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Egyptian Pharma Market ‘what you have to know’
Dr. Haytham Mohamed Marei
Marketing Manager
Hikama Pharmaceuticals
Marketing Club Instructor
14
2017-2022: Global Markets Dynamics
North America
• Size (2017) : US$ 485.8 Bn
• CAGR ’17-22’: 5.4%
Europe
• Size (2017) : US$ 263.3 Bn
• CAGR ’17-22’: 4.1%
China
• Size (2017): US$ 131.7 Bn
• CAGR ’17-22’: 4.6%
Japan & S. Korea
• Size (2017): US$ 102 Bn
• CAGR ’17-22’: -0.3%
Egypt
• Size (2017): US$ 2.7 Bn
• CAGR ‘’17-22’: 16.1%
Oceania
• Size (2017): US$ 14.5 Bn
• CAGR ’18-22’: 1.1%
Indian Subcontinent
• Size (2017): US$ 25.3 Bn
• CAGR ’17-22’: 10%
Latin America & Carrib.
• Size (2017): US$ 59.7 Bn
• CAGR ’17-22’: 7.5%
Global Market
Size (2017): $1.15Tn
CAGR ’17-22’: 4.8 %
CIS
• Size (2017): US$ 19.9 Bn
• CAGR ’17-22’: 8%
Overall MENA
• Size (2017) : US$ 22.4 Bn
• CAGR ’17-22 : 6.7%
The top 15 companies in the region contribute ~50% of total MENA sales,
with the majority being MNCs…
Rank
Top Corporations in
MENA
Sales MAT Q3 2018, Bn LC$
1 Sanofi 1.3
2 Novartis 1.1
3 Glaxosmithkline 0.9
4 Pfizer 0.8
5 Novo Nordisk 0.6
6 Hikma 0.6
7 AstraZeneca 0.6
8 MSD 0.5
9 Julphar 0.4
10 Tabuk 0.4
11 Spimaco 0.4
12 Roche 0.4
13 Abbott 0.4
14 Bayer 0.4
15 Johnson & Johnson 0.3
-8
-6
-4
-2
0
2
4
6
8
10
12
-25 -20 -15 -10 -5 0 5 10 30
AstraZeneca
Pfizer
Sanofi
MSD
Novartis
Hikma
Glaxosmithkline
Novo Nordisk
JulpharSpimaco
Roche
Johnson & Johnson
Abbott
Bayer
CAGRMATQ32014–2018%
15 20 25
PPG MAT Q3 2014-2018 %
MNC Local/Regional
CAGR= +8%
PPG = +11%
Overall market: Top 15 Corporations in MENA
Bubble size indicates sales value in MAT Q3 2018
16
Tabuk
14
However, the growth of Generics and local companies is clearly outpacing
Originals and MNCs
Key Highlights
• Across MENA countries, Gx are gaining sharesfaster
than Ox at 12% vs 5% CAGR respectively
• Gx accounts for 34% share of themarket
 Algeria has the highest share of Gx (49%)
 Egypt, UAE and Algeria showed the highestgrowth
of Generics
• MNCs still dominate the MENA market however local and
regional MNF sales are growing faster at ~13% CAGR as
compared to MNC sales (5%)
 Egypt, Algeria and UAE have the highest growthof
local/regional companies
Generics penetration in MENA pharma market, Bn LC$,MAT Q3 ’14-’18
**Others include nutritional supplements, diagnostics, and somevaccines.
22% 24% 14% 22% 19% 22% 27% 18% 28%
44% 48%
37%
34%
59%
34%
49%
38%
37%
34% 27%
49%
22% 24%
44% 44% 43% 35%
18.9 7.8 2.5 3.6 2.2 1.1 0.8 0.6 0.3
CAGR ’14-’18 MENA* KSA Algeria Egypt UAE Morocco Lebanon Tunisia Jordan
12% 8% 11% 25% 13% 4% 6% 9% 4%
5% 3% 4% 17% 9% 3% 3% -1% 7%
8% 6% 4% 23% 12% 4% 6% 6% 3%
Gx
Ox
Others
61% 66%
51% 44%
78%
60% 71% 65% 58%
39% 34%
49% 56%
22%
40%
29% 35% 42%
MNC vs Local/regional split in MENA pharma market, Bn LC$. MAT Q3 ’14-’18
18.9 7.8 2.5 3.6 2.2 1.1 0.8 0.6 0.3
CAGR ’14-’18 MENA* KSA Algeria Egypt UAE Morocco Lebanon Tunisia Jordan
Local/
Regional
13% 10% 16% 24% 15% 5% 6% 11% 5%
MNC 5% 3% 1% 19% 9% 2% 4% 1% 5%
21
Growth>=Market Growth=Market Growth<Market
Despite the challenges posed by flotation of Egyptian pound the reforms
taken by govt. is providing positive results
Egyptian Pound vs. USD Exchange rates
Key Highlights
• The float of EGP followed a one-off devaluation of
approximately 12% in mid-March 2016, and again in
November 2016, where the exchange ratio against USD
changed from 8.5 EGP to ~18 EGP
• Due to this the rate of inflation rose as high as35%
• The impact of the devaluation was compounded by a
reduction in energy subsidies, together with a looser
monetary policy, which were required for the country totap
a $12 billion loan from the IMF
• The government has taken measures to put the economy
on a sustainable path of growth, following years of decline
in the wake of political chaos
• Inflationary pressures expected to ease and follow the
downward trend established since August 2017. This is
due, in part, to the Central Bank of Egypt’s (CBE) effortsto
curb inflation with a 7% hike in interest rates since
November 2016
• CBE is targeting a decline in inflation to around 13% forQ4
2018 and to single-digit inflation from 2019onwards
10
Key Highlights
• The growth rate of the older population groups (40-59 and 60+)
are the highest among the population and will continue to bethe
highest
• This has led to an increase in incidence of chronic diseasesand
ailments associated with elderly, and this trend will continue
• On the other hand, the population group of 20-39, which
represents the major income earning segment has grownonly
1%, and is expected to have an even slower growth by 2022
• This indicates a shrinking labour force which in turn couldput
burden on public health carecosts
Egypt has a young population with ~74% under the age of 40 years however
its fast aging population presents an increase in healthcare needs
Population distribution by age
Key demographics Egypt MENA
Population growth, 2013-2017 2.1% 1.8%
Population aged >65 years in 2017 5.2% 4.9%
Urban population 38.8% 64.5%
42%
32%
42%
33%
2013
97.6
18%
8%
18%
102.9
2020
8% 8%
2015
32%
18%
2017
42% 42%
31%
19%
9%
8%
2018
31%
19%
8%
41%
106.4
20%
30%
89.8
2022
42%
93.8
99.4
2.1%
1.7%
Age Group % of population Growth 2013-17 Growth 2018-22
0-19 42% 2% 1%
20-39 32% 1% 0.7%
40-59 18% 3% 3%
60+ 8% 3% 3%
11
13
While private sector has the maximum number of hospitals, MOH and other
govt. inst. account for ~72% of hospital beds in Egypt
Key Highlights
• In 2014 there were 122,477 hospital beds in the country as a whole; this number includes 24,647 beds in the private sector, 41,129 in MOHP run facilities, and
24,828 beds in other facilities administered by theMOHP
• The overall average number of beds per one hospital was 105 beds in government sector, 93 beds per one hospital in public or parastatal sector and only 17
beds in private sector
• Alongside private and public bodies, charity hospitals have emerged as a key component of the countries healthcare system, especially in specialist areas
such as oncology
• The uneven distribution of medical personnel – between urban and rural areas, between primary, secondary or tertiary care, and among the different
specialties – exacerbates sharp disparities in the quantity and quality of Egypt’s healthcareprovision
391
268
MOHP Other Governmental Private Sector
Sector
No. of Hospitals in different Sectors (2014)
1,403
45%
27%
27%
No. of beds in different Sectors (2014)
MOHP
Other gov. sector
Private
Health worker distribution in all sectors (2015)
29%
54%
12%
5%
Physicians
Nurses
Pharmacists
Dentists
Egyptian Health Care at
Glance
HEALTHCARE IN EGYPT – AN OVERVIEW
 Egypt’s pharmaceutical and healthcare markets are among the most attractive in the Middle East and North
Africa (MENA) region. After a succession of economic and regulatory reform, there has been an uptick in interest
and investment from multinational drug makers and healthcare providers.
