Serbia Pharmaceuticals and Healthcare Report Q3 2012

Published : July 2012
No. of Pages : 96

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BMI View: The short-term outlook for the Serbian pharmaceutical market will continue to be clouded by corruption, debts accrued by the country’s health insurance agency and also the liquidity of the country’s wholesalers. Additionally, the challenging economic situation will hamper the purchase of necessary medicines by the majority of the cash-strapped population, especially as out-of-pocket contribution to healthcare in general stands at almost 40%. We therefore envisage generic medicines gaining further ground on their patented counterparts, although imports will continue to play an important part in the overall market.
Headline Expenditure Projections 􀂃 Pharmaceuticals: RSD74.78bn (US$1.02mn) in 2011 to RSD79.30bn (US$934mn) in 2012; +6.0% in local currency terms and -8.4% in US dollar terms. Forecast slightly lower from Q212 due to macroeconomic factors.
􀂃 Healthcare: RSD335.38bn (US$4.57bn) in 2011 to RSD360.98bn (US$4.25bn) in 2012; +7.6% in local currency terms and -7.0% in US dollar terms. Forecast slightly lower from Q212 due to macroeconomic factors.
􀂃 Medical devices: RSD16.97bn (US$231mn) in 2011 to RSD17.71bn (US$209mn) in 2012; +4.3% in local currency terms and -9.8% in US dollar terms. Forecast lower from Q212 due to macroeconomic factors.
Business Environment Rating: In BMI’s regional Risk/Rewards Rating (RRR) matrix for Q312, Serbia moved up by two places, now ranking 14th out of the 20 key markets surveyed. However, its composite score is unchanged from Q212, with its overall risks and rewards scores both remaining below the regional average. Issues such as insufficient funding for public healthcare and corruption will continue to hamper the development of legitimate medicines market.
Key Trends & Developments 􀂃 In May 2012, Serbian drugmaker Hemofarm, a subsidiary of German firm Stada Arzneimittel, started direct sales to state-run pharmacies, which allows it to avoid some wholesalers. The company said the new policy will help it reduce the complexity of the supply chain. Hemofarm previously incurred losses after some Serbian pharmaceutical wholesalers did not make payments for medicines manufactured by the company, which resulted in a write-down for Stada.
􀂃 In February 2011, Serbia''s state-run health insurance fund secured a 10% write-down of its debt to drugmakers, valued at more than RSD14bn (US$186mn), according to the fund''s general manager Aleksandar Vuksanovic. The fund has also promised to accelerate payments for delivery, having negotiated deals with domestic drugmakers Galenika and Jugoremedija for terminating a portion of their claims, as well as reducing some prices for new deliveries.
BMI Economic View: The Serbian economy contracted by an estimated 1.3% in Q112 and public debt breached the constitutional ceiling of 45%. Although the economy is likely to perform better later in the year, we hold to our forecast that real GDP will grow by just 0.4% in 2012. The IMF''s suspension of the EUR1.0bn Stand-By Arrangement, uncertainty surrounding the results of the May 6 2012 presidential and parliamentary election – with the incumbent Boris Tadic from the Democrat Party (DP) losing presidency to Tomislav Nikolic from the Progressive Party (SNS), coupled with large fiscal and current account deficits, will weigh on Serbian assets and the country’s wider investment climate.
BMI Political View: Serbia will continue with the EU accession process, despite the incumbent Democrat Party losing the presidency and 35 seats in parliament. Although the election results were not a rejection of the DP''s pro-Europe stance – rather, they were a referendum on corruption amid wider economic stagnation – we have downgraded our short-term political outlook for Serbia on the basis of the increased potential for policy gridlock and social instability. Nikolic''s victory somewhat undermines the next government''s ability to tackle the severe economic challenges facing Serbia, not least a widening fiscal deficit and ballooning public debt.

