Thank you for the insightful presentation on the evolving RMA opportunities in Iberia and Latin America. This was a comprehensive overview of the key markets, regulations, and opportunities across the different countries. I appreciate you taking the time to share your expertise.
This document provides a comparative study of consumer trends in Latin America and Asia-Pacific emerging markets. It finds that while incomes are rising across these regions, Latin America suffers from greater income inequality which impacts spending patterns. The middle class makes up a smaller portion of households in Latin America compared to Asia-Pacific. Looking ahead, the document predicts technology and communications as well as health and wellness will be growing consumer sectors in these emerging markets in the coming years as incomes rise further.
This document provides a template for creating scientific posters. It includes suggestions for formatting, design principles, and sections like the title, abstract, methods, results, and conclusions. The template is meant to simplify poster creation and emphasize key points for viewers through techniques like italics, boldface, and effective use of space. Proper formatting of images, tables, and graphs is also discussed. The goal is to design posters that are easy to understand and focused on the needs of the audience.
Este documento define el ecosistema para la prestación de servicios de consultoría, asesoría y explotación de servicios de cloud computing. Propone que los ingenieros autónomos u pequeñas empresas puedan ofrecer estos servicios de cloud a pymes locales. Esto incluye servicios de consultoría sobre cloud computing, actuar como agentes de nubes públicas, o proveer servicios de nube propios hospedando aplicaciones comunes para pymes. El COIT podría ayudar desarrollando formación, actuando como portal mayorista de compras, y
The document discusses developing a pilot project for coverage with evidence development (CED) in the private sector. A stakeholder workgroup selected pharmacogenetic testing for estimating initial warfarin dosing as the topic. The workgroup discussed operational and study design issues, such as coverage models, communication with patients and providers, funding, and informed consent. Conducting private sector CED poses challenges but payers remain interested to generate better information for coverage decisions through this mechanism.
La reunión de kick off de Incube4all tendrá lugar el 16 de diciembre de 2010 en la sede del IESE en Madrid. Los objetivos de la reunión son dar a conocer la iniciativa Incube4all, conocerse entre los participantes y compartir inquietudes, y diseñar los siguientes pasos y primeros acuerdos sobre qué quieren hacer con Incube4all y las primeras responsabilidades y expansión de la iniciativa. La agenda incluye presentaciones individuales, una presentación de la idea preliminar de Incube4all, un espacio abierto para discut
El documento presenta un modelo de incubadora virtual llamada INcube4all cuya misión es generar ideas y apoyar transiciones profesionales. La incubadora ofrece asesoramiento, recursos compartidos, y servicios de apoyo a emprendedores mediante una red de profesionales. El modelo también describe cómo los miembros pueden obtener ingresos al traer proyectos o hacer referencias y compartir los honorarios con la red de forma gratuita para los miembros.
Este documento describe el ecosistema de nube y cloud computing. Explica los rasgos clave como la estructura en capas, los servicios ofrecidos en un catálogo, y el pago por uso. También analiza las oportunidades para consultoras como barreras bajas de entrada y conocimiento de múltiples proveedores. El objetivo es desarrollar el mercado de asociaciones y pymes mediante la agrupación de servicios de micronubes.
This study analyzed insurance claims data from before and after the implementation of the Federal Mental Health Parity and Addiction Equity Act to examine the effects of parity on substance use disorder treatment. The results showed:
1) There was no change in the use of substance use disorder services or the total annual spending per enrollee on these services (which increased by only $10 per enrollee).
2) There was also no change in out-of-pocket spending for substance use disorder treatment users or several HEDIS quality measures related to identification and initiation of treatment.
3) This suggests that concerns about parity greatly increasing health care costs related to substance use disorder treatment were unfounded.
This document provides a comparative study of consumer trends in Latin America and Asia-Pacific emerging markets. It finds that while incomes are rising across these regions, Latin America suffers from greater income inequality which impacts spending patterns. The middle class makes up a smaller portion of households in Latin America compared to Asia-Pacific. Looking ahead, the document predicts technology and communications as well as health and wellness will be growing consumer sectors in these emerging markets in the coming years as incomes rise further.
