Pharmaceutical Industry: Key Issues in Growth in Pakistan & International Market

© European Journal of Scientific Research, Vol. 93, No 1, 2012
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European Journal of Scientific Research ISSN: 1450-216X / 1450-202X
Vol. 93 (1): 234-249, December 2012
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Pharmaceutical Industry Report - 2012
Pharmaceutical Industry: Key Issues in Growth in Pakistan &
International Market
Rizwan Raheem Ahmed
Hamdard University, Karachi, PAKISTAN
1. Introduction
Pakistan has a very vibrant and forward-looking Pharma Industry. At the time of
independence in 1947, there was hardly any pharma industry in the country.
Today Pakistan has about 400 pharmaceutical manufacturing units including
those operated by 25 multinationals present in the country. The Pakistan
Pharmaceutical Industry meets around 70% of the country's demand of Finished
Medicine. The domestic pharma market, in term of share market is almost evenly
divided between the Nationals and the Multinationals (Ahmed & Saeed, 2012).
The National pharma industry has shown a progressive growth over the years,
particularly over the last one decade. The industry has invested substantially to
upgrade itself in the last few years and today the majority industry is following
Good Manufacturing Practices (GMP), in accordance with the domestic as well
as international Guidance. Currently the industry has the capacity to manufacture
a variety of product ranging from simple pills to sophisticated Biotech, Oncology
and Value Added Generic compounds (Aamir & Zaman, 2011).
Although Pakistan 's pharmaceutical and healthcare sectors are expanding and
evolving rapidly, about half the population has no access to modern medicines.
Clearly this presents an opportunity, but much more work needs to be done by
the government and industry's stakeholders. The value of pharmaceuticals sold
in 2007 exceeded US$1.4bn, which equates to per capita consumption of less
than US$ 10 per year and value of medicines sold is expected to exceed US$2.3
B by 2012 (Ahmed et al., 2011).

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Pakistan is a developing pharmaceutical market, with a large population and
economic progress evident, but per capita drug spending was rather low at
around US$9.30 in 2007 (Ahmed & Jalees, 2008). Private spending accounts for
65% of total healthcare expenditure sourced through out-of pocket payments,
international aid and religious or charitable institutions. Pharmaceutical spending
accounts for less than 1% of the country's GDP, comparable to levels in some
neighboring countries but above that in some of the South Asian countries
(Federal Bureau of Statistics, 1997). The forecast period is likely to witness the
marginal strengthening of the generics sector, albeit more in terms of volumes
than values. The share of generics is also likely to increase further as major
drugs come off patent in the near term, to the likely benefit of the generics-
dominated local industry (Dr. Akhtar, 2006).
The Pakistan pharma industry is relatively young in the international markets with
an export turnover of over US$ 100 Million as of 2007. Pakistan Pharma Industry
boasts of quality producers and regulatory authorities all over the world approve
many units. Like domestic market the sales in international market have gone
almost double during last five years. The pharma industry is focusing to an
Export Vision of USD 500 Million by 2013. In the meantime, exports are also
likely to be boosted by new regional and global opportunities (Ahmed & Saeed,
2012).
The Pakistan Pharmaceutical Industry is a success story, providing high quality
essential drugs at affordable prices to Millions. Technologically, strong and self
reliant National Pharmaceutical Industry is not only playing a key role in
promoting and sustaining development in the vital field of medicine within the
country, but is also well set to take on the international markets (Kemal et al.,
2002).
2. Pakistan overview
The pharmaceutical industry is considered the backbone of public health services
in Pakistan. This is strategically important both for the well being of the
population in general and for the provision of good yet affordable healthcare in
particular (Ahmed et al., 2012). The low cost of production and the huge potential
of this sector has attracted major multinationals to establish their operations and
production facilities in Pakistan (Trade Development Authority, 2000-02).
Local (Pakistani) pharmaceutical companies started in the 1960s but their growth
increased in the 1980s. During the last decade, they made substantial
investments in production facilities and introduced the latest technology along
with many new high quality products that were previously either unavailable or
available on a limited scale at very expensive prices. By providing quality
medicines at economical rates in this fashion, Pakistani pharmaceutical
companies have contributed substantially towards public health (Kemal et al.,
1997).

