Post on 05-Jul-2020
The perspective of a U.S. Multinational Company
Liz Barrett Regional President Europe Innovative Pharmaceuticals, Pfizer Rome - October 22nd,2014
The main driver for the future growth is…
The Key factor to compete and prosper in the 21st century global economy
BioPharma: our role in supporting innovation
Generating new medicines
Investing in R&D
Ensure access to financial capital
Employing highly qualified talent
…still high unmet medical needs
84
47
31
20
13
13
12
12
7
6
- 20 40 60 80 100
Cardiovascular diseases
Malignant neoplasms
Mental and behavioraldisorders
Musculoskeletal diseases
Neurological conditions
Digestive diseases
Respiratory diseases
Infectious and parasitic diseases
Diabetes mellitus
Genitourinary diseases
DALYs* lost, 2013 (m)
TOTAL: 308m DALYs*
lost
Burden of disease associated with 10 highest-burden diseases in 2013
Death rate decreases for selected diseases treated with pharmaceuticals
* Disability Adjusted Life Years
-25%
-13%
-29%
-45%
-49%
-51%
-60% -50% -40% -30% -20% -10% 0%
All Causes
Cancer
Ischaemic heart disease
Ulcers
Pneumonia
Respiratory diseases
% decrease in mortality 1980-2011
Sources: 1) WHO Global Health Estimates 2013: Burden of Disease 2) WHO European Mortality Database (MDB), last updated April 2014
Medicines as a cost effective public health investment
Disease treatment cost savings vs. cost of childhood vaccination
Government revenue benefits vs. cost of adult vaccination
Hospital cost savings vs. cost of treatment with cardiovascular medicines
Return on investment in health interventions1,2,3
Sources: 1) Centers for Disease Control (CDC). Immunizations and Respiratory Factsheet (USA); 2) Supporting Active Ageing Through Immunisation (SAATI) Partnership (2013), Adult vaccination: A key component of healthy ageing (Netherlands); 3) Lichtenberg, F (2009), Have newer cardiovascular drugs reduced hospitalization? Evidence from longitudinal country-level data on 20 OECD countries, 1995-2003, Health Econ. 18(5):519-34 (20 OECD countries);
x10.2
x4.0
x3.7
The Value of Statins 1/2
1) Grabowski, David C., et al. (2012). The Large Social Value Resulting From Use Of Statins Warrants Steps To Improve Adherence And Broaden Treatment. Health Affairs, 31; 10 2276-2285; 2) Lakdawalla, Darius N., et al. (2010). An economic evaluation of the war on cancer, Journal of Health Economics 29 (2010) 333–346;3 Philipson, Tomas J. and Jena, Anupam B. (2005). Who benefits from new medical technologies? Estimates of consumer and producer surpluses for HIV/AIDS drugs, National Bureau of Economic Research Working Paper 11810
Benefits and Costs of Statin use, by Period of Inflation, U.S. 1987–2008
In one year alone... From 1987-2008 benefits estimated in…
$ 1.25 trillion
The Value of Statins 2/2
Source: Lindgren et al.: Cost–effectiveness of statins revisited: lessons learned about the value of innovation, (2011) - Sweden
On-patent period
Off-patent period
54
237
454
40 4 5
-
50
100
150
200
250
300
350
400
450
500
1987 - 2002 2003 - 2008 2009 - 2018
Patient Surplus Manufacturer Surplus
€m
npe
r mn
inha
bita
nts
Patient and manufacturer surplus
No innovation
No generics
No surplus to distribute
A look to the Global Scenario
Source : IMS data , Global Insights
Turnover trend, 2007-2017 (B$ and annual average growth)
Advanced Economies BRIC and rest of the world
Investments trend in the pharmaceutical industry (% of total)
0
20
40
60
80
100
2017 2006 2010 2014 2002
705
+11,3%
+4,5%
+12,5%
+0,8% 149
288 462
723 552
2017 2012 2007 0
1200
1000
800
600
400
200
Growth and investments move to the emerging economies
Pfizer contribution to global health challenge
Pfizer in the EU
Pfizer Worldwide
Strong science based regulatory
system Economic,
Political and Healthcare Scenarios
Taxation rate
HC access, coverage and
payment
Cost of Business Operations
Market opportunities
Quality of Resources
IP Protections
Key factors in decision making process
Economic scenario varies considerably in Europe
EU/EEA1 Macroeconomic Indicators - 2015
Worst Avg. Best
GDP Growth 0.4% 2.0% 4.4%
Unemployment rate 24.9% 9.9% 3.0%
Gross Public Debt (% GDP) 171% 72% 10%
Govt. Budget Balance (% GDP) -5.2% -1.8% 9.9%
Non-EU2 Macroeconomic Indicators - 2015
Worst Avg. Best
GDP Growth 0.1% 4.4% 12.5%
Unemployment rate 28.0% 11.5% 0.6%
Gross Public Debt (% GDP) 73% 37% 9%
Govt. Budget Balance (% GDP) -6.9% -2.5% 4.1%
>5
>4.5
>4
>3.5
3.5 or below
Composite Risk Score:
Composite Economic Risk Score
Source: IMF data
Healthcare Spend (%GDP) 2015 7.86%
Pharma Spend (%GDP) 2015 1.65%
Market access conditions in Italy vs other big EU countries
Source: BCG
Access conditions
Before Launch
National Guidelines
Risk Sharing Agreement
P&R setting (HTA)
Regional Guidelines
Authorization/PTOs(*)
Web-monitoring
Product Spend ceiling
Category Spend ceiling
Product Registries
National Spend Ceiling
After Launch
Hospital budget
Physicians prescription
Me-too drugs quotas
Me-too drugs quotas
Reg
ional
Nati
onal
Nati
onal
Reg
ional
Condition generally/widely applied Condition applied only in selected/specific cases
(*) Hospital formulary
Conditions at market launch for new medicines
400 300 200 100 0
314
300
221
61
38
150 100 50 0
IT 100
SP 106
UK 113
GE 120
FR 140
Further delays for regional
access
Average prices at launch (sales/units, Italy index=100)
Time to market (average days of delay compared to the EMA authorization)
60 40 20 0
Nr of new products (authorized by EMA from 2010 to 2012)
46
14
21
22
39
Survey from January 2010 to September 2012
More stable and attractive scenario
Improve access to innovation
Respect of IP and therapeutic “differences”
Remove pharma expenditure ceiling
How Italy can improve its attractiveness
Thank you for your attention!