Most populous Arab nation
with a population expected
to reach over 151 million
by 2050 (97.99 million in
2018)
3rd in Africa and 14th in
the world; 1.2% of the
world’s population
Poverty: 27.8%
(25.5 million);
Illiteracy rate: 15.8%
(14.5 million)
Urban population
remains below 50%
(43.2% in 2016),
growing at a rate of
2.2% per year
Egypt’s population
will shift from Baby
Boomers to
Generation X, Y & Z
The World Bank expects
government spending on
healthcare to reach at least 3% of
GDP compared to the global
average of 6%.
Egypt Country Review
Egypt Country Review
HEALTHCARE IN EGYPT - AN ATTRACTIVE INVESTMENT OPPORTUNITY
 The implementation of reforms along with the gradual restoration of confidence and stability
are starting to yield positive results.
 In FY 2018, real GDP grew at 5.3%, compared to 4.2% in FY 2017, This pickup in GDP was mainly
driven by public and private investments as well as private consumption.
Egypt Country Review
HEALTHCARE IN EGYPT - AN ATTRACTIVE INVESTMENT OPPORTUNITY
 Egypt's generic drug market will experience robust growth in
the long term, driven by the government's focus on cost
containment, the impending patent cliff and greater
awareness of generic medicines as a substitute for
expensive patented medicines.
Egypt Country Review
HEALTHCARE IN EGYPT - Generic Drug Market
Egypt Health Care Expenditure
Total population (2016) 95,000
Gross national income per capita (PPP international $, 2013) 10
Life expectancy at birth m/f (years, 2016) 68/73
Probability of dying under five (per 1 000 live births, 0)
not available
Probability of dying between 15 and 60 years m/f (per 1 000
population, 2016)
205/121
Total expenditure on health per capita (Intl $, 2014) 594
Total expenditure on health as % of GDP (2014) 5.6
Marketing orientation
Egypt, How much spent on health
• Despite a positive outlook, the country’s restrictive drug pricing regime and the pound's flotation will pose
challenges over the coming years.
• Egypt's healthcare market will remain among the largest in the MENA region. The growth in the Egyptian market will
be driven by the country's growing demand for prescription medicines , a rapid increase in the country's population
and g rowing health awareness .
• Increase awareness about non-communicable disease will boost business in this area especially in Diabetes market
inside Egypt.
• High inflation rates push more local companies for more growth and at same time the economic stability will help
investor to inject more money in coming years
• Many companies change business model for more prescription drugs rather than acute drugs
perspective and prospective on Egyptian
pharmaceutical market
Egypt Country Review
Total Market Performance
24.6
28.0
31.7
41.6
51.6
66.6
14.0
13.3
31.2
24.0
29.1
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
LE Sales
Y/2013
LE Sales
Y/2014
LE Sales
Y/2015
LE Sales
Y/2016
LE Sales
Y/2017
LE Sales
Y/2018
Growth
Billions
Sales Growth
Egypt Country Review
Pharmaceutical Market PerformanceDec YTD 2018
Corporate
Rank Value Growth Market Share
M Q YTD M Q YTD M Q YTD M Q YTD
Selected Market 0 0 0 6519469233 18728550736 66620038769 33% 25% 29%
NOVARTIS 1 1 1 464,133,953.0 1,375,421,695.0 4,903,479,270.0 9.3 10.3 18.8 7.1 7.3 7.4
GLAXOSMITHKLINE* 2 2 2 445,191,002.0 1,217,633,372.0 4,097,586,575.0 35.9 22.2 22.5 6.8 6.5 6.2
SANOFI 4 4 3 317,836,051.0 947,699,639.0 3,489,547,020.0 23.2 25.8 28.7 4.9 5.1 5.2
PHARCO* 3 3 4 344,328,232.0 981,991,790.0 3,404,886,459.0 42.3 30.6 24.5 5.3 5.2 5.1
AMOUN PHARM.CO.* 5 5 5 295,901,732.0 896,430,480.0 3,283,416,807.0 27.3 31.1 34.6 4.5 4.8 4.9
EIPICO* 10 9 6 170,141,440.0 581,007,275.0 2,329,079,452.0 10.5 6.4 17.6 2.6 3.1 3.5
EVA PHARMA* 6 6 7 276,656,061.0 670,173,932.0 2,316,638,689.0 38.8 23.3 24.5 4.2 3.6 3.5
PFIZER* 8 7 8 196,635,271.0 613,963,159.0 2,127,562,484.0 48.6 30.5 28.5 3.0 3.3 3.2
HIKMA PLC* 7 8 9 203,430,906.0 582,259,615.0 1,792,411,388.0 64.8 62.6 44.7 3.1 3.1 2.7
MEDICAL UNION PHA* 9 11 10 172,859,332.0 421,453,152.0 1,599,460,409.0 33.0 18.3 38.7 2.7 2.3 2.4
MARCYRL* 11 10 11 164,185,433.0 434,166,878.0 1,558,999,147.0 66.0 52.8 54.3 2.5 2.3 2.3
ASTRAZENECA* 12 12 12 139,240,562.0 395,148,566.0 1,345,270,331.0 32.0 41.5 41.1 2.1 2.1 2.0
GLOBAL NAPI* 16 14 13 107,024,436.0 354,398,056.0 1,328,558,512.0 31.6 32.6 28.2 1.6 1.9 2.0
MERCK 15 15 14 108,923,727.0 337,913,449.0 1,319,454,483.0 15.8 27.5 36.9 1.7 1.8 2.0
MULTIAPEX PHARM. 14 13 15 121,778,927.0 359,016,269.0 1,290,885,178.0 24.6 26.6 24.5 1.9 1.9 1.9
Total Others (817) xxx xxx xxx 2,991,202,168.0 8,559,873,409.0 30,432,802,565.0 23 24.7 30.3 45.9 45.7 45.7
Egypt Country Review
Top 10 Companies Evolution index
0
20
40
60
80
100
120
NOVARTIS GSK SANOFI PHARCO AMOUN EIPICO EVA PFIZER HIKMA
PLC
MUP
112
Egypt Country Review
0
5
10
15
20
25
30
35
40
45
50
-2 29 36-3 -1 17 18 19 20 21 28 30
GSK
PHARCO
PFIZER
EIPICO
EVA PHARMA
AZ
GLOBALNAPI
MARCYRL
MERCK KGAA
MEDICAL UNION
SANOFI
NOVARTIS
CAGR%,’14-’18
37 38 54
PPG %, ’17-’18
Market CAGR: 22%
Market PPG: 26%Bubble size indicate
sales in 2018, EGP Bn
2.7
EVA PHARMA
MEDICAL UNION
PFIZER
EIPICO
1.1
PHARCO
NOVARTIS
AZ
GSK
AMOUN PHARM.CO.
