED FOR THIS STUDY


ABIFISA (Brazilian Association of Phytotherapic, Food Supplement and Companies Related to Health Promotion). Phytotherapic market information http://www.abifisa.org.br ABIQUIF (Brazilian Association of Pharmochemical Industries). Pharmaceutical chemical market information - http://www.abiquif.org.br/ ABRIFAR (Brazilian Association of the Distributors Pharmaceutical Inputs, Cosmetic, Veterinary, Food Pharmaceutical inputs providers - http://www.abrifar.org.br/ and and Importers of Supplement).

ALFOB (Association of the Brazilian Official Laboratories) State owned laboratories information - http://www.alfob.com.br/ ANFARMAG (National Association of the Magistral Pharmacists). Compounding pharmacies market information - http://www.anfarmag.com.br/ ANVISA (National Health Surveillance Agency). Regulations of drugs and health related products and services in the country. - http://www.anvisa.gov.br/ BIOMINAS (Biominas Foundation; dedicated to the Brazilian Biotechnology industry). Information on biotech market - http://www.biominas.org.br/ Brazilian Central Bank. FDI (Foreign Direct Investment) - http://www.bcb.gov.br/ CBDL (Brazilian Chamber of Laboratory Diagnosis). In vitro diagnostic medical devices market - http://www.cbdl.com.br/ Febrafarma Brazilian Pharmaceutical Innovation report. R&D Investments profile and figures. Febrafarma Painel de Empresas reports (Brazilian Federation Pharmaceutical Industry). Capital Assets - Febrafarma close up in 2009 of the

FGV (Getlio Vargas Foundation). Manufacturing capacity usage in the pharmaceutical industry - http://portalibre.fgv.br/ Grupemef (Group of the Professional Executives of the Pharmaceutical Market). . Brazilian pharmaceutical non-retail sales data - http://www.grupemef.com.br/ IBGE (Brazilian Institute of Geography and Statistics). Socioeconomic data http://www.ibge.gov.br/ IMS Health Flashes. Brazilian pharmaceutical retail sales figures. IMS releases publishings in different magazines and news websites. World statistics and market remarks. IPEA (Institute of Applied Economics Research). Economic Brazilian figures http://www.ipea.gov.br/ Ministry of Development, Industry and Foreign Trade. Foreign trade time series - http://aliceweb.desenvolvimento.gov.br/ Portal Sade. State expense with medicines and government politics http://portal.saude.gov.br/

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Pr Genricos. News and http:/www.progenericos.org.br/

figures

related

to

Generics

medicines

Prospectiva Consultoria restricted reports. Pharmaceutical market segments figures and scenario; R&D information; Biotech data; Manufacture outsourcing information; Regulation and government politicies environment and trend information Prospectiva Consultoria Website. Pharmaceutical industry news http://www.prospectivaconsultoria.com.br/en/Latest-news/PharmaceuticalIndustry/ -

Sade Business Web Website. Market news and industry press releases http://www.saudebusinessweb.com.br/

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