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Copyright 2002, IMS HEALTH. No portion of this document may be reproduced, used or distributed in any form without written
authorization. All trademarks assumed.
PRESENTED BY
Jack Tuttle
Copyright 2002, IMS HEALTH
Pharma Industry Growth 1997 - 2001
1997 2001
Other
J apan
Europe
N. America$396B
$296B
CAGR8 %
Copyright 2002, IMS HEALTH
North America Leads the World in Dollar Percent Growth (Constant Exchange)
9
10
12
16
3
3
5
7
8
12
13
J apan
France
I taly
Aust/ NZ
Key Markets
Germany
Spain
Mexico
UK
USA
Canada
Comparison is Latest 12 months ending September 2002 vs. Latest 12 Months ending September 2001
Brazil –7Argentina -52
Copyright 2002, IMS HEALTH
US Pharma Continues to Extend Its Large Lead
0
20
40
60
80
100
120
140
160
180
$US Bil
Source: IMS HEALTH: MIDAS, 2001 * Pharmacy only ** Hospital only
Sale
s
RxRx
Copyright 2002, IMS HEALTH
2002 RecapGenerics in the SpotlightHormone Replacement Concerns“Personal Importation” No Medicare Drug Benefit State Medicaid budget deficits force states to tackle drug costs“Truthful” DTCPharmaceutical Industry under attackThree Tier Co pays continue to expand“Innovation Drought” ContinuesNexium/Prilosec, Clarinex/Claritin transitions• Claritin—Generic?, OTC, or OtherAmgen/Immunex merger, Pfizer/Pharmacia, Others?Counterfeit DrugsDrug Shortages
Copyright 2002, IMS HEALTH
Express Scripts-Top Developments in the 2002 Pharmaceutical Landscape
•Claritin Goes OTC•Generic Market Share Reaches All-Time High•Prilosec Faces Generic Competition•Hormone Replacement Studies cause Concern and Confusion•Several High-Profile Drugs Approved-Others Delayed•Marketing Landscape Chills For Pharmaceutical Manufacturers•Speciality Injectable Drugs Gain Market Share
Copyright 2002, IMS HEALTH
The 2002 Pharmaceutical Market Should Exceed $190 Billion Dollars
All Outlets- Ex Wholesale Cost
61.2 66.6 73.4 82 92.9107.3
128146.8
172.2194.4
0
50
100
150
200
250
93 94 95 96 97 98 99 '00 "01* 02E
Compounded Growth = 13.8%* 2001 had 53 weeks of sales
Copyright 2002, IMS HEALTH
8%9%
10%
12%13%
15%
19%
15%
17%
13%14%14%
0%2%4%6%8%
10%12%14%16%18%20%
2002 Mid-Year US Dollar Growth shows a Return to More Historic Levels
Percent Change vs. Year Ago
CAGR is 13.8%
Copyright 2002, IMS HEALTH
2002 Retail & Mail Prescriptions Are Growing at 5%
5%5%
1%3%
4%5% 6%
4%5%
7%9%
5%
0%2%4%6%8%
10%12%14%16%18%20%
Percent Change Vs. Year Ago Retail and Mail (excludes LTC)
Copyright 2002, IMS HEALTH
Forecast of Future Rx Dispensed Growth U.S. Retail Market (Bill.) At 5.5% CAG Rate
1.6 1.6 1.6 1.61.9 1.9 2.0 2.0 2.1 2.2 2.3
2.52.7 2.8
3.03.2
3.4 3.53.7
0
0.5
1
1.5
2
2.5
3
3.5
4
87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02E 03E 04E '05E
Compounded Growth = 5.5% 1 Mail Rx = 1 RX(Excludes LTC)
Copyright 2002, IMS HEALTH
Rising Rx Expenditures: A Function of Demand
0 5 10 15 20 25
Price Increases
Other
New Users
New Drugs
Increased Days perRX
Increases RXs peruser
Source: PCS Health Systems 2000
Copyright 2002, IMS HEALTH
Total Prescriptions Dispensed Have Grown by 153 Million Rx’s Over the Last Year
(MAT Sept 2002 vs. MAT Sept 2001)
4866
5674
6887
7168
7168
8455
8666
18219
9041
12746
Antipsychotics
Ace Inhibitors
Bisphosponates
Antihistamines
Seizure Disorders
Beta Blockers
Codeine & Comb