SANOFI
HIKMA
MARCYRL
GLOBALNAPI
MERCK KGAA
ROCHE
5.2
4.0
3.6
3.3
1.6
1.6
2.2
2.0
1.9
1.5
1.4
1.3
1.2
Top 15 corporations sales
EGP Bn, 2018
Pharco suffering drop in Systemic
Antivirals, Vtamin B group & Anti-Platelets
Medical Union showing strong
performance in Anti-bacterial,
Insulins, Vitamins and Allergy
products
HIKMA
AMOUN PHARM.CO. ROCHE
AstraZeneca growing
through Oncology &
Anti diabetes products
Hikma showing exponential
growth in Ani-epileptics
MNC
0 16
Local/Regional
Top 15 corporations in Egypt- Short term vs long term growth
Pharma market PMA Market Trends
Top companies include a mix of Regional and MNCs; Regional companies
Medical Union, Marcyrl & Hikma are growing faster than MNCs
37
Product Corporation Molecule Value (Egy Mn), 2018 Contr. to tot. market (value) CAGR
Augmentin Glaxosmithkline Amoxicillin#clavulanic acid 0.8% 15%
Hibiotic Amoun pharm.Co. Amoxicillin#clavulanic acid 0.7% 24%
Clexane Sanofi Enoxaparin sodium 0.7% 30%
Ins mixtard 30 hm Novo nordisk Insulin human base#insulin human isophane 0.7% 12%
Lyrolin Hikma plc Pregabalin 0.6% 133%
Concor Merck Bisoprolol 0.6% 25%
Brufen Abbott Ibuprofen 0.5% 27%
Rani Pharco Ranitidine 0.5% 31%
Controloc Takeda Pantoprazole 0.5% 18%
Cataflam Novartis Diclofenac 0.5% 16%
Unictam Medical union pha Ampicillin#sulbactam 0.5% 46%
Alphintern Amoun pharm.Co. Chymotrypsin#trypsin 0.5% 33%
Plavix Sanofi Clopidogrel 0.5% 17%
Crestor Astrazeneca Rosuvastatin 0.5% 34%
Cefotax Eipico Cefotaxime 0.4% 9%
Panadol Glaxosmithkline Caffeine#paracetamol 0.4% 36%
Diamicron Servier Gliclazide 0.4% 21%
Depovit b12 Pharco Hydroxocobalamin 0.4% 21%
Voltaren Novartis Diclofenac 0.4% 18%
Herceptin Roche Trastuzumab 0.4% 49%
462
265
512
350
273
477
477
393
374
339
335
326
324
322
321
283
308
301
301
278
Pharma market PMA Market Trends
Augmentin and Hibiotic are top selling products; 7 out of top 10 products in
Egypt are by MNCs, Hikma’s Lyrolin is 5th largest selling product in Egypt
Pharma market: Top 20 Product analysis
EGP Mn, 2018
Contribution of Hospital BusinessMAT Q3 2018
69.5 67.2
57.8
68.0
85.9 83.9
68.7
84.2 85.9
68.2
81.4
30.5 32.8
42.2
32.0
14.1 16.1
31.3
15.8 14.1
31.8
18.6
Retail Market Hospitals
Egypt Country Review
Top 10 Companies Hospitals SalesMAT Q3 2018
0
500
1,000
1,500
2,000
2,500
2,326 2,312
1,549
634
588
904
429
359
716
313
Millions
Egypt pharma market is expected to grow at double digits as a result of rise
in health awareness causing a shift to innovative medicines & price growth
Pharma Market Dynamics
Growth drivers
 Price growth will be a significant driver of market growth in short
term
 Volume growth will be the main driver of growth from 2020
onwards
 The introduction of the new universal health insurancescheme
would include more populatedareas
 Rising rates of obesity, sedentary lifestyles, increasing rates of
smoking have upped the incidence of non communicable
diseases and chronic diseases
 Rise in health awareness would increase demand for new and
more innovative medicines, causing a shift towards use of more
expensive products and driving price growth
Growth constraints
 Slower growth rate of Egypt’s population and falling birth rates
pose to be a major constraint on the pharmaceutical market
growth
 High, though declining, inflation will affect the growth in
consumer spending and delay investment decisions
 Increased input costs, affecting the rate of expansion inthe
manufacturing sector2019F2014 2015
115.0
20182016 2017 2020F 2022F2021F
30.3
35.8
44.1
53.6
67.5
77.1
88.1
100.7
22.1%
14.3%
Egypt Pharma market Outlook (Value)
EGP Bn, 2014-2022F
Systemic Antibacterial is the largest TA while New generation type II Anti
diabetes (+45%) is among fastest growing TAs in the market
0
10
5
15
20
25
30
35
242216 17 19 20 41 4218 4321 29 3025 3123 3532 33 34
Insulins & Analogs
Antihypertensives
Traditional Type II Antidiabetes
Anti-Epileptics
Anti-Ulcerants
26 27 28
PPG (2017-2018)
Systemic Antibacterials
CAGR(2014-2018)
Allergy Oncologics - Targeted
Opthalmologicals & Otologicals
Anti-Inflammatory & Anti-Rheumatic Products
Lipid Regulators
Erectile Dysfunction ProductsVitamin B Group
Cough & Cold Preparations
Asthma & COPD
Size of the bubble represents sales in EGP Mn, MAT Q4 2018
PPG: 26%
CAGR: 22%
Acute
Chronic
Acute & Chronic
Egypt pharma market: Top 15 TAanalysis
Note: Top 15 TAs exclude Non-Therapeutics
22
0.0
10.0
20.0
30.0
40.0
50.0
60.0
0.0
2,000,000,000.0
4,000,000,000.0
6,000,000,000.0
8,000,000,000.0
10,000,000,000.0
12,000,000,000.0
14,000,000,000.0
16,000,000,000.0
LE Sales
Y/2018
LE Sales
Y/2018
%AV+
With local players dominating the market, generics occupy highest share
and have been growing fast compared to original products
PPG %
’17-’18
CAGR %
’14-’18
23% 18%
31% 25%
22% 23%
26% 22%
39%
21% 39%
20%
67.5
36%
21%
34%
22%
33%
45%
30.3 35.8
44.1
53.6
23%
Key Highlights
• Generics products are growing significantly above market growth as a result of
current economic status and country pushing towards localization
• Generics products growth is driven by Anti-bacterials, Anti-ulcerants, Allergy