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The key to the success of Pakistani pharmaceutical companies is based on a
simple formula, i.e. the production of high quality products at current Good
Manufacturing Practices (cGMP)-compliant facilities and offering them at the
most economical rates. Nearly all of Pakistan’s leading pharmaceutical
companies has maintained high standards to ensure compliance of all operations
of production and quality control under the cGMP guidelines. As a result, they are
now successfully exporting their products to various international territories
(TDAP, 2000).
Top 25 national pharmaceutical companies are as follows:
No. Company No. Company
1. Getz Pharma Pakistan (Pvt.) Ltd 14. Macter International (Pvt.) Ltd
2. Sami Pharmaceutical (Pvt.) Ltd 15. Brookes Pharmaceuticals Labs
3. Ali Gohar Pharmaceuticals 16. Himont Pharmaceuticals (Pvt.) Ltd
4. Werrick Pharmaceuticals 17. Ferozesons Laboratories Ltd
5. Hilton Pharma (Pvt.) Ltd 18. Indus Pharma (Pvt.) Ltd
6. Barrett and Hodgson Pakistan 19. Tabros Pharma
7. Wilsons Pharmaceuticals 20. Schazoo Laboratories (Pvt.) Ltd
8. Bosch Pharmaceuticals (Pvt.) Ltd 21. Highnoon Laboratories Ltd
9. Zafa Laboratories (Pvt.) Ltd 22. Atco Laboratories (Pvt.) Ltd
10. Global Pharmaceuticals 23. Remington Pharmaceutical
11. Platinum Pharmaceuticals 24. PharmEvo (Pvt.) Ltd
12. CCL Pharmaceuticals (Pvt.) Ltd 25. Amson Vaccines and Pharma
13. Nabiqasim Industries (Pvt.) Ltd
* Included in IMS as a national company, although they have foreign
shareholding and are a member of OCCI.
(Source: IMS, Q2, 2006)
Top 10 multinational pharmaceutical companies
No. Company No. Company
1. GSK 6. Novartis Pharma (Pakistan) Ltd
2. Sanofi Aventis 7. Bristol-Myers Squibb
3. Abbott Laboratories (Pakistan) 8. Pharmacia and Upjohn (Pvt.) Ltd
4. Merck Marker (Pvt.) Ltd 9. Parke-Davis
5. Roche Pharmaceuticals 10. Wyeth Pakistan Ltd
Source: IMS, Q2, 2006

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3. Pakistani Pharmaceutical Sector:
• $ 2.3 Billion Industry
• 15.69% CAGR IN PKR, 9.98% IN US$ (IMSQ2, ‘12)
• Total Domestic Investment of $ 500 Million
• Foreign Direct Investment of $ 100 Million
• The largest employer of University Graduates in Semi-urban and Rural Areas
4. Comparison with India
Why Compare:
1. Part of tier 2 & 3 Pharmerging Countries
2. Similarities of market factors (Population, people behavior & economic
conditions)
3. Medical Infrastructure
4. Prevalence, practices & treatment of diseases.
5. Growing markets with low cost of production like Pakistan
5. Industry Evolution –10 Years India vs. Pakistan
2002:
• Indian Pharma’s Domestic Sales were $ 4 Billion
• Pakistan Pharma’s Domestic Sales were $ 1.2 Billion
2012:
• Indian Pharma Market croessed $ 16 Billion (300% Growth in a Decade or 18% per
annum)
• Pakistan Pharma Market reached $ 2 Billion (66% Growth in a Decade or 4% per
annum)
6. History of Pharmaceutical Regulation in Pakistan:
1972: Drugs (Generics) Act passed prohibiting use of brand
names/differentiation, instituting 100% controls on drug Pricing.
1976: Drugs Act 1976 Passed, allowing for use of Brand Names, but continuing
with Draconian Price Controls on 100% of all Pharmaceutical Products.
2001: Last price increase Granted by the Ministry of Health to Manufacturers to
allow for inflation, rise in cost of inputs