This document provides a template for creating scientific posters. It includes suggestions for formatting, design principles, and sections like the title, abstract, methods, results, and conclusions. The template is meant to simplify poster creation and emphasize key points for viewers through techniques like italics, boldface, and effective use of space. Proper formatting of images, tables, and graphs is also discussed. The goal is to design posters that are easy to understand and focused on the needs of the audience.
Este documento define el ecosistema para la prestación de servicios de consultoría, asesoría y explotación de servicios de cloud computing. Propone que los ingenieros autónomos u pequeñas empresas puedan ofrecer estos servicios de cloud a pymes locales. Esto incluye servicios de consultoría sobre cloud computing, actuar como agentes de nubes públicas, o proveer servicios de nube propios hospedando aplicaciones comunes para pymes. El COIT podría ayudar desarrollando formación, actuando como portal mayorista de compras, y
The document discusses developing a pilot project for coverage with evidence development (CED) in the private sector. A stakeholder workgroup selected pharmacogenetic testing for estimating initial warfarin dosing as the topic. The workgroup discussed operational and study design issues, such as coverage models, communication with patients and providers, funding, and informed consent. Conducting private sector CED poses challenges but payers remain interested to generate better information for coverage decisions through this mechanism.
La reunión de kick off de Incube4all tendrá lugar el 16 de diciembre de 2010 en la sede del IESE en Madrid. Los objetivos de la reunión son dar a conocer la iniciativa Incube4all, conocerse entre los participantes y compartir inquietudes, y diseñar los siguientes pasos y primeros acuerdos sobre qué quieren hacer con Incube4all y las primeras responsabilidades y expansión de la iniciativa. La agenda incluye presentaciones individuales, una presentación de la idea preliminar de Incube4all, un espacio abierto para discut
El documento presenta un modelo de incubadora virtual llamada INcube4all cuya misión es generar ideas y apoyar transiciones profesionales. La incubadora ofrece asesoramiento, recursos compartidos, y servicios de apoyo a emprendedores mediante una red de profesionales. El modelo también describe cómo los miembros pueden obtener ingresos al traer proyectos o hacer referencias y compartir los honorarios con la red de forma gratuita para los miembros.
Este documento describe el ecosistema de nube y cloud computing. Explica los rasgos clave como la estructura en capas, los servicios ofrecidos en un catálogo, y el pago por uso. También analiza las oportunidades para consultoras como barreras bajas de entrada y conocimiento de múltiples proveedores. El objetivo es desarrollar el mercado de asociaciones y pymes mediante la agrupación de servicios de micronubes.
This study analyzed insurance claims data from before and after the implementation of the Federal Mental Health Parity and Addiction Equity Act to examine the effects of parity on substance use disorder treatment. The results showed:
1) There was no change in the use of substance use disorder services or the total annual spending per enrollee on these services (which increased by only $10 per enrollee).
2) There was also no change in out-of-pocket spending for substance use disorder treatment users or several HEDIS quality measures related to identification and initiation of treatment.
3) This suggests that concerns about parity greatly increasing health care costs related to substance use disorder treatment were unfounded.
Relatorio Portugal 2013 by Credito Y CaucionJoão Pinto
This document provides an overview and summary of key economic indicators for Portugal. The main points are:
1) The Portuguese economy contracted sharply in 2012 as domestic demand decreased and exports growth slowed. Unemployment rose to over 15% while inflation remained above the EU average.
2) Fiscal consolidation efforts have been impressive but revenue targets were missed due to weak growth. Additional austerity measures were implemented to reduce the budget deficit.
3) Structural reforms have addressed some labor market issues but more progress is needed in product markets. Banks have bolstered capital ratios with ECB funding but credit remains tight.
The key points from the document are:
1) Portugal's 2013 budget draft includes tax increases and spending cuts worth 3.2% of GDP as the government implements further fiscal tightening measures.