TAs which grew at 21%, 27% and 28% CAGR in value salesrespectively
• On the other hand, Originals from Systemic Antibacterials lost 3% volume
sales YoY over the last 5 years
Growth>=Market Growth=Market Growth<Market
21%
52%
27%
83.8
28% 27%
21%
51%
22%
51%
20%
52%
28%
18%
55%
27%
69.8 72.2 78.2 71.7
Egypt market split by Product type
EGP Bn, 2014-2018
Egypt market split by Product type
SU Bn, 2014-2018
PPG %
’17-’18
CAGR %
’14-’18
10% 2%
22% 6%
13% 5%
Total Market 17% 5%
40% 40% 43% 43%
2014 2015 2016 2017 2018 2014 2015 2016 2017 2018
Original
Generics
Others*
Original
Generics
Others*
Total Market
Market price trends
EGP/SU , 2014-2018
0.8
0.9 0.9
1.3
1.5
0.3 0.4
0.54
0.6 0.7
20182015 Label2016 2017
Originals
Others*
Generics
23
In Generic market, Systematic antivirals (excl. Anti HIV) and Anti Epileptics
are the fastest growing therapeutic areas
100
90
80
70
60
50
40
30
20
10
0
-10
56
Anti-Ulcerants
Lipid Regulators
Allergy
Opthalmologicals & Otologicals Functional GI Disorder Drugs
Anti-Inflammatory & Anti-Rheumatic Products
Oncologics - Cytotoxics
Asthma & COPD
CAGR(2014-2018)
Dermatological Anti-Infectives Anti-Epileptics
Systemic Antibacterials
Antihypertensives
Erectile Dysfunction Products
Systemic Antivirals Excl. Anti-HIV
Cough & Cold Preparations
Size of the bubble represents sales in EGP Mn, MAT Q4 2018
PPG: 31%
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
PPG (2017-2018)
CAGR: 25%
Acute
Chronic
Acute & Chronic
Egypt Generic pharma market: Top 15 TAanalysis
Note: Top 15 TAs exclude Non-Therapeutics
Across top therapy areas, penetration of Gx products vary; highest
Gx (>70%) share observed in 4 out of top 15 TAs
45%
71%
46%
60%
75%
64% 66% 70%
98% 97%
80%
51%
61% 55% 60%
73%
33%
43%
39% 31% 27%
40%
39%
44% 40%
22%
11%
5% 6% 1% 9%
2%
27%
3.8
1% 2%
19%
0%
25%
1.4
1%
29%
1%
3.0
3%
8.6 1.3
0% 1%
67.5
3%
24%
Total Market Antibacterials NSAIDs Antihypertensives Anti- Allergy Cough Anti- Oncologics Vitamin Opthalmo Insulins & Traditional Asthma Lipid Reg ED Products
Ulcerants & Cold Epileptics - Targeted B Group Analogs T2D & COPD
2.6 2.2 1.21.93.1 1.4 1.4 1.3 1.31.9
Total 22% 19% 22% 22% 24% 26% 25% 33% 30% 26% 22% 22% 16% 25% 25% 27%
Others 23% 26% 23% 7% 34% 34% 29% 27% 33% 26% - 23% 6% 9% - 25%
Original 18% 14% 21% 20% 16% 21% 7% 19% 29% - 16% 19% 16% 23% 22% 28%
Generics 25% 21% 22% 25% 27% 28% 22% 42% 48% 31% 185% 23% 16% 27% 27% 26%
CAGR 2014-2018
Therapy area like Antibacterials, Anti-ulcerants,
Allergy, Anti-epileptics Lipid regulators &
Erectile dysfunction have high generic
penetration
*Others include nutritional supplements, diagnostics, and some vaccines
Top 15 TAs in Egypt
EGP Bn, 2018
Best Launches
0.0
10,000,000.0
20,000,000.0
30,000,000.0
40,000,000.0
50,000,000.0
60,000,000.0
70,000,000.0
80,000,000.0
90,000,000.0
LE Sales
Y/2013
LE Sales
Y/2014
LE Sales
Y/2015
LE Sales
Y/2016
LE Sales
Y/2017
LE Sales
Y/2018
VILDAGLUSE PLUS VICTOZA GONAPURE VERDENODEB ZURCAL ZYTIGA XANTHISTOP
Local Companies Performance
0.0
200,000,000.0
400,000,000.0
600,000,000.0
800,000,000.0
1,000,000,000.0
1,200,000,000.0
1,400,000,000.0
1,600,000,000.0
1,800,000,000.0
2,000,000,000.0
LE Sales
Y/2013
LE Sales
Y/2014
LE Sales
Y/2015
LE Sales
Y/2016
LE Sales
Y/2017
LE Sales
Y/2018
HIKMA PLC* MEDICAL UNION PHA* MARCYRL* MULTIAPEX PHARM. RAMEDA* AUG PHARMA* UTOPIA
Companies per therapy areas
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
HIKMA PLC* MEDICAL UNION PHA* MARCYRL* MULTIAPEX PHARM. RAMEDA* AUG PHARMA* UTOPIA
J0 SYSTEMIC ANTI-INFECTIVES N0 NERVOUS SYSTEM A0 ALIMENTARY T.& METABOLISM R0 RESPIRATORY SYSTEM
C0 CARDIOVASCULAR SYSTEM M0 MUSCULO-SKELETAL SYSTEM G0 G.U.SYSTEM & SEX HORMONES S0 SENSORY ORGANS
L0 ANTINEOPLAST+IMMUNOMODUL B0 BLOOD + B.FORMING ORGANS D0 DERMATOLOGICALS V0 VARIOUS
H0 SYSTEMIC HORMONES P0 PARASITOLOGY J0 SYSTEMIC ANTI-INFECTIVES R0 RESPIRATORY SYSTEM
13th Cairo Marketing Club 10-4-2019
Egyptian Pharma Market Growth Outlook

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Egyptian Pharma Market Growth Outlook

  • 1. Egyptian Pharma Market ‘what you have to know’ Dr. Haytham Mohamed Marei Marketing Manager Hikama Pharmaceuticals Marketing Club Instructor
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  • 10. 14 2017-2022: Global Markets Dynamics North America • Size (2017) : US$ 485.8 Bn • CAGR ’17-22’: 5.4% Europe • Size (2017) : US$ 263.3 Bn • CAGR ’17-22’: 4.1% China • Size (2017): US$ 131.7 Bn • CAGR ’17-22’: 4.6% Japan & S. Korea • Size (2017): US$ 102 Bn • CAGR ’17-22’: -0.3% Egypt • Size (2017): US$ 2.7 Bn • CAGR ‘’17-22’: 16.1% Oceania • Size (2017): US$ 14.5 Bn • CAGR ’18-22’: 1.1% Indian Subcontinent • Size (2017): US$ 25.3 Bn • CAGR ’17-22’: 10% Latin America & Carrib. • Size (2017): US$ 59.7 Bn • CAGR ’17-22’: 7.5% Global Market Size (2017): $1.15Tn CAGR ’17-22’: 4.8 % CIS • Size (2017): US$ 19.9 Bn • CAGR ’17-22’: 8% Overall MENA • Size (2017) : US$ 22.4 Bn • CAGR ’17-22 : 6.7%