Chol. Red
PPI
SSRI/SNRI
Copyright 2002, IMS HEALTH
1.9 3.0 4.0 3.9 4.9 4.4 4.2 3.3
7.8
13.06.7 7.7
1.6 2.5
8.5
10.811.7
12.010.8
15.0
-113579
1113151719
1995 1996 1997 1998 1999 2000 2001 20021Q
20022Q
20023Q
Price Non Price Factors
Non Price Factors Drive Industry Growth
Source: IMS HEALTH: Retail & Provider Perspective, 2001 with 2001 adjusted for underlying 52 week trend
Copyright 2002, IMS HEALTH
Average Rx Retail PriceAt Price To Consumer
All Rx’s Brands Generics
1990 22.06 27.16 10.29
1995 30.01 40.22 14.84
2000 45.79 65.29 19.33
4Q 2001 49.27 72.28 22.96
1Q 2002 50.35 72.84 23.11
2Q 2002 52.19 77.14 23.70
3Q 2002 53.29 80.21 24.63
Note: Prices are simple averages not adjusted for product mix and Rx size
Copyright 2002, IMS HEALTH
Cash and Third Party Disbursements Have Switched Places
Source: IMS HEALTH: NPA+7, Method of Payment Report, YE 2001
63
33 29 25 21 19 16 14
11
1211
11 11 11 11
26
55 60 65 68 70 73 74
10
0
10
20
30
40
50
60
70
80
90
100
1990 1996 1997 1998 1999 2000 2001 MATSept2002
Cash Medicaid Third Party
% NRx Dispensed
Copyright 2002, IMS HEALTH
Co-Payments Are Going Up!
$5.00
$6.93$8.77
$7.66
$15.91
$30.56
$0.00
$5.00
$10.00
$15.00
$20.00
$25.00
$30.00
$35.00
1996 2001
Generic(Preferred) Brand(Preferred) Brand(Non-Formulary)
GF vs. BNF=$3.77 $22.90
Source: Novartis Pharmacy Benefit Report 2001 Edition
Copyright 2002, IMS HEALTH
As Co-payments Increase…. Noncompliance Will Probably Get Worse
0%
5%
10%
15%
20%
25%
Had Not Filled One RX Taken Smaller Dose Taken MedicationLess Frequently
ActionSource: Harris Interactive Survey
Copyright 2002, IMS HEALTH
Mail Service Prescriptions Are Growing Faster Than Retail Prescriptions
0
2
4
6
8
10
12
Ttl. Retail & Mail Retail Mail
'98 '99 '00 '01 MAT Aug '02
Copyright 2002, IMS HEALTH
Factors That Influence the Pharmaceutical Market $ Growth Rate! 1996-2001
Positive• DEMOGRAPHICS
• Managed Care Coverage
• DTC
• Blockbuster New Products
• Growth in Sales Force Size
• Price Increases
Negative• Pressure on Prices
• Two Tier Copays
• Generics
Copyright 2002, IMS HEALTH
Factors That Will Influence the Pharmaceutical Market $ Growth Rate!
2001-2006 Positive
• DEMOGRAPHICS
• Technology
• Pipeline Still Strong
• Lifestyle Drugs
• Under-treated disease states
• Medicare Rx Benefit
Negative
• Weak/delayed new products in 2001 & 2002
• Negative Publicity
• Multi-tier Copays
• Generics
• Claritin/Prilosec go OTC or Generic
• Economic slow-down
• Slower growth in sales force size
• Personal importation
• State programs
Copyright 2002, IMS HEALTH
Pharmaceutical Cost Containment Strategies may be getting traction
• Increase Co-payments/ Exclude list
•Maximize use of Generics
•Encourage use of Mail Service
•Formularies
•Therapeutic Substitution
•Reimbursement of OTC’s
• Informatics and POS
Copyright 2002, IMS HEALTH
Health Plans Ask Themselves…
• To Merge or Not to Merge
• Targeted Marketing with Strict Pricing
• Concentric Networks with Variable Cost Sharing
• Participate in Medicare + Choice
• NCQA or bust
• How Much Copay Cost Shift to Consumer
• Extent of Utilization and Cost Containment
Copyright 2002, IMS HEALTH
Leading MCO’s
• National Models• Aetna• CIGNA• United Healthcare• Humana• Wellpoint• Anthem
• Regional Models• Kaiser• Health Net• PacifiCare• Oxford• Harvard Pilgrim• The “Blue’s” ??