Executive Summary ... 5
SWOT Analysis 7
Serbia Pharmaceuticals And Healthcare Industry SWOT 7
Serbia Political SWOT ... 8
Serbia Economic SWOT . 8
Serbia Business Environment SWOT . 8
Pharmaceutical Risk/Reward Ratings . 10
Table: Emerging Europe Regional Pharma Risk/Reward Ratings for Q312 10
Rewards ... 12
Risks ... 12
Serbia – Market Summary . 14
Regulatory Regime .. 15
Table: The Number of Products on the Drugs List ... 15
Corruption In The Healthcare Sector .. 16
Intellectual Property Environment ... 18
Pricing Regime .. 19
Price Developments . 20
Reimbursement Regime 21
Table: Leading Suppliers of Medicines to RZZO, by Value (RSDmn) 23
Table: Cost of Prescriptions Covered by RZZO by Anatomical Therapeutic Chemical (ATC) Classification (RSD ''000) . 23
Industry Developments . 24
Epidemiology . 24
Communicable Diseases .. 24
Non-Communicable Diseases 25
Healthcare Sector .. 26
Table: Major General And Specialised Hospitals 26
Healthcare Insurance ... 28
Healthcare Debts ... 29
Clinical Trials 30
Medical Devices . 31
Table: Medical Device Classification In Serbia ... 32
Industry Forecast Scenario .. 33
Overall Market Forecast .. 33
Table: Pharmaceutical Sales Indicators 2008-2016 34
Healthcare Market Forecast .. 35
Table: Healthcare Expenditure Indicators 2008-2016 .. 36
Table: Healthcare Governmental Indicators 2008-2016... 36
Table: Healthcare Private Indicators 2008-2016 37
Key Growth Factors – Macroeconomic . 38
Table: Prescription Drug Sales Indicators 2008-2016 .. 45
Table: Drug Sales By ATC Classification System 45
Patented Drug Market Forecast 47
Table: Patented Drug Market Indicators 2008-2016 . 48
Generic Drug Market Forecast ... 49
Table: Generic Drug Sales Indicators 2008-2016 ... 50
OTC Medicine Market Forecast 51
Table: OTC Medicine Sales Indicators 2008-2016 .. 52
Pharmaceutical Trade Forecast . 53
Table: Exports and Imports Indicators 2008-2016 .. 55
Medical Device Market Forecast . 56
Table: Medical Devices Sales Indicators 2008-2016 . 57
Other Healthcare Data Forecasts 58
Key Risks to BMI’s Forecast Scenario . 58
Competitive Landscape 59
Investment Climate 59
Pharmaceutical Industry .. 59
Table: Companies Involved In The Serbian Pharmaceutical Industry ... 60
Domestic Pharmaceutical Industry .. 60
Domestic Company Activity ... 62
Foreign Pharmaceutical Industry 63
Table: Proposed Members Of Serbia’s Pharmaceutical Industry Association . 63
Foreign Company Activity . 64
Pharmaceutical Wholesale And Retail . 65
Company Monitor 66
Indigenous Company Profiles 66
Hemofarm (Stada) .. 66
Galenika . 70
Zdravlje Actavis . 74
Jugoremedija . 77
Multinational Company Profiles 79
Pfizer.. 79
GlaxoSmithKline 80
Novartis ... 81
Sanofi-Aventis 82
Merck & Co . 83
Krka ... 84
Demographic Outlook . 86
Table: Serbia''s Population By Age Group, 1990-2020 (''000) .. 87
Table: Serbia''s Population By Age Group, 1990-2020 (% of total) ... 88
Table: Serbia''s Key Population Ratios, 1990-2020 .. 89
Table: Serbia''s Rural And Urban Population, 1990-2020 . 89
Glossary ... 90
BMI Methodology . 92
How We Generate Our Pharmaceutical Industry Forecasts 92
Pharmaceuticals Business Environment Ratings . 93
Risk/Reward Ratings Methodology .. 93
Ratings System ... 93
Table: Pharmaceutical Business Environment Indicators .. 94
Weighting . 94
Table: Weighting Of Components 95
Sources 95Table: Emerging Europe Regional Pharma Risk/Reward Ratings for Q312 . 10

Table: The Number of Products on the Drugs List . 15

Table: Leading Suppliers of Medicines to RZZO, by Value (RSDmn) . 23

Table: Cost of Prescriptions Covered by RZZO by Anatomical Therapeutic Chemical (ATC) Classification (RSD ''000) . 23

Table: Major General And Specialised Hospitals . 26

Table: Medical Device Classification In Serbia . 32

Table: Pharmaceutical Sales Indicators 2008-2016 . 34

Table: Healthcare Expenditure Indicators 2008-2016 . 36

Table: Healthcare Governmental Indicators 2008-2016. 36

Table: Healthcare Private Indicators 2008-2016 . 37

Table: Prescription Drug Sales Indicators 2008-2016 . 45

Table: Drug Sales By ATC Classification System . 45

Table: Patented Drug Market Indicators 2008-2016 . 48

Table: Generic Drug Sales Indicators 2008-2016 . 50

Table: OTC Medicine Sales Indicators 2008-2016 . 52

Table: Exports and Imports Indicators 2008-2016 . 55

Table: Medical Devices Sales Indicators 2008-2016 . 57

Table: Companies Involved In The Serbian Pharmaceutical Industry . 60

Table: Proposed Members Of Serbia''s Pharmaceutical Industry Association . 63

Table: Serbia''s Population By Age Group, 1990-2020 (''000) . 87

Table: Serbia''s Population By Age Group, 1990-2020 (% of total) . 88

Table: Serbia''s Key Population Ratios, 1990-2020 . 89

Table: Serbia''s Rural And Urban Population, 1990-2020 . 89

Table: Pharmaceutical Business Environment Indicators . 94

Table: Weighting Of Components . 95

Serbia Pharmaceuticals and Healthcare Report Q3 2012

Published By: Business Monitor International

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