  • 11. The top 15 companies in the region contribute ~50% of total MENA sales, with the majority being MNCs… Rank Top Corporations in MENA Sales MAT Q3 2018, Bn LC$ 1 Sanofi 1.3 2 Novartis 1.1 3 Glaxosmithkline 0.9 4 Pfizer 0.8 5 Novo Nordisk 0.6 6 Hikma 0.6 7 AstraZeneca 0.6 8 MSD 0.5 9 Julphar 0.4 10 Tabuk 0.4 11 Spimaco 0.4 12 Roche 0.4 13 Abbott 0.4 14 Bayer 0.4 15 Johnson & Johnson 0.3 -8 -6 -4 -2 0 2 4 6 8 10 12 -25 -20 -15 -10 -5 0 5 10 30 AstraZeneca Pfizer Sanofi MSD Novartis Hikma Glaxosmithkline Novo Nordisk JulpharSpimaco Roche Johnson & Johnson Abbott Bayer CAGRMATQ32014–2018% 15 20 25 PPG MAT Q3 2014-2018 % MNC Local/Regional CAGR= +8% PPG = +11% Overall market: Top 15 Corporations in MENA Bubble size indicates sales value in MAT Q3 2018 16 Tabuk 14
  • 12. However, the growth of Generics and local companies is clearly outpacing Originals and MNCs Key Highlights • Across MENA countries, Gx are gaining sharesfaster than Ox at 12% vs 5% CAGR respectively • Gx accounts for 34% share of themarket  Algeria has the highest share of Gx (49%)  Egypt, UAE and Algeria showed the highestgrowth of Generics • MNCs still dominate the MENA market however local and regional MNF sales are growing faster at ~13% CAGR as compared to MNC sales (5%)  Egypt, Algeria and UAE have the highest growthof local/regional companies Generics penetration in MENA pharma market, Bn LC$,MAT Q3 ’14-’18 **Others include nutritional supplements, diagnostics, and somevaccines. 22% 24% 14% 22% 19% 22% 27% 18% 28% 44% 48% 37% 34% 59% 34% 49% 38% 37% 34% 27% 49% 22% 24% 44% 44% 43% 35% 18.9 7.8 2.5 3.6 2.2 1.1 0.8 0.6 0.3 CAGR ’14-’18 MENA* KSA Algeria Egypt UAE Morocco Lebanon Tunisia Jordan 12% 8% 11% 25% 13% 4% 6% 9% 4% 5% 3% 4% 17% 9% 3% 3% -1% 7% 8% 6% 4% 23% 12% 4% 6% 6% 3% Gx Ox Others 61% 66% 51% 44% 78% 60% 71% 65% 58% 39% 34% 49% 56% 22% 40% 29% 35% 42% MNC vs Local/regional split in MENA pharma market, Bn LC$. MAT Q3 ’14-’18 18.9 7.8 2.5 3.6 2.2 1.1 0.8 0.6 0.3 CAGR ’14-’18 MENA* KSA Algeria Egypt UAE Morocco Lebanon Tunisia Jordan Local/ Regional 13% 10% 16% 24% 15% 5% 6% 11% 5% MNC 5% 3% 1% 19% 9% 2% 4% 1% 5% 21 Growth>=Market Growth=Market Growth<Market
  • 13. Despite the challenges posed by flotation of Egyptian pound the reforms taken by govt. is providing positive results Egyptian Pound vs. USD Exchange rates Key Highlights • The float of EGP followed a one-off devaluation of approximately 12% in mid-March 2016, and again in November 2016, where the exchange ratio against USD changed from 8.5 EGP to ~18 EGP • Due to this the rate of inflation rose as high as35% • The impact of the devaluation was compounded by a reduction in energy subsidies, together with a looser monetary policy, which were required for the country totap a $12 billion loan from the IMF • The government has taken measures to put the economy on a sustainable path of growth, following years of decline in the wake of political chaos • Inflationary pressures expected to ease and follow the downward trend established since August 2017. This is due, in part, to the Central Bank of Egypt’s (CBE) effortsto curb inflation with a 7% hike in interest rates since November 2016 • CBE is targeting a decline in inflation to around 13% forQ4 2018 and to single-digit inflation from 2019onwards 10
  • 14. Key Highlights • The growth rate of the older population groups (40-59 and 60+) are the highest among the population and will continue to bethe highest • This has led to an increase in incidence of chronic diseasesand ailments associated with elderly, and this trend will continue • On the other hand, the population group of 20-39, which represents the major income earning segment has grownonly 1%, and is expected to have an even slower growth by 2022 • This indicates a shrinking labour force which in turn couldput burden on public health carecosts Egypt has a young population with ~74% under the age of 40 years however its fast aging population presents an increase in healthcare needs Population distribution by age Key demographics Egypt MENA Population growth, 2013-2017 2.1% 1.8% Population aged >65 years in 2017 5.2% 4.9% Urban population 38.8% 64.5% 42% 32% 42% 33% 2013 97.6 18% 8% 18% 102.9 2020 8% 8% 2015 32% 18% 2017 42% 42% 31% 19% 9% 8% 2018 31% 19% 8% 41% 106.4 20% 30% 89.8 2022 42% 93.8 99.4 2.1% 1.7% Age Group % of population Growth 2013-17 Growth 2018-22 0-19 42% 2% 1% 20-39 32% 1% 0.7% 40-59 18% 3% 3% 60+ 8% 3% 3% 11
  • 15. 13 While private sector has the maximum number of hospitals, MOH and other govt. inst. account for ~72% of hospital beds in Egypt Key Highlights • In 2014 there were 122,477 hospital beds in the country as a whole; this number includes 24,647 beds in the private sector, 41,129 in MOHP run facilities, and 24,828 beds in other facilities administered by theMOHP • The overall average number of beds per one hospital was 105 beds in government sector, 93 beds per one hospital in public or parastatal sector and only 17 beds in private sector • Alongside private and public bodies, charity hospitals have emerged as a key component of the countries healthcare system, especially in specialist areas such as oncology • The uneven distribution of medical personnel – between urban and rural areas, between primary, secondary or tertiary care, and among the different specialties – exacerbates sharp disparities in the quantity and quality of Egypt’s healthcareprovision 391 268 MOHP Other Governmental Private Sector Sector No. of Hospitals in different Sectors (2014) 1,403 45% 27% 27% No. of beds in different Sectors (2014) MOHP Other gov. sector Private Health worker distribution in all sectors (2015) 29% 54% 12% 5% Physicians Nurses Pharmacists Dentists