Copyright 2002, IMS HEALTH
Nationwide Employee Benefit Costs
• Expected to Increase at an Average Rate of 15% this Year vs 2% overall inflation
• Aggressively Managed Benefits will Increase at 11%
• Those with Minimal Management will Increase at 18%
• Hospital Costs Increase at 25%
• Pharmacy Costs Increase at 17%
• Employees Bear• 22% of the Cost for Family Coverage• 17% of the Cost for Single Coverage
Copyright 2002, IMS HEALTH
Insurance Options Offered
• Employers are Streamlining Costs by Offering Fewer Health Plans and Thereby Negotiating More Aggressively with Carriers for Larger Volumes
• Examples:• CalPERS 1.2 million members keeping 5 HMO’s only and
dropping 2 major health plans (Health Net and PacifiCare) with a rate increase of 25.1%
• Sears, Roebuck and Co dropped 120 HMO’s retaining only 65• American Express dropped 164 HMO’s keeping 48• Xerox dropped 92 of its 222 health plans
Copyright 2002, IMS HEALTH
Employers Want Quality
• Leapfrog is a Coalition of Fortune 500 Companies Mobilizing the Nation’s Biggest Purchasers of Health-Care Services to Demand Quality
• Leapfrog was Started after a 1999 Institute of Medicine reported 98,000 Deaths each Year from Medical Errors
• Leaps in Patient Safety and Customer Value Will Be Recognized and Rewarded with Preferential Use
• 7 State pilot Project Measuring Hospital Quality• Computerized Physician Order Entry• Critical Care Trained ICU Daytime Staff• Evidence Based Hospital Referrals
Copyright 2002, IMS HEALTH
Medicare Prescription Drug Coverage
Republican Proposal
• $35-40 Premium/Month
• $250 Deductible
• 70% Coverage to $1,000
• 50% Coverage $1,000 - $2,250
• No Coverage $2,250 - $5,000
• 100% Coverage > $5,000
• Private Insurance Risk
• $350 Billion Over 10 years
Democratic Proposal
• $25 Premium/Month
• $0 Deductible
• 50% Coverage up to $4,000
• 100% Coverage > $4,000
• Medicare and Private PBM’s Risk
• $425 Billion Over 7 years
Copyright 2002, IMS HEALTH
Medicare Prescription Drug Coverage Issues
• Private Sector Solution will Likely Increase Role of Large PBMs• Increase Purchasing / Negotiating Power• Impact on Smaller PBMs
• PBMs will Need to Market Directly to Consumers
• Expanded Coverage is Expected to Increase Pharmaceutical Usage
• Loss of One of the Last Blocks of Cash Business
Copyright 2002, IMS HEALTH
Pharmacy Discount Card (Bush)
• Private Sector PBM Solution
• $25.00 Annual Fee
• Negotiate Discounts with Manufacturers
• Closed Networks
• Preferred Drug Lists
• Mail Service
• Telephone Call Centers
• Retail Pharmacy Sponsored Lawsuit
• Concern Over Limited PBM Oversight
Copyright 2002, IMS HEALTH
Pharmaceutical Industry Response
• GlaxoSmithKline “Orange Card” Giving Discounts To Qualifying Seniors on all GSK Products, Admin by ESI
• Novartis “Care Card” Gives 25% or Greater Discount, Enroll Via Pharmacies and Administered by a PBM
• “Pfizer for Living” Share Card Offers a 30-day Supply of its Drugs for a $15 fee. Currently 80,000 enrollees
• Others: Eli Lily “LilyAnswers” Merck, Pharmacia
• NACDS Pharmacy Care One Card Program
Copyright 2002, IMS HEALTH
Pharmaceutical Industry Response
• Together Rx Card Created by 7 Pharma Co’s for Seniors without Drug Coverage with Discounts of 20% to 40% on 150 Drugs.
• Qualifying Income is $28,000 individually or $38,000 as a couple
• The companies sponsoring the card are: Abbott, AstraZeneca, Aventis, BristolMyers Squibb, GlaxoSmithKline, Johnson & Johnson and Novartis
• Bristol Myers Squibb and GlaxoSmithKline recently decreased their discounts so as to not interfere with Medicaid Best Price
Copyright 2002, IMS HEALTH
Rx Financing Challenges
• Overall Pharmacy Benefit Inflation
• Flexibility at What Cost?