2) Non-performing loans in Spain reached 10.51% in August, the highest level since 1962, as the economy continues to deleverage.
3) Eurozone trade data for August suggests GDP growth in Q3 could be a positive surprise, with exports up 3.7% and imports up 2.1%.
The document provides an overview of recent economic developments and market events:
- Portugal's 2013 budget draft includes fiscal tightening measures worth 3.2% of GDP through tax increases and spending cuts as the country's GDP is forecast to decline further.
- Spanish regional elections and the ongoing constitutional clash in Catalonia were important political events that could influence the timing of Spain's request for financial aid.
- Moody's kept Spain's credit rating at investment grade but on a negative outlook, seeing significant risks to Spain's economic outlook.
- Spanish banks' non-performing loan ratio reached a record high 10.51% in August as the economy continues to deleverage.
- Eurozone
The document provides an overview of Brazil's key economic indicators, trade, political system, cultural behaviors, and comparisons to Spain and Germany. It notes that Brazil has a population of over 200 million, GDP of around $2.3 trillion, and GDP growth of 2.8%. Major exports include transport equipment, soybeans, and footwear, while major imports include machinery, chemicals, and automotive parts. The political system is a federative republic led by a president, and the culture emphasizes respectful relationships and clear instructions from managers.
ALI - Brazil Private Equity (Parts 1 & 2)Eric Saucedo
The document summarizes recent positive economic trends in Brazil that make it an attractive market for private equity investment, despite past boom and bust cycles. GDP growth rebounded strongly in 2Q09 and Brazil has been less impacted by the global recession than other markets. Private equity deals and M&A activity have remained robust in Brazil while declining globally. Significant institutional capital from Brazilian pension funds is now being allocated to local private equity, representing an important difference from previous cycles. Major international private equity firms are increasingly active in Brazil due to opportunities to invest in and expand portfolio companies into the large and growing market.
This document outlines Coca-Cola's strategic vision and plans for 2020. It projects continued global economic growth, rising incomes, and 1 billion new consumers entering the global economy by 2020. This will drive increased consumption of non-alcoholic ready-to-drink beverages. Coca-Cola aims to more than double its system revenue over this period while expanding margins. Its 2020 business agenda focuses on maximizing cash flow, winning with Coca-Cola brands, accelerating innovation, and optimizing its franchise structure. Coca-Cola also outlines social commitments around sustainability, water stewardship, and promoting active healthy living.
Pharmaceutical market evolution after egypt’s revolutionMohamed Saleh
This document analyzes the pharmaceutical market in Egypt after the 2011 revolution. It begins with a SWOT analysis, noting Egypt's strategic location but also weaknesses like corruption. Healthcare spending is projected to grow steadily, with the pharmaceutical market reaching $30-36 billion by 2014. The market is currently dominated by multinational firms and generics are expected to grow substantially. Overall the market is forecast to continue growing at a normal rate of around 8-14% annually despite economic changes from the revolution, as healthcare remains a priority for Egyptian consumers.
Gartner confirms the 2008-09 financial crisis has triggered widespread adaptation of BPO and shared services by European countries and corporations. Presentation for the Shared Services and Outsourcing Exchange in Europe.
Brazil had a healthcare expenditure of $222.71 billion in 2011 and was the largest pharmaceutical market and third largest medical devices market in Latin America. The government is increasing funding for healthcare and providing free or low-cost medicines for conditions like hypertension and diabetes. Brazil also aims to boost its pharmaceutical industry and reduce reliance on imports by investing in research and developing domestic generic and biosimilar drug markets. However, corruption and intellectual property issues remain challenges.
The document analyzes nominal GDP, real GDP, and economic growth in the Philippines from 1986-2009. Nominal GDP increased significantly over this period but fluctuated more than real GDP. The services sector experienced the highest growth, while agriculture grew the least. Among industries, finance grew the most steadily, while manufacturing declined. Growth is determined by factors like interest rates, currency value, government intervention, and environmental controls. Some data shows inconsistencies that call official economic growth figures into question.