  • 16. Egyptian Health Care at Glance
  • 17. HEALTHCARE IN EGYPT – AN OVERVIEW  Egypt’s pharmaceutical and healthcare markets are among the most attractive in the Middle East and North Africa (MENA) region. After a succession of economic and regulatory reform, there has been an uptick in interest and investment from multinational drug makers and healthcare providers. Most populous Arab nation with a population expected to reach over 151 million by 2050 (97.99 million in 2018) 3rd in Africa and 14th in the world; 1.2% of the world’s population Poverty: 27.8% (25.5 million); Illiteracy rate: 15.8% (14.5 million) Urban population remains below 50% (43.2% in 2016), growing at a rate of 2.2% per year Egypt’s population will shift from Baby Boomers to Generation X, Y & Z The World Bank expects government spending on healthcare to reach at least 3% of GDP compared to the global average of 6%. Egypt Country Review
  • 18. Egypt Country Review HEALTHCARE IN EGYPT - AN ATTRACTIVE INVESTMENT OPPORTUNITY  The implementation of reforms along with the gradual restoration of confidence and stability are starting to yield positive results.  In FY 2018, real GDP grew at 5.3%, compared to 4.2% in FY 2017, This pickup in GDP was mainly driven by public and private investments as well as private consumption.
  • 19. Egypt Country Review HEALTHCARE IN EGYPT - AN ATTRACTIVE INVESTMENT OPPORTUNITY
  • 20.  Egypt's generic drug market will experience robust growth in the long term, driven by the government's focus on cost containment, the impending patent cliff and greater awareness of generic medicines as a substitute for expensive patented medicines. Egypt Country Review HEALTHCARE IN EGYPT - Generic Drug Market
  • 21. Egypt Health Care Expenditure Total population (2016) 95,000 Gross national income per capita (PPP international $, 2013) 10 Life expectancy at birth m/f (years, 2016) 68/73 Probability of dying under five (per 1 000 live births, 0) not available Probability of dying between 15 and 60 years m/f (per 1 000 population, 2016) 205/121 Total expenditure on health per capita (Intl $, 2014) 594 Total expenditure on health as % of GDP (2014) 5.6
  • 22. Marketing orientation Egypt, How much spent on health
  • 23. • Despite a positive outlook, the country’s restrictive drug pricing regime and the pound's flotation will pose challenges over the coming years. • Egypt's healthcare market will remain among the largest in the MENA region. The growth in the Egyptian market will be driven by the country's growing demand for prescription medicines , a rapid increase in the country's population and g rowing health awareness . • Increase awareness about non-communicable disease will boost business in this area especially in Diabetes market inside Egypt. • High inflation rates push more local companies for more growth and at same time the economic stability will help investor to inject more money in coming years • Many companies change business model for more prescription drugs rather than acute drugs perspective and prospective on Egyptian pharmaceutical market Egypt Country Review
  • 24. Total Market Performance 24.6 28.0 31.7 41.6 51.6 66.6 14.0 13.3 31.2 24.0 29.1 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 LE Sales Y/2013 LE Sales Y/2014 LE Sales Y/2015 LE Sales Y/2016 LE Sales Y/2017 LE Sales Y/2018 Growth Billions Sales Growth Egypt Country Review
  • 25. Pharmaceutical Market PerformanceDec YTD 2018 Corporate Rank Value Growth Market Share M Q YTD M Q YTD M Q YTD M Q YTD Selected Market 0 0 0 6519469233 18728550736 66620038769 33% 25% 29% NOVARTIS 1 1 1 464,133,953.0 1,375,421,695.0 4,903,479,270.0 9.3 10.3 18.8 7.1 7.3 7.4 GLAXOSMITHKLINE* 2 2 2 445,191,002.0 1,217,633,372.0 4,097,586,575.0 35.9 22.2 22.5 6.8 6.5 6.2 SANOFI 4 4 3 317,836,051.0 947,699,639.0 3,489,547,020.0 23.2 25.8 28.7 4.9 5.1 5.2 PHARCO* 3 3 4 344,328,232.0 981,991,790.0 3,404,886,459.0 42.3 30.6 24.5 5.3 5.2 5.1 AMOUN PHARM.CO.* 5 5 5 295,901,732.0 896,430,480.0 3,283,416,807.0 27.3 31.1 34.6 4.5 4.8 4.9 EIPICO* 10 9 6 170,141,440.0 581,007,275.0 2,329,079,452.0 10.5 6.4 17.6 2.6 3.1 3.5 EVA PHARMA* 6 6 7 276,656,061.0 670,173,932.0 2,316,638,689.0 38.8 23.3 24.5 4.2 3.6 3.5 PFIZER* 8 7 8 196,635,271.0 613,963,159.0 2,127,562,484.0 48.6 30.5 28.5 3.0 3.3 3.2 HIKMA PLC* 7 8 9 203,430,906.0 582,259,615.0 1,792,411,388.0 64.8 62.6 44.7 3.1 3.1 2.7 MEDICAL UNION PHA* 9 11 10 172,859,332.0 421,453,152.0 1,599,460,409.0 33.0 18.3 38.7 2.7 2.3 2.4 MARCYRL* 11 10 11 164,185,433.0 434,166,878.0 1,558,999,147.0 66.0 52.8 54.3 2.5 2.3 2.3 ASTRAZENECA* 12 12 12 139,240,562.0 395,148,566.0 1,345,270,331.0 32.0 41.5 41.1 2.1 2.1 2.0 GLOBAL NAPI* 16 14 13 107,024,436.0 354,398,056.0 1,328,558,512.0 31.6 32.6 28.2 1.6 1.9 2.0 MERCK 15 15 14 108,923,727.0 337,913,449.0 1,319,454,483.0 15.8 27.5 36.9 1.7 1.8 2.0 MULTIAPEX PHARM. 14 13 15 121,778,927.0 359,016,269.0 1,290,885,178.0 24.6 26.6 24.5 1.9 1.9 1.9 Total Others (817) xxx xxx xxx 2,991,202,168.0 8,559,873,409.0 30,432,802,565.0 23 24.7 30.3 45.9 45.7 45.7 Egypt Country Review