• New Drugs with Higher Replacement Costs
• Disease Management• Prevention Emphasis
• Improved Compliance
• Expansion of Prescription Drug Coverage
• Direct to Consumer Advertising
• Management of Injectable Drugs
Copyright 2002, IMS HEALTH
PBM MembershipImpact of Consolidation
Advance PCSMedco Health SolutionsExpress ScriptsMedImpactWellpointCaremarkRxNew EckardPharmacare/CVSFirst HealthPrescription SolutionsPrime TherapeuticsAetnaWalgreens
75,000,00065,000,00047,000,00038,500,00029,000,00023,000,00016,000,00012,000,0009,400,0005,300,0005,000,0004,800,0002,100,000
Copyright 2002, IMS HEALTH
2001 HMO Average PMPM Expendituresby Line of Business
Source: Novartis Pharmacy Benefit Report™
Copyright 2002, IMS HEALTH
Level of Pharmacy BenefitManagement Control
• 92% of all Rx’s are Filled Within the Formulary
• 58% of Rx’s are Filled with Branded Drugs
• 82.1% of all HMO’s Require Generic Substitution
• 68.7% Require Some Additional Charge for the Branded Drug When a Generic is Available
Copyright 2002, IMS HEALTH
Three Tier Copays
• Cover Approximately 35% of IPA HMO Enrollees
• Expected to Rise to 47% of All Beneficiaries by year end 2002
• Average Copays will Approach $10/$25/$40 within next 12 months
• Source: Health Industries Three Tier Copay Report Spring 2001
Copyright 2002, IMS HEALTH
Copay Variations
• Humana Four Tier Program• Generic $10• Brand $25• Brand with Lower Drug Price Alternative $45• Expensive “Top of the Line” Drugs 25% of Retail Price
• Express Scripts Five Tier Program• Employers Select Copay and Drugs by Tiers• Selected Based in Cost, Effectiveness and Rebates
• Wellpoint Reference Policy Pricing Plan• Reference Price Established by Therapeutic Company
• Prime Therapeutics• Tiers are Based on Evidence of Value to Patient & System
Copyright 2002, IMS HEALTH
Pipeline Presentations
• Customers are Closely Tracking Products in Development 2 – 5 years from Launch• Potential for Formulary Impact• Copay Assignment• Coverage Policies / Limitations
• Specific Pipeline Committees Separate and Distinct from the Pharmacy and Therapeutics Committees
• Drug Trend Reports Produced by• Medco Health Solutions• Express Scripts• PCS
Copyright 2002, IMS HEALTH
Managed Injectables and Specialty Pharmacy Providers
• MCO’s Carving Out the Management of High Cost Injectable Drugs
• MCO Heighten Level of Interest to Control Cost of Injectables• Exclusivity?• Administrative Challenges
• Specialty Pharmacies May Be Stand Alone Companies or Subsidiaries of PBMs or Wholesalers
• Specialty Pharmacies Provide Integrated Distribution, Training, Reimbursement Hotlines, Patient Assistance Programs, Educational Services and Reporting
Copyright 2002, IMS HEALTH
Electronic Prescribing:Ideal Functionality
• Single Device Per Practice
• Connect to all PBM Systems
• Include all Formularies
• Conduct Real Time Drug Utilization Review
• Provide Reference Sources
• Interface with Electronic Transmission Vendors
• Integrated into the Physician Practice System
• Wireless Connection to Office System
Copyright 2002, IMS HEALTH
RxHub
• Connectivity Hub for Electronic Prescribing Information between Physicians, Pharmacies, PBM’s, Health Plans
• Formed Through the Joint Partnership of AdvancePCS, Express Scripts and Medco Health Solutions
• 60 Million Capital Invested Recovered Over 5 Years Through Transaction Fees
• Open to all Players, Not Just Funding PBM’s• Transaction Fees Same for All Players• No Charge to MD’s
• Pre-Adjudication will Check for Drug Interactions, Formulary Status, Prior Authorization Requirements and Step Care Guidelines
Copyright 2002, IMS HEALTH
Source: IMS HEALTH: DDD & Statistical Services. Trade Prices.Mail Service is projected Prescription Pharmaceuticals and Insulin, 2002
The US Market Will Exceeded $190 Billion in 2002 (Mail is Projected)
12 months ending September 2002
Hospitals 21.5 11.3 8.9Clinics 15.0 7.9 17.4LTC/HH 8.5 4.5 16.8HMOs (Staff Model) 1.5 0.8 3.0Others 0.8 0.4 12.5
%$ Bil % Change
Retail Channels 143.3 75.2%13.1%Chains 55.8 29.3 11.3
Independents 30.9 16.3 10.3 Mail Order 26.1 13.7 21.4 Food Stores 17.2 9.0 15.3 Mass Merchandisers 13.0 6.8 9.7
Institutional Channels 47.2 24.8 12.7
Total 190.2 100.0 13.0
Copyright 2002, IMS HEALTH
Chains & Independents Still Largest, But Not Fastest Growing
Source: IMS HEALTH: DDD, 2001 12 months ending December 2001 Mail Service Projected
Food Store9.0%
Mail Service13.7%
Hospital11.3%
Independent16.3%
Chain29.3%
Staff HMO 0.8%Misc 0.4%LTC/HH 4.5%Clinic 7.9%Mass Mdse 6.8%
{Largest Fastest
Growing
$ Share of US Rx Market (ex-manufacturer)
Copyright 2002, IMS HEALTH
Average Health Care Cost IncreasesActive Employees
0%2%4%6%8%
10%12%14%16%
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003Est.