The document summarizes the key aspects of Yemen's National Food Security Strategy developed in collaboration between the Yemeni government and IFPRI. It provides an overview of the strategy's development process, objectives of increasing food security and reducing child malnutrition by specific targets years, and a 7-point action plan. Modeling analysis examined scenarios of promoting industry and service sector growth or agricultural policy reforms, finding the latter could significantly reduce undernourishment, especially among farmers. Future research will analyze impacts of Yemen's conflicts on development and food security in the medium to long term. IFPRI and MOPIC produced various documents and briefs summarizing the strategy and modeling results.
1) The document provides an analysis of the market strategy and top investment picks for May 2010. It discusses the recovery of growth rates in various sectors to historical levels based on Q4 results.
2) The portfolio focuses on banking, infrastructure, and several bottom-up stock opportunities. Large cap picks discussed include Bharti Airtel, ICICI Bank, Maruti Suzuki, and SBI. Mid/small cap opportunities highlighted are in infrastructure, auto ancillary, IT, and pharma.
3) A Sensex target of 21,000 by March 2011 is provided based on an estimated 8.5-9% GDP growth driving a 21% CAGR in Sensex earnings and assigning a
The Estonian economy grew strongly in the first quarter of 2011, reaching 8% growth driven by strong export sector performance and increased investment activity. Inflation remained high at 5.4% in April due to increasing commodity prices globally. The unemployment rate rose slightly to 14.4% in the first quarter due to rising economic activity, while employment growth was strong at 6.8%. Real wages continued to decline, allowing competitiveness to improve but weakening household purchasing power. Overall, the Estonian economy is growing further but high inflation continues to impact households.
Brazil experienced solid economic growth from 2000-2015, driven initially by rising commodity prices and Chinese demand. However, growth has slowed recently due to declining commodity prices and a contracting economy. Key developments over this period include a significant reduction in poverty through social programs, rising wages that outpaced productivity growth, and challenges in transitioning to a more productive and competitive economy as population growth declines.
The Portuguese economy is forecast to slowly recover over the next few years, though 2011 has been difficult with high VAT rates. Hotel occupancy increased in 2010 for 3, 4, and 5-star hotels, but ADRs continued falling. New hotel openings in 2011 will increase room inventory by 753 rooms, risking oversupply issues for 5-star hotels. Projections show RevPAR for 5-star hotels continuing to fall in 2011 with healthier increases starting in 2013 when oversupply impacts ease. The 4-star segment is recovering faster, expected to be driven by ADR increases as occupancy remains stable due to limited new supply.
The commercial real estate market is lagging behind the broader economic recovery. Job losses have been significantly sharper in this recession compared to previous ones, and it will likely take several years to regain the jobs lost. As a result, real estate fundamentals will remain weak for an extended period. Transaction data shows rising capitalization rates and spreads, reflecting the return of risk to commercial real estate pricing. Cap rates could remain high for 12-24 months or rise further if space market fundamentals remain weak. This would result in value declines of 40% or more from the combination of higher cap rates and deteriorating fundamentals. The recovery path for cap rates and values is uncertain but will ultimately depend on the pace of job growth and economic
This chart appears to be comparing Brazil's GDP per capita (measured in PPP, or purchasing power parity) to other countries from 1990 to 2020. Some key details:
- Brazil's GDP per capita has generally been increasing over this time period, rising from around $8,000 in 1990 to over $15,000 projected for 2020.
- However, Brazil still lags behind many other major economies. In 2020 it is projected to have a lower GDP per capita than countries like China, Russia, Mexico, and Turkey.
- Among the BRIC countries (Brazil, Russia, India, China), Brazil has had the highest GDP per capita historically but is now behind China and will likely be surpassed by Russia in the
The Greek parliament passed additional austerity measures but Greece's debt remains unsustainable. The Troika acknowledged Greek debt is unsustainable and options like extending maturities or lowering interest rates could help. However, Greece will likely need more funds and its debt will exceed the 2020 target of 120% GDP. Further austerity has been associated with a 15% GDP decline making debt relief necessary to keep Greece in the eurozone.