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2011: Devolution under the 18th Amendment led to dissolution of MoH, DRAP
not Formed until Feb ’12, Shifted to new Division in April 12, Still not Fully
Functional
7. Reasons for Stunted Growth of Pakistani Pharma Sector
1. Arbitrary Regulations: No price adjustments for inflation in a DECADE.
2. No Vitamin Policy, No policy for Over the Counter (OTC) Drugs. OTC drugs
are a large segment for Big Pharma globally, adding to scale and profitability
3. Poor Domestic Regulation and weak government procurement policies that do
not encourage investment in quality.
4. Energy Crisis Rendering Sector Uncompetitive. Electricity and Steam are the
two Costliest Inputs. No R&D Grants or Tax Benefits to Pharma. No Support on
Utilities
8. Global Pharmaceutical Industry and Trends
8.1 Global scenario
The pharmaceutical industry in any country is considered as the mainstay of
public health.
Looking at the global scenario, the importance given by developing nations to the
pharmaceutical sector can be clearly identified by including healthcare and
pharmaceutical industry in their health and welfare strategy. The global
pharmaceutical market is valued at no less than US$440 billon, with annual
growth of 6% (Aday, 1996).
Table 1: Major pharmaceutical companies.
Company
HQ
location
Revenue of
pharmaceutical
segment, mln
USD
Total
sales, mln
USD
Share of
pharmaceutica
l segment, %
Pfizer NY, U.S. 46,133 52,516 87.85%
GlaxoSmithKlin
e UK 31,434 37,324 84.22%
Johnson &
Johnson NJ, U.S. 22,190 47,348 46.87%
Merck NJ, U.S. 21,494 22,939 93.70%
AstraZeneca UK 21,426 21,426 100.00%
Novartis
Switzerlan
d 18,497 28,247 65.48%
Sanofi-Aventis France 17,861 18,711 95.46%

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Roche
Switzerlan
d 17,460 25,168 69.37%
Bristol-Myers
Squibb NY, U.S. 15,482 19,380 79.89%
Wyeth NJ, U.S. 13,964 17,358 80.45%
Abbott IL, U.S. 13,600 19,680 69.11%
Eli Lilly IN, U.S. 13,059 13,858 94.23%
Takeda Japan 8,648 10,046 86.09%
Schering-
Plough NJ, U.S. 6,417 8,272 77.57%
Bayer Germany 5,458 37,013 14.75%
Source: 2004 Annual Reports of the companies
As Table above shows, the majority of the largest pharmaceutical companies are
not diversified. They are either concentrated exclusively on pharmaceutical
products (Eli Lilly and AstraZeneca are good examples with virtually 100% of
their revenues coming from sales of pharmaceutical products).
Table 2: Average 2004 exchange rates.
Currency Exchange rate
EUR / USD 1.2438
GBP / USD 1.8333
USD / JPY 108.1508
USD / CHF 1.2426
Source: calculated using Federal Reserve daily data
8.2 Industry Trends
Several factors are worth mentioning. First, for almost all companies presented in
the table, the pharmaceutical segment is the largest; and only for one of them,
world giant Johnson & Johnson, sales of pharmaceutical segment are below 50%
(Catlin et al, 2007).
Table 3: Business segments of major U.S. pharmaceutical companies
Pfizer J&J Merck BMS Wyeth Lilly* Abbott
Schering-
Plough
Pharmaceutical 87.8% 46.9% 93.7% 80.0% 80.4% 94.2% 69.0% 77.6%
Consumer
Health &
Nutritional
products 6.7% 17.6% 10.0% 14.7% 13.1%
Animal Health 3.7% 4.8% 5.8% 9.3%
Medical Devices 35.5% 31.0%

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and Diagnostics
Other
Healthcare 10.0%
Other 1.8% 6.3%
Source: Annual Reports of the companies
*In Financial statements Animal Health products are not stated as separate segment
Table 4: Top 5 pharmaceutical products for each company based on the sales
in 2004
Sales,
mln USD
% of
total
sales
Sales,
mln USD
% of
total
sales
Pfizer Wyeth
Lipitor $10,862 20.7% Effexor $3,347 19.3%
Norvasc $4,463 8.5% Protonix $1,591 9.2%
Zoloft $3,361 6.4% Prevnar $1,054 6.1%
Celebrex $3,302 6.3%
Premarin
family $880 5.1%
Neurontin $2,723 5.2%
Zosyn /
Tazocin $760 4.4%
J&J Eli Lilly
Procrit /
Eprex $3,589 7.6% Zyprexa $4,420 31.9%
Risperdal $3,050 6.4% Gemzar $1,214 8.8%
Remicade $2,145 4.5% Humalog $1,102 8.0%
Duragesic $2,083 4.4% Evista $1,013 7.3%
Topamax $1,410 3.0% Humilin $998 7.2%
Merck Schering-Plough
Zocor $5,200 22.7% Remicade $746 9.0%
Fosamax $3,200 14.0%
Clarinex /
Aerius $692 8.4%
Cozaar $2,800 12.2% Nasonex $594 7.2%
Singulair $2,600 11.3% Peg-intron $563 6.8%
AZLP $1,500 6.5% Temodar $459 5.5%
BMS
Plavix $3,327 17.2%
Pravachol $2,635 13.6%
Taxol $991 5.1%
Avapro /
Avalide $930 4.8%
Paraplatin $673 3.5%