Source: Harris Interactive Survey
Copyright 2002, IMS HEALTH
Average Health Care Cost Increasesare going up dramatically
0%
5%
10%
15%
20%
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003Est.
Source: Towers Perrin 2002 health care cost survey
Yellow is Retirees Green is Active Employees
Copyright 2002, IMS HEALTH
US Rx Growth Draws AttentionDespite its Relatively Small Share . . .
Physician Svcs25%
Pharmaceutical10%
Hospital Care30%Nursing/ HH
10%
Other Medical
11%
Pgm Admin
7%
Public Hlth Activity
4%Research &
Constr3%
Source: CMS (HCFA), 2001 projected data
9.6% Total HC Growth
16.4% Rx Growth
Where it Went...
Copyright 2002, IMS HEALTH
Hospital Outpatient is Outpacing Pharmaceutical Growth
02468
1012141618
All Services RX Drugs HospitalOutpatient
GDP
200020012002
Strunk Et Al Health Affairs Sept. 25, 2002
Copyright 2002, IMS HEALTH
29% of People think the the Pharmaceutical Industry is doing a bad job of servicing their consumers
Type Good Bad Type Good Bad
1 Banks 74 20 8 Telephone 58 36
2 Hospitals 73 17 9 Life Ins 55 21
3 Car Mfgr 64 23 10 Health Ins. 51 38
4 Airlines 63 16 11 Oil 38 44
5 Comp Soft 60 12 12 HMO’s 33 45
6 Comp Hard 59 10 13 Tobacco 25 61
7 Pharmaceutical 59 29
Copyright 2002, IMS HEALTH
The Pharmaceutical Industry Approval Rate is Declining
0
10
20
30
40
50
60
70
80
1997 1999 2001
Doing a Good Job
Copyright 2002, IMS HEALTH
Most New Drugs Aren’t “New”?
11
35
55
0 5 10 15 20 25 30 35 40 45 50 55 60
New Drugs with sameactive ingredient as
an identical drugalready on the market
Drugs with new activeingredients
New Versions ofDrugs with Old Active
Ingredients
Source: National Institute for Health Care Management
Copyright 2002, IMS HEALTH
11,874.017,222.5 18,499.3
21,363.723,887.8
6,802.9
1,617.4
3,333.5
6,454.9
4,667.1
4,219.63,839.0
0
5,000
10,000
15,000
20,000
25,000
30,000
1990 1995 1998 1999 2000 2001e
R&D Spending Continues to Increase, Mostly in the US
Source: PhRMA, Pharmaceutical Industry Profile 2002
R&D Expendituresin $ Millions
Research and development abroad
US Research and development
Copyright 2002, IMS HEALTH
Approval Times Beginning to Rise
Source: US FDA, 2001
26 2522
28
53
39
30
35
2724
19
1012141618202224262830323436384042444648505254
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Mean approval time (months)
Total # new molecular entitiesapproved each year
Copyright 2002, IMS HEALTH
71% 11% 12% 4% 2%
6,2256,225
935935 1,0671,067
328328 167167
PRECLINICAL PHASE I PHASE II PHASE III PRE-REG/REG
Source: IMS Lifecycle CD ROM December 2001
2001 Global Pipeline Is Fully Loaded
To December 2001 8,722 Products
New
Products
Copyright 2002, IMS HEALTH
Importation & Reimportation Concerns
• Fear of Tampering• Counterfeit Medicines• Regulatory Supervision• Poisoning by Terrorists
The Number of FDA Criminal Counterfeit Cases is Growing1999 6 cases2000 10 cases2001 23 cases2002 YTD 16 cases
Copyright 2002, IMS HEALTH
Generics are Gaining Traction
Source: IMS HEALTH: NPA+7, Method of Payment Report, YE 2001
84 85 86 85 84
50 51 51 51 50
9 8 8 9
12 12 11 11 11
7 7 6 7 8
38 38 38 38 39
9
0
10
20
30
40
50
60
70
80
90
100
1998 1999 2000 2001 2002Est
1998 1999 2000 2001 2002Est
Brands Branded Generics Generics
% Dollars % Total Prescriptions Dispensed
Copyright 2002, IMS HEALTH
2002 Patent Expirations Product Company 2001 Sales
Glucophage BMS $2.0 Billion
Prilosec AZ $4.6 Billion
Zestril AZ $933 Million
Prinivil Merck $683 Million
Accutane Roche $566 Million
Augmentin GlaxoSmithkline $1.6 Billion
Claritin Schering $1.3 Billion
Ultram J&J $600 Million
Copyright 2002, IMS HEALTH
Other Possible Patent Expirations 2002 2004Intron A LovenoxAxid DiflucanRelafen Lupron
Lamisil2003 ParaplatinCipro XenicalSingulairFlovent 2005Flonase Zocor ZofranEngerix B Prevacid Aredia
Zoloft ZoladexPravacholZithromaxBiaxin
Source: Generic Pharmaceutical Associations
Copyright 2002, IMS HEALTH
Generics Gain Quick Acceptance when Patents Expire
7072747678808284868890
After 5 Weeks After 10 Weeks Current 9/ 6/ 02
Generics Share of NRX’s
IMS NPA Plus
Copyright 2002, IMS HEALTH
The Top 10 Manufacturers Represent 58.0% of the US Rx Industry
Leading corporations. Prescription products and insulin. All Audited Channels. Excludes co-marketing and JV agreements. Data run by custom redesign to include recent M&As.