More Related Content
Similar to The Evolving Rma Opportunities In Iberia And Latam
Relatorio Portugal 2013 by Credito Y CaucionJoão Pinto
This document provides an overview and summary of key economic indicators for Portugal. The main points are:
1) The Portuguese economy contracted sharply in 2012 as domestic demand decreased and exports growth slowed. Unemployment rose to over 15% while inflation remained above the EU average.
2) Fiscal consolidation efforts have been impressive but revenue targets were missed due to weak growth. Additional austerity measures were implemented to reduce the budget deficit.
3) Structural reforms have addressed some labor market issues but more progress is needed in product markets. Banks have bolstered capital ratios with ECB funding but credit remains tight.
The key points from the document are:
1) Portugal's 2013 budget draft includes tax increases and spending cuts worth 3.2% of GDP as the government implements further fiscal tightening measures.
2) Non-performing loans in Spain reached 10.51% in August, the highest level since 1962, as the economy continues to deleverage.
3) Eurozone trade data for August suggests GDP growth in Q3 could be a positive surprise, with exports up 3.7% and imports up 2.1%.
The document provides an overview of recent economic developments and market events:
- Portugal's 2013 budget draft includes fiscal tightening measures worth 3.2% of GDP through tax increases and spending cuts as the country's GDP is forecast to decline further.
- Spanish regional elections and the ongoing constitutional clash in Catalonia were important political events that could influence the timing of Spain's request for financial aid.
- Moody's kept Spain's credit rating at investment grade but on a negative outlook, seeing significant risks to Spain's economic outlook.
- Spanish banks' non-performing loan ratio reached a record high 10.51% in August as the economy continues to deleverage.
- Eurozone
The document provides an overview of Brazil's key economic indicators, trade, political system, cultural behaviors, and comparisons to Spain and Germany. It notes that Brazil has a population of over 200 million, GDP of around $2.3 trillion, and GDP growth of 2.8%. Major exports include transport equipment, soybeans, and footwear, while major imports include machinery, chemicals, and automotive parts. The political system is a federative republic led by a president, and the culture emphasizes respectful relationships and clear instructions from managers.
ALI - Brazil Private Equity (Parts 1 & 2)Eric Saucedo
The document summarizes recent positive economic trends in Brazil that make it an attractive market for private equity investment, despite past boom and bust cycles. GDP growth rebounded strongly in 2Q09 and Brazil has been less impacted by the global recession than other markets. Private equity deals and M&A activity have remained robust in Brazil while declining globally. Significant institutional capital from Brazilian pension funds is now being allocated to local private equity, representing an important difference from previous cycles. Major international private equity firms are increasingly active in Brazil due to opportunities to invest in and expand portfolio companies into the large and growing market.
This document outlines Coca-Cola's strategic vision and plans for 2020. It projects continued global economic growth, rising incomes, and 1 billion new consumers entering the global economy by 2020. This will drive increased consumption of non-alcoholic ready-to-drink beverages. Coca-Cola aims to more than double its system revenue over this period while expanding margins. Its 2020 business agenda focuses on maximizing cash flow, winning with Coca-Cola brands, accelerating innovation, and optimizing its franchise structure. Coca-Cola also outlines social commitments around sustainability, water stewardship, and promoting active healthy living.
Pharmaceutical market evolution after egypt’s revolutionMohamed Saleh
This document analyzes the pharmaceutical market in Egypt after the 2011 revolution. It begins with a SWOT analysis, noting Egypt's strategic location but also weaknesses like corruption. Healthcare spending is projected to grow steadily, with the pharmaceutical market reaching $30-36 billion by 2014. The market is currently dominated by multinational firms and generics are expected to grow substantially. Overall the market is forecast to continue growing at a normal rate of around 8-14% annually despite economic changes from the revolution, as healthcare remains a priority for Egyptian consumers.