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Chart 1: Liquidity analysis
Chart 2: Geographical distribution of sales, 2004
Liquidity ratios
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
1.60
1.80
2.00
Pfizer J&J Merck BMS Wyeth Eli Lilly Abbott Schering-
Plough
Current Ratio CF from operations to Total Liabilities Debt-Equity Ratio
Geographical distribution of sales in 2004
58%
68%
59%
55% 57% 55% 57%
39%
42%
32%
41%
45% 43% 45% 43%
61%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Pfizer J&J Merck* BMS Wyeth* Lilly Abbott* Schering-
Plough*
USA International

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*No geographical distribution of pharmaceutical segment is available.
Proportions calculated on geographical distribution of total sales.
Table 5: Sales dynamics of non-US pharmaceutical companies, 2002-2004
2002 2003 2004
GlaxoSmithKline 3.5% 1.1% -5.0%
AstraZeneca 10.0% 5.6% 13.7%
Novartis 11.3% 19.1% 13.6%
Roche 1.0% 6.0% 0.2%
Sanofi-Aventis 14.8% 8.1% 86.9%
Takeda 4.3% 4.1% 3.9%
Bayer -2.2% -3.6% 4.2%
Source: calculations, data used from Annual Reports of the
companies
Table 6: Total assets dynamics of non-US pharmaceutical companies,
2002-2004
2002 2003 2004
GlaxoSmithKline -0.1% -5.0% 6.5%
AstraZeneca 16.7% 9.3% 8.7%
Novartis 13.3% 9.5% 10.4%
Roche -15.0% -7.0% -2.4%
Sanofi-Aventis -5.1% 3.1% 687.3%
Takeda 12.4% 4.8% 13.4%
Bayer 12.6% -10.2% 1.0%
companies
Bayer’s current acquisitions (seed treatment business and over-the-counter
medicines) even further decreased its share of pharmaceutical segment. Major
acquisitions of non-US pharmaceutical companies are summarized in Table 7.
Table 7: Recent acquisitions by major non-US pharmaceutical companies
Company
Company
acquired*
Core business of
target Purchase price
GlaxoSmithKli
ne
Merger of Glaxo
Wellcome and
SmithKline
Beecham
Megrer of two
major
pharmaceutical
companies
(registered in 2000)
-
Block Drug
Oral care and over-
the-counter
medicines
843 mln GBP
AstraZeneca
Merger of Astra
and Zeneca
Megrer of two
major
-

____________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________ 243
pharmaceutical
companies
Novartis
Sabex
Generic
manufacturer with
a leading position
in generic
injectables
565 mln USD
Mead Johnson's
adult nutrition
business
Global adult
medical nutrition
385 mln USD
Idenix
Pharmaceuticals
Inc
Biotechnology
255 mln USD + up to
357 mln USD in
possible additional
payments
Roche
Igen International
Human in-vitro
diagnostics
1,823 mln CHF
Disetronic
Insulin pumps and
injection systems
for the treatment of
diabetes.
1,132 mln CHF
Sanofi-Aventis
Merger of Sanofi-
Synthelabo and
Aventis
Merger of two
major
pharmaceutical
companies
-
Bayer
Roche's over-the-
counter business
Over-the-counter
medicines
206 mln EUR
Gustafson Seed treatment 100 mln EUR
*Acquisition of patents is not included in this table
Overall, as shown in Table 8, non-US pharmaceutical companies have
approximately similar R&D costs as % of total sales to those of U.S. companies.
Table 8: R&D costs as % of 2004 total sales
2001 2002 2003 2004
GlaxoSmithKline 12.5% 12.9% 12.9% 13.9%
AstraZeneca 17.1% 17.2% 18.3% 17.7%
Novartis 13.5% 13.6% 15.1% 14.9%
Roche 13.3% 14.5% 15.3% 16.3%
Sanofi-Aventis 15.9% 16.4% 16.4% 49.6%
Takeda 9.3% 10.0% 11.9% 11.9%
Bayer 8.5% 8.7% 8.4% 7.1%