Source: IMS HEALTH: Retail & Provider Perspective, 2002
High Growth
MAT September 2002
1. Pfizer 19,319 10.1 + 15%2. GlaxoSK 17,292 9.0 + 16% 3. Merck 12,917 6.7 + 11%4. Johnson & Johnson 12,470 6.5 + 24%5. Astra Zeneca 10,969 5.7 + 16%6. BMS 9,436 4.9 - 7%7. Novartis 7,608 4.0 + 18%8. Wyeth 7,397 3.9 + 14%9. Pharmacia 7,069 3.7 + 13%10. Lilly 6,668 3.5 - 13%
Corp by Legend Drugs $ in Mil % Shr % Chg
Copyright 2002, IMS HEALTH
The Top 10 Manufacturers Represent 61.2% of the US Rx Industry
Leading corporations. Prescription products and insulin. All Audited Channels. Excludes co-marketing and JV agreements. Data run by custom redesign to include recent M&As.
Source: IMS HEALTH: Retail & Provider Perspective, 2002
High Growth
MAT September 2002
1. Pfizer/Pharmacia 26,968 13.8 + 15%2. GlaxoSK 17,292 9.0 + 16% 3. Merck 12,917 6.7 + 11%4. Johnson & Johnson 12,470 6.5 + 24%5. AstraZeneca 10,969 5.7 + 16%6. BMS 9,436 4.9 - 7%7. Novartis 7,608 4.0 + 18%8. Wyeth 7,397 3.9 + 14%9. Lilly 6,668 3.5 -13%10. Schering 6,061 3.2 +
2%
Corp by Legend Drugs $ in Mil % Shr % Chg
Copyright 2002, IMS HEALTH
Top 20 Companies Represent 79.0% of US Market
Source: IMS HEALTH: Retail & Provider Perspective, 2002
High Growth
MAT September 2002
11. Schering Plough 6,061 3.2 + 2%12. Aventis 5,878 3.1 + 26%13. Amgen 5,275 2.8 + 21%14. Abbott 5,265 2.8 + 9%15. TAP 4,684 2.4 + 6%16. Hoffman-LaRoche 4,165 2.2 + 11%17. Boehringer Ingelheim 2,448 1.3 + 27%18. Forest 2,161 1.1 +33%19. Teva 2,145 1.1 + 37%20. Mylan 1,977 1.0 +22%
Corp by Legend Drugs $ in Mil % Shr % Chg
Leading corporations. Prescription products and insulin. All Audited Channels. Excludes co-marketing and JV agreements. Data run by custom redesign to include recent M&As.
Copyright 2002, IMS HEALTH
Absolute Growth- Corporations12 Months ending September 2002
Dollars Inc. $ Mil. TRX Dispensed Inc TRX’s Mil.