Gartner confirms the 2008-09 financial crisis has triggered widespread adaptation of BPO and shared services by European countries and corporations. Presentation for the Shared Services and Outsourcing Exchange in Europe.
Brazil had a healthcare expenditure of $222.71 billion in 2011 and was the largest pharmaceutical market and third largest medical devices market in Latin America. The government is increasing funding for healthcare and providing free or low-cost medicines for conditions like hypertension and diabetes. Brazil also aims to boost its pharmaceutical industry and reduce reliance on imports by investing in research and developing domestic generic and biosimilar drug markets. However, corruption and intellectual property issues remain challenges.
The document analyzes nominal GDP, real GDP, and economic growth in the Philippines from 1986-2009. Nominal GDP increased significantly over this period but fluctuated more than real GDP. The services sector experienced the highest growth, while agriculture grew the least. Among industries, finance grew the most steadily, while manufacturing declined. Growth is determined by factors like interest rates, currency value, government intervention, and environmental controls. Some data shows inconsistencies that call official economic growth figures into question.
The document summarizes the key aspects of Yemen's National Food Security Strategy developed in collaboration between the Yemeni government and IFPRI. It provides an overview of the strategy's development process, objectives of increasing food security and reducing child malnutrition by specific targets years, and a 7-point action plan. Modeling analysis examined scenarios of promoting industry and service sector growth or agricultural policy reforms, finding the latter could significantly reduce undernourishment, especially among farmers. Future research will analyze impacts of Yemen's conflicts on development and food security in the medium to long term. IFPRI and MOPIC produced various documents and briefs summarizing the strategy and modeling results.
1) The document provides an analysis of the market strategy and top investment picks for May 2010. It discusses the recovery of growth rates in various sectors to historical levels based on Q4 results.
2) The portfolio focuses on banking, infrastructure, and several bottom-up stock opportunities. Large cap picks discussed include Bharti Airtel, ICICI Bank, Maruti Suzuki, and SBI. Mid/small cap opportunities highlighted are in infrastructure, auto ancillary, IT, and pharma.
3) A Sensex target of 21,000 by March 2011 is provided based on an estimated 8.5-9% GDP growth driving a 21% CAGR in Sensex earnings and assigning a
The Estonian economy grew strongly in the first quarter of 2011, reaching 8% growth driven by strong export sector performance and increased investment activity. Inflation remained high at 5.4% in April due to increasing commodity prices globally. The unemployment rate rose slightly to 14.4% in the first quarter due to rising economic activity, while employment growth was strong at 6.8%. Real wages continued to decline, allowing competitiveness to improve but weakening household purchasing power. Overall, the Estonian economy is growing further but high inflation continues to impact households.
Brazil experienced solid economic growth from 2000-2015, driven initially by rising commodity prices and Chinese demand. However, growth has slowed recently due to declining commodity prices and a contracting economy. Key developments over this period include a significant reduction in poverty through social programs, rising wages that outpaced productivity growth, and challenges in transitioning to a more productive and competitive economy as population growth declines.
The Portuguese economy is forecast to slowly recover over the next few years, though 2011 has been difficult with high VAT rates. Hotel occupancy increased in 2010 for 3, 4, and 5-star hotels, but ADRs continued falling. New hotel openings in 2011 will increase room inventory by 753 rooms, risking oversupply issues for 5-star hotels. Projections show RevPAR for 5-star hotels continuing to fall in 2011 with healthier increases starting in 2013 when oversupply impacts ease. The 4-star segment is recovering faster, expected to be driven by ADR increases as occupancy remains stable due to limited new supply.
The commercial real estate market is lagging behind the broader economic recovery. Job losses have been significantly sharper in this recession compared to previous ones, and it will likely take several years to regain the jobs lost. As a result, real estate fundamentals will remain weak for an extended period. Transaction data shows rising capitalization rates and spreads, reflecting the return of risk to commercial real estate pricing. Cap rates could remain high for 12-24 months or rise further if space market fundamentals remain weak. This would result in value declines of 40% or more from the combination of higher cap rates and deteriorating fundamentals. The recovery path for cap rates and values is uncertain but will ultimately depend on the pace of job growth and economic
This chart appears to be comparing Brazil's GDP per capita (measured in PPP, or purchasing power parity) to other countries from 1990 to 2020. Some key details:
- Brazil's GDP per capita has generally been increasing over this time period, rising from around $8,000 in 1990 to over $15,000 projected for 2020.
- However, Brazil still lags behind many other major economies. In 2020 it is projected to have a lower GDP per capita than countries like China, Russia, Mexico, and Turkey.
- Among the BRIC countries (Brazil, Russia, India, China), Brazil has had the highest GDP per capita historically but is now behind China and will likely be surpassed by Russia in the
The Greek parliament passed additional austerity measures but Greece's debt remains unsustainable. The Troika acknowledged Greek debt is unsustainable and options like extending maturities or lowering interest rates could help. However, Greece will likely need more funds and its debt will exceed the 2020 target of 120% GDP. Further austerity has been associated with a 15% GDP decline making debt relief necessary to keep Greece in the eurozone.
Similar to The Evolving Rma Opportunities In Iberia And Latam (20)
The Evolving Rma Opportunities In Iberia And Latam
1. The evolving RMA opportunities in
IBERIA and LATAM
PRESENTED BY JOSÉ MIGUEL FERNÁNDEZ
NOVEMBER 2010
TO
PAREXEL
2. Some interesting facts and figures
Year 2008
Argentina Brazil Colombia Chile Mexico Portugal Spain
Country
Serie
Total expenditure on health, %
of gross domestic product 9,8 8,4 5,9 6,9 5,9 10,1 9
Total health expenditure per
capita, US$ PPP 801 904 518 999 852 2334 2902
Pharmaceutical expenditure, %
total expenditure on health 11,7 12,2 9,9 5,4 28,3 22,8 20,5
Pharmaceutical expenditure per
capita, US$ PPP 93,72 110,29 51,28 53,95 241,12 532,15 596
Year 2006
Argentina Brazil Colombia Chile Mexico Portugal Spain
Country
Serie
Total expenditure on health, %
of gross domestic product 10,2 8,5 6,2 5,9 5,7 9,9 8,4
Total health expenditure per
capita, US$ PPP 561 765 483 772 761 2151 2477
Pharmaceutical expenditure, %
total expenditure on health N/A 11 9,2 4,7 26,3 21,8 21,6
Pharmaceutical expenditure per
capita, US$ PPP N/A 84,15 44,44 36,28 200 469 535
Sources: WHO, WTO, UN, and local statistics agencies
3. More interesting facts and figures
General Goverment Whole Region Brazil vs. Spain
expend in health /
Total health
expenditure in % -
AVERAGE in Region-
Western Europe 73,6 71,7
LATAM 47,7 33,9
• Causes:
• LATAM’s low efficiency model => high out of the pocket spent
• Private coverage has been steadily growing in LATAM
• But…there are also signs of a trend reversal
• Colombia & Argentina look to have universal coverage and
• More stable / new, P&R schemas
4. The key drivers in population / economics
Country Economic Population HIV prevalence in Politics
(Million People) adults %
2009
Spain GDP contraction expected 46.5 0.33 Uncertainty with local
to last until 2012 elections to be held in May
2011
Portugal Flat GDP growth since ’06 10.7 0.55 Minority Socialist Gvmnt
pendant to release
reforms
Argentina Possitive, though weak 40.9 0.5 Presidential election to be
outlook for 2011 called in 2011
Brazil Strong growth supported 199 0.6 Stability under Lula’s
by foreign investment and heritage
commodities
Chile Strong recovery, but 16.7 0.3 Stability with new cabinet
mainly due to high copper just one year ago
market prices
Colombia Flat GDP growth in 2010, 45.7 0.6 New president and
better outlook in 2011, FARC’s surrender would
though weak. comfort investors.
Mexico Flat GDP growth set up for 111.2 0.4 Chain of elections starting
2011, pushed by the in 2011, battered by
weakness of US demand terrorism.
5. The pharma market in the countries
Country Market Size, 2009 Main Payers Regulation (strong, Others (local
(Millio USD @ weak, medium) and characteristics)
exchange ratio) P&R schema
Spain 25,6 Regional Goverments and According to EMEA and Price and Reimbursement
private insurance (12%) ICH standards. AGEMED is made up by the
is the P&R Ministry Arm. Ministry but payers are
STRONG. regional gvmt
Portugal 5,04 Ministry of Health, few INFARMED is the state Few local players, and
private insurance market agency which follows increasing dominance of
share stringent rules to allow generics
drug approval.
Argentina 3,37 Three layers, 22% APS, No active control until Strong local players. P&R
34% semiprivate, 43% late 2009. OTC is strong. only since 2009
private OOP
Brazil 15,1 SUS and other public Strict SUS and Ministerio Goverment to breach
system (75%), private de Saude Control. TRIPS agreements if
insurance (25%) . OOP. Preference to generics / needed (HIV pandemy)
bioequivalents
Chile 1,15 Public Schema, FONASA, No P&R schema to Strong local players; lack
50%, private insurance, «stimulate» competition. of price cap, lowest prices
ISAPRE, 20%, 30% OOP in region.
and others
Colombia 2,24 54% Public Social Security Only for 5% of drugs, for Recent trade agreement
Schema, 26% OOP, 20% the rest, only partial with US to ease exports.
private insurance. reimbursement. Second fastest growing in
region
Mexico 15,5 Private Insurance (3%), No formal P&R schema. Counterfeiting is rampant
Social Security (IMSS and But buying method is . New regulations for
others, 61%), rest (non always public tenders. access to antibiotics put in
workers, SSA, 36%) place, late 2009
(prescription)
6. SWOTs per country. Spain.
Strenghts Weaknesses
• Well developped Health • Budget deficit imposing
Coverage System drastic measurements in
• Well structured P&R P&R schema
schema. • Generics are rapidly
• Wide range of pharma labs, growing
with strong local players to • Complex payers system
support (15+ regional)
• C/E awareness rising
Opportunities Threats
• Education for medium size and • Goverment plans to further cuts
local pharma labs (outsourcing) on P&R-> rising unemployment
• Biotech labs are increasingly in Pharma
rising • Change on politics every 4 years.
• MDs education (need it) in Payers and Administrators too
Pharma Economics. linked to politicians
• Partnering with Ministry of • Consolidation in the market,
Health / local administrations living only niche local players.
• Orphan drugs, actively
supported by Ministry of Health
7. SWOTs per country. Portugal.
Strenghts Weaknesses
• Well developped Health • Budget deficit imposing
Coverage System drastic measurements in
• Well structured P&R P&R schema
schema. • Generics are rapidly
• Only one interface, growing
Infarmed. • Local players dissapearing.
• Well educated system
(influenced by NHS and
NICE guidelines)
Opportunities Threats
• Education for medium size and • Goverment plans to further cuts
local pharma labs (outsourcing) on P&R-> rising unemployment
• Medical Devices and nano- in Pharma
medicine start ups and some • Consolidation in the market,
established companies. living only niche local players.
• MDs education (need it) in • Decissions to be taken from
Pharma Economics. abroad (at multinational level)
• Orphan drugs manufacturers
8. SWOTs per country. Argentina
Strenghts Weaknesses
• Many Local players • Fragmented and poor
(majority of the market) perceived health system
now dealing with P&R • Generics and copy-cut
regulation dominants
• Market Size to grow by near • P&R and market access just
double digit in next years. trying to be established
Opportunities Threats
• Education for medium size and • Political unstability, with
local pharma labs (outsourcing) elections to be called in 2011
• Some consulting to goverment,
insurance companies. • Fraud and OOP expenditure.
9. SWOTs per country. Chile
Strenghts Weaknesses
• Many Local players • Generics and copy-cut
(majority of the market) dominants
• Well perceived Health • No P