  • 26. Top 10 Companies Evolution index 0 20 40 60 80 100 120 NOVARTIS GSK SANOFI PHARCO AMOUN EIPICO EVA PFIZER HIKMA PLC MUP 112 Egypt Country Review
  • 27. 0 5 10 15 20 25 30 35 40 45 50 -2 29 36-3 -1 17 18 19 20 21 28 30 GSK PHARCO PFIZER EIPICO EVA PHARMA AZ GLOBALNAPI MARCYRL MERCK KGAA MEDICAL UNION SANOFI NOVARTIS CAGR%,’14-’18 37 38 54 PPG %, ’17-’18 Market CAGR: 22% Market PPG: 26%Bubble size indicate sales in 2018, EGP Bn 2.7 EVA PHARMA MEDICAL UNION PFIZER EIPICO 1.1 PHARCO NOVARTIS AZ GSK AMOUN PHARM.CO. SANOFI HIKMA MARCYRL GLOBALNAPI MERCK KGAA ROCHE 5.2 4.0 3.6 3.3 1.6 1.6 2.2 2.0 1.9 1.5 1.4 1.3 1.2 Top 15 corporations sales EGP Bn, 2018 Pharco suffering drop in Systemic Antivirals, Vtamin B group & Anti-Platelets Medical Union showing strong performance in Anti-bacterial, Insulins, Vitamins and Allergy products HIKMA AMOUN PHARM.CO. ROCHE AstraZeneca growing through Oncology & Anti diabetes products Hikma showing exponential growth in Ani-epileptics MNC 0 16 Local/Regional Top 15 corporations in Egypt- Short term vs long term growth Pharma market PMA Market Trends Top companies include a mix of Regional and MNCs; Regional companies Medical Union, Marcyrl & Hikma are growing faster than MNCs
  • 28. 37 Product Corporation Molecule Value (Egy Mn), 2018 Contr. to tot. market (value) CAGR Augmentin Glaxosmithkline Amoxicillin#clavulanic acid 0.8% 15% Hibiotic Amoun pharm.Co. Amoxicillin#clavulanic acid 0.7% 24% Clexane Sanofi Enoxaparin sodium 0.7% 30% Ins mixtard 30 hm Novo nordisk Insulin human base#insulin human isophane 0.7% 12% Lyrolin Hikma plc Pregabalin 0.6% 133% Concor Merck Bisoprolol 0.6% 25% Brufen Abbott Ibuprofen 0.5% 27% Rani Pharco Ranitidine 0.5% 31% Controloc Takeda Pantoprazole 0.5% 18% Cataflam Novartis Diclofenac 0.5% 16% Unictam Medical union pha Ampicillin#sulbactam 0.5% 46% Alphintern Amoun pharm.Co. Chymotrypsin#trypsin 0.5% 33% Plavix Sanofi Clopidogrel 0.5% 17% Crestor Astrazeneca Rosuvastatin 0.5% 34% Cefotax Eipico Cefotaxime 0.4% 9% Panadol Glaxosmithkline Caffeine#paracetamol 0.4% 36% Diamicron Servier Gliclazide 0.4% 21% Depovit b12 Pharco Hydroxocobalamin 0.4% 21% Voltaren Novartis Diclofenac 0.4% 18% Herceptin Roche Trastuzumab 0.4% 49% 462 265 512 350 273 477 477 393 374 339 335 326 324 322 321 283 308 301 301 278 Pharma market PMA Market Trends Augmentin and Hibiotic are top selling products; 7 out of top 10 products in Egypt are by MNCs, Hikma’s Lyrolin is 5th largest selling product in Egypt Pharma market: Top 20 Product analysis EGP Mn, 2018
  • 29. Contribution of Hospital BusinessMAT Q3 2018 69.5 67.2 57.8 68.0 85.9 83.9 68.7 84.2 85.9 68.2 81.4 30.5 32.8 42.2 32.0 14.1 16.1 31.3 15.8 14.1 31.8 18.6 Retail Market Hospitals Egypt Country Review
  • 30. Top 10 Companies Hospitals SalesMAT Q3 2018 0 500 1,000 1,500 2,000 2,500 2,326 2,312 1,549 634 588 904 429 359 716 313 Millions
  • 31. Egypt pharma market is expected to grow at double digits as a result of rise in health awareness causing a shift to innovative medicines & price growth Pharma Market Dynamics Growth drivers  Price growth will be a significant driver of market growth in short term  Volume growth will be the main driver of growth from 2020 onwards  The introduction of the new universal health insurancescheme would include more populatedareas  Rising rates of obesity, sedentary lifestyles, increasing rates of smoking have upped the incidence of non communicable diseases and chronic diseases  Rise in health awareness would increase demand for new and more innovative medicines, causing a shift towards use of more expensive products and driving price growth Growth constraints  Slower growth rate of Egypt’s population and falling birth rates pose to be a major constraint on the pharmaceutical market growth  High, though declining, inflation will affect the growth in consumer spending and delay investment decisions  Increased input costs, affecting the rate of expansion inthe manufacturing sector2019F2014 2015 115.0 20182016 2017 2020F 2022F2021F 30.3 35.8 44.1 53.6 67.5 77.1 88.1 100.7 22.1% 14.3% Egypt Pharma market Outlook (Value) EGP Bn, 2014-2022F