Pfizer +2.55 Pfizer +20.1
Johnson & Johnson
+2.40 Barr Labs +18.2
GlaxoSmithkline +2.37 Mylan Labs +17.5
AstraZeneca +1.49 Par +14.3
Merck +1.29 Mallinkrodt +13.0
Aventis +1.21 AstraZeneca +10.2
Novartis +1.16 Ranbaxy +9.9
Amgen +.90 URL/Mutual +9.6
Wyeth +.89 Upsher Smith +8.9
Pharmacia +.83 Qualitest +8.2
Copyright 2002, IMS HEALTH
Cholesterol Reducers Are the Leading Class By Sales Volume
Source: IMS HEALTH: Retail & Provider Perspective, 2002
CATEGORY $ (Mil) % Chg
1. Cholesterol Reducers 12,138 20%2. Proton Pump Inhibitors 11,202 23%3. SSRI/SNRI 9,991 10%4. Anti-psychotics 5,925 27%5. Erythropoietins 5,670 26%6. Seizure Disorders 5,045 26%7. Cox-2 Inhibitors 4,833 12%8. Anti-histamines 4,704 22%9. Calcium Blockers 4,554 1%10. Ace Inhibitors 3,964 12%
MAT September 2002
Leading USC 4 classes. All Audited Channels. Prescription products and insulin
Copyright 2002, IMS HEALTH
Lipitor is the Top Dollar Product 12 Months ending September 2002
Brand Mfgr 2002 Rank
MAT Sept 2002 $ Vol
2002 % Change
Share of Market
Lipitor® Pfizer 1 $6.0 +22 3.1
Zocor ® Merck 2 4.3 +29 2.2
Prilosec ® AstraZeneca 3 3.9 -16 2.0
Prevacid ® TAP 4 3.7 +6 1.9
Procrit ® J&J 5 3.0 +33 1.6
Zyprexa ® Lilly 6 2.8 +20 1.5
Epogen ® Amgen 7 2.8 +16 1.5
Celebrex ® Pharmacia 8 2.7 +6 1.4
Zoloft ® Pfizer 9 2.5 +28 1.3
Paxil ® Glaxo 10 2.4 +18 1.3
Source: IMS HEALTH Retail & Provider Perspective
Copyright 2002, IMS HEALTH
Absolute Growth- Products12 Months ending September 2002
Dollars Inc. $ Mil.
TRX Dispensed Inc TRX’s Mil.
Nexium (AZ) +1.40 Nexium (AZ) +10.9
Lipitor (Pfizer) +1.07 HYCD/APAP (MKR) +9.2
Advair Diskus (GSK) +1.05 Lipitor (Pfizer) +8.6
Zocor (Merck) +.95 Advair Diskus (GSK) +7.8
Procrit (J&J) +.76 Fluoxetine (Barr) +6.9
Protonix (Wyeth) +.59 Celexa (Forest) +6.2
Aciphex (Eisai) +.54 Toprol-XL (AZ) +6.1
Plavix (BMS/Sanofi) +.54 Protonix (Wyeth) +6.0
Celexa (Forest) +.53 Fosamax (Merck) +5.1
Zyprexa (Lilly) +.47 Glucophage XR (BMS) +5.0
Copyright 2002, IMS HEALTH
Worldwide Biotechnology Dollar Sales 1992-2002*
0
4
8
12
16
20
24
28
32
36
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002*
US
$b
n
*Estimated 2002 Sales
Copyright 2002, IMS HEALTH
Worldwide Biotechnology Dollar Sales 1992-2002*
0
4
8
12
16
20
24
28
32
36
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002*
GLOBALUSAROWU
S$
bn
*Estimated 2002 Sales
Copyright 2002, IMS HEALTH
The Top 10 US Biotech Companies Account for 88.1% of Dollar Sales
(MAT June 2002)
1.6%
2.1%
2.1%
2.7%
3.1%
4.7%
8.4%
10.2%
24.0%
29.2%
Schering AG
Serono
Novo Nordisk
Medimmune
Schering
Biogen
Genentech
Lilly
J&J
Amgen/Immunex
Copyright 2002, IMS HEALTH
The Top 10 US Biotech Products Account for 66.4% of Dollar Sales
(MAT June 2002)
2.1%
2.1%
2.6%
4.7%
4.8%
5.0%
5.7%
7.0%
15.4%
17.0%
Humulin NPH
Humalog
Synagis
Avonex
Rituzan
Enbrel
Remicade
Neupogen
Epogen
Procrit
Copyright 2002, IMS HEALTH
Fastest Growing U.S. Biotech CorporationsMat/June/2002 Based Absolute Growth
Top 10 Corporations Rank Absolute Growth ($ Millions)
% Change
U.S. Biotech Market +3,304.9
J & J 2 1,274.4 47.0
Amgen/Immunex 1 710.6 17.2
Roche (Genentech) 4 344.1 32.7
Lilly 3 241.2 16.6
Aventis 12 154.1 313.9
Biogen 5 151.9 24.2
Schering Plough 10 147.4 131.3
Novo Nordisk 8 87.0 32.4