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To calculate this ratio R&D costs and revenues for all business segments of the
company were used
Table 9: Top 5 pharmaceutical products based on the sales in 2004
GlaxoSmith
Kline
Sales
, mln
GBP
% of
total
sales
Sales
, mln
USD Roche
Sales,
mln
CHF
% of
total
sales
Sales
, mln
USD
Seretide /
Advair
£2,46
1
12.1
%
$4,51
2
MabThera
/ Rituxan
CHF
3,378
10.8
%
$2,71
9
Avandial /
Avandamet
£1,11
6 5.5%
$2,04
6
NeoRecor
mon,
Epogin
CHF
2,082 6.7%
$1,67
6
Paxil
£1,06
3 5.2%
$1,94
9
Pegasys +
Copegus
CHF
1,562 5.0%
$1,25
7
Zofran £763 3.7%
$1,39
9 Herceptin
CHF
1,435 4.6%
$1,15
5
Wellbutrin £751 3.7%
$1,37
7 CellCept
CHF
1,403 4.5%
$1,12
9
AstraZeneca
Sales
, mln
USD
% of
total
sales
Sanofi-
Aventis
Sales,
mln
EUR
% of
total
sales
Sales
, mln
USD
Nexium
$3,88
3
18.1
% Lovenox
€
1,904
12.7
%
$2,36
8
Seroquel
$2,02
7 9.5% Plavix
€
1,694
11.3
%
$2,10
7
Losec /
Prilosec
$1,94
7 9.1% Allegra
€
1,502
10.0
%
$1,86
8
Seloken
$1,38
7 6.5% Taxotere
€
1,436 9.5%
$1,78
6
Pulmicort
$1,05
0 4.9% Stilnox
€
1,423 9.5%
$1,77
0
Novartis
Sales
, mln
USD
% of
total
sales Bayer
Sales,
mln
EUR
% of
total
sales
Sales
, mln
USD
Diovan / Co-
Diovan
$3,09
3
10.9
%
Ciprobay /
Cipro € 837 2.8%
$1,04
1
Gleevec/Gliv
ec
$1,63
4 5.8% Adalat € 670 2.3% $833
Lamisil $1,16 4.1% Ascensia € 627 2.1% $780

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____________________________________________________________________ 245
2
Zometa
$1,07
8 3.8% Aspirin € 615 2.1% $765
Neoral /
Sandimmun
$1,01
1 3.6% Kogenate € 563 1.9% $700
Source: Financial reports of the companies
Sales are provided in the currency of financial reports; conversion of sales into
USD was made for comparison purposes
Table 10: Profitability analysis
2002 2003 2004
GlaxoSmithKline
ROA 17.6% 20.6% 19.7%
Profit margin 18.5% 20.9% 21.1%
Total Assets Turnover Ratio 0.95 0.99 0.93
AstraZeneca
ROA 14.2% 13.4% 15.5%
Profit margin 15.9% 16.1% 17.8%
Novartis
ROA 11.1% 10.6% 11.1%
Profit margin 22.6% 20.2% 20.4%
Roche
ROA -5.8% 5.0% 11.3%
Profit margin -13.7% 9.8% 21.2%
Sanofi-Aventis
ROA 18.1% 21.6% -8.3%
Profit margin 23.6% 25.8% -24.0%
Takeda
ROA 12.5% 13.5% 13.0%
Profit margin 23.1% 26.0% 26.3%
Bayer
ROA 2.7% -3.4% 1.6%
Profit margin 3.6% -4.8% 2.0%
companies

____________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________ 246
It is also interesting to compare European and Asian business models: Takeda,
the only Asian country in this group, showed the lowest debt-equity ratio (0.25)
that is much lower than average 0.48 for the whole group (Lexchin, 1995).
Chart 3: Liquidity analysis
Chart 4: Geographical distribution of sales, 2004
Source: Annual reports of the companies
0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
G
laxoSm
ithKline
AstraZeneca
N
ovartis
R
oche
Sanofi-Aventis
Takeda
Bayer
Current Ratio CF from operations to Total Liabilities Debt-Equity Ratio
49%
45%
40%
35%
31% 27%
36%
30% 36%
34%
38% 49%
14%
36%
21% 19%
26% 26%
20%
59%
28%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
G
laxoS
m
ithK
line
A
straZeneca
N
ovartis
R
oche*
S
anofi-A
ventis
Takeda*
B
ayer
USA Europe Other

____________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________ 247
* No geographical distribution of pharmaceutical segment is available.
Proportions calculated on the basis of geographical distribution of total sales
(Agarwal, 2001).
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Pharmaceutical Industry: Key Issues in Growth in Pakistan & International Market

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