  • 32. Systemic Antibacterial is the largest TA while New generation type II Anti diabetes (+45%) is among fastest growing TAs in the market 0 10 5 15 20 25 30 35 242216 17 19 20 41 4218 4321 29 3025 3123 3532 33 34 Insulins & Analogs Antihypertensives Traditional Type II Antidiabetes Anti-Epileptics Anti-Ulcerants 26 27 28 PPG (2017-2018) Systemic Antibacterials CAGR(2014-2018) Allergy Oncologics - Targeted Opthalmologicals & Otologicals Anti-Inflammatory & Anti-Rheumatic Products Lipid Regulators Erectile Dysfunction ProductsVitamin B Group Cough & Cold Preparations Asthma & COPD Size of the bubble represents sales in EGP Mn, MAT Q4 2018 PPG: 26% CAGR: 22% Acute Chronic Acute & Chronic Egypt pharma market: Top 15 TAanalysis Note: Top 15 TAs exclude Non-Therapeutics 22
  • 34. With local players dominating the market, generics occupy highest share and have been growing fast compared to original products PPG % ’17-’18 CAGR % ’14-’18 23% 18% 31% 25% 22% 23% 26% 22% 39% 21% 39% 20% 67.5 36% 21% 34% 22% 33% 45% 30.3 35.8 44.1 53.6 23% Key Highlights • Generics products are growing significantly above market growth as a result of current economic status and country pushing towards localization • Generics products growth is driven by Anti-bacterials, Anti-ulcerants, Allergy TAs which grew at 21%, 27% and 28% CAGR in value salesrespectively • On the other hand, Originals from Systemic Antibacterials lost 3% volume sales YoY over the last 5 years Growth>=Market Growth=Market Growth<Market 21% 52% 27% 83.8 28% 27% 21% 51% 22% 51% 20% 52% 28% 18% 55% 27% 69.8 72.2 78.2 71.7 Egypt market split by Product type EGP Bn, 2014-2018 Egypt market split by Product type SU Bn, 2014-2018 PPG % ’17-’18 CAGR % ’14-’18 10% 2% 22% 6% 13% 5% Total Market 17% 5% 40% 40% 43% 43% 2014 2015 2016 2017 2018 2014 2015 2016 2017 2018 Original Generics Others* Original Generics Others* Total Market Market price trends EGP/SU , 2014-2018 0.8 0.9 0.9 1.3 1.5 0.3 0.4 0.54 0.6 0.7 20182015 Label2016 2017 Originals Others* Generics 23
  • 35. In Generic market, Systematic antivirals (excl. Anti HIV) and Anti Epileptics are the fastest growing therapeutic areas 100 90 80 70 60 50 40 30 20 10 0 -10 56 Anti-Ulcerants Lipid Regulators Allergy Opthalmologicals & Otologicals Functional GI Disorder Drugs Anti-Inflammatory & Anti-Rheumatic Products Oncologics - Cytotoxics Asthma & COPD CAGR(2014-2018) Dermatological Anti-Infectives Anti-Epileptics Systemic Antibacterials Antihypertensives Erectile Dysfunction Products Systemic Antivirals Excl. Anti-HIV Cough & Cold Preparations Size of the bubble represents sales in EGP Mn, MAT Q4 2018 PPG: 31% 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 PPG (2017-2018) CAGR: 25% Acute Chronic Acute & Chronic Egypt Generic pharma market: Top 15 TAanalysis
  • 36. Note: Top 15 TAs exclude Non-Therapeutics Across top therapy areas, penetration of Gx products vary; highest Gx (>70%) share observed in 4 out of top 15 TAs 45% 71% 46% 60% 75% 64% 66% 70% 98% 97% 80% 51% 61% 55% 60% 73% 33% 43% 39% 31% 27% 40% 39% 44% 40% 22% 11% 5% 6% 1% 9% 2% 27% 3.8 1% 2% 19% 0% 25% 1.4 1% 29% 1% 3.0 3% 8.6 1.3 0% 1% 67.5 3% 24% Total Market Antibacterials NSAIDs Antihypertensives Anti- Allergy Cough Anti- Oncologics Vitamin Opthalmo Insulins & Traditional Asthma Lipid Reg ED Products Ulcerants & Cold Epileptics - Targeted B Group Analogs T2D & COPD 2.6 2.2 1.21.93.1 1.4 1.4 1.3 1.31.9 Total 22% 19% 22% 22% 24% 26% 25% 33% 30% 26% 22% 22% 16% 25% 25% 27% Others 23% 26% 23% 7% 34% 34% 29% 27% 33% 26% - 23% 6% 9% - 25% Original 18% 14% 21% 20% 16% 21% 7% 19% 29% - 16% 19% 16% 23% 22% 28% Generics 25% 21% 22% 25% 27% 28% 22% 42% 48% 31% 185% 23% 16% 27% 27% 26% CAGR 2014-2018 Therapy area like Antibacterials, Anti-ulcerants, Allergy, Anti-epileptics Lipid regulators & Erectile dysfunction have high generic penetration *Others include nutritional supplements, diagnostics, and some vaccines Top 15 TAs in Egypt EGP Bn, 2018
  • 37. Best Launches 0.0 10,000,000.0 20,000,000.0 30,000,000.0 40,000,000.0 50,000,000.0 60,000,000.0 70,000,000.0 80,000,000.0 90,000,000.0 LE Sales Y/2013 LE Sales Y/2014 LE Sales Y/2015 LE Sales Y/2016 LE Sales Y/2017 LE Sales Y/2018 VILDAGLUSE PLUS VICTOZA GONAPURE VERDENODEB ZURCAL ZYTIGA XANTHISTOP
  • 38. Local Companies Performance 0.0 200,000,000.0 400,000,000.0 600,000,000.0 800,000,000.0 1,000,000,000.0 1,200,000,000.0 1,400,000,000.0 1,600,000,000.0 1,800,000,000.0 2,000,000,000.0 LE Sales Y/2013 LE Sales Y/2014 LE Sales Y/2015 LE Sales Y/2016 LE Sales Y/2017 LE Sales Y/2018 HIKMA PLC* MEDICAL UNION PHA* MARCYRL* MULTIAPEX PHARM. RAMEDA* AUG PHARMA* UTOPIA
  • 39. Companies per therapy areas 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% HIKMA PLC* MEDICAL UNION PHA* MARCYRL* MULTIAPEX PHARM. RAMEDA* AUG PHARMA* UTOPIA J0 SYSTEMIC ANTI-INFECTIVES N0 NERVOUS SYSTEM A0 ALIMENTARY T.& METABOLISM R0 RESPIRATORY SYSTEM C0 CARDIOVASCULAR SYSTEM M0 MUSCULO-SKELETAL SYSTEM G0 G.U.SYSTEM & SEX HORMONES S0 SENSORY ORGANS L0 ANTINEOPLAST+IMMUNOMODUL B0 BLOOD + B.FORMING ORGANS D0 DERMATOLOGICALS V0 VARIOUS H0 SYSTEMIC HORMONES P0 PARASITOLOGY J0 SYSTEMIC ANTI-INFECTIVES R0 RESPIRATORY SYSTEM
  • 40. 13th Cairo Marketing Club 10-4-2019