Pharmacia Corp 18 81.0 145.1
CSL 22 54.8 980.1
Copyright 2002, IMS HEALTH
U.S. Leading Biotech ProductsMat/June/2002 Based on US Dollar Sales
Top 10 Products Rank US $ (Millions) % Change
U.S. Biotech Market 16,587.1 24.9
Erypo/Procrit 1 2,825.1 38.7
Epogen 2 2,554.0 12.9
Neupogen 3 1,153.0 11.7
Remicade 4 940.1 103.0
Enbrel 5 827.3 13.8
Mabthera/Rituxan 6 803.0 58.4
Avonex 7 780.3 24.2
Synagis 8 424.8 14.2
Humalog 9 346.1 57.0
Humulin NPH 10 343.1 -6.7
Copyright 2002, IMS HEALTH
Syntex
Copyright IMS HEALTHRetail Perspective, Provider PerspectiveNumbers Are In Thousands (000)s
Tot DollarsCalYr/12/1992
MAT OCT/02 DOL TOT
Growth In Dollar Sales
ANAPROX 187,423 4,898 -97%CARDENE 62,342 13,516 -78%CELLCEPT 434,665 FEMSTAT 11,736 79 -99%LIDEX 42,977 7,227 -83%NAPROSYN 561,727 10,430 -98%NASALIDE 29,025 7,898 -73%NORINYL 39,079 14,649 -63%SYNALAR 8,095 1,665 -79%SYNAREL 18,705 4,780 -74%TICLID 22,176 6,937 -69%TORADOL 201,228 2,281 -99%VAGITROL 179 -100%
1,184,693 509,025
Copyright 2002, IMS HEALTH
Syntex
Twelve Months of Sales in 1992 Compared to Twelve Months of Sales Ending October 2002
-
100,000
200,000
300,000
400,000
500,000
600,000
ANAPROX
CARDENE
CELLCEPT
FEMSTAT
LIDEX
NAPROSYN
NASALIDE
NORINYL
SYNALAR
SYNAREL
TICLID
TORADOL
VAGITROL
Products
Dollars (000's)
Tot DollarsCalYr/12/1992
MAT OCT/02 DOL TOT
Copyright 2002, IMS HEALTH
Syntex
Copyright IMS HEALTHNPA 20K - Monthly Rx AuditNumbers Are In Thousands (000)s
Dispensed NRXCalYr/12/1992
MAT NOV/02 NRX
Dispensed TRXCalYr/12/1992
MAT NOV/02 TRX
Growth In NRx's
Growth In TRx's
ANAPROX 921 49 1,338 82 -95% -94%CARDENE 511 25 1,699 99 -95% -94%CELLCEPT 690 674FEMSTAT 516 1 654 1 -100% -100%LIDEX 989 87 1,529 131 -91% -91%NAPROSYN 8,019 71 13,349 120 -99% -99%NASALIDE 647 41 1,246 93 -94% -93%NORINYL 282 29 1,208 119 -90% -90%SYNALAR 268 28 389 38 -90% -90%SYNAREL 28 4 62 8 -86% -87%TICLID 149 12 322 47 -92% -85%TORADOL 2,309 27 2,793 36 -99% -99%VAGITROL 1 1 -100% -100%
Copyright 2002, IMS HEALTH
Syntex
New Prescriptions For Twelve Months in 1992 Compared to New Prescriptions For Twelve Months Ending October 2002
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
ANAPROX
CARDENE
CELLCEPT
FEMSTAT
LIDEX
NAPROSYN
NASALIDE
NORINYL
SYNALAR
SYNAREL
TICLID
TORADOL
VAGITROL
Products
Prescriptions (000's)
Dispensed NRXCalYr/12/1992
MAT NOV/02 NRX
Copyright 2002, IMS HEALTH
Syntex
Total Prescriptions For Twelve Months in 1992 Compared to Total Prescriptions For Twelve Months Ending October 2002
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
ANAPROX
CARDENE
CELLCEPT
FEMSTAT
LIDEX
NAPROSYN
NASALIDE
NORINYL
SYNALAR
SYNAREL
TICLID
TORADOL
VAGITROL
Products
Prescriptions (000's)
Dispensed TRXCalYr/12/1992
MAT NOV/02 TRX
Copyright 2002, IMS HEALTH
The Future Looks Good, But More Challenging
•Price restraint•Formulary enforcement
•Generic exposure•Recession pressures•Delayed launches•Negative public opinion
•Demographics–Older–Smarter
•Med/tech advances
–Pipeline•Expanded access & awareness
11-14%
CAGR2003-2006
+_
Year End 2002
Copyright 2002, IMS HEALTH. No portion of this document may be reproduced, used or distributed in any form without written authorization. All trademarks assumed.
Jack TuttleIMS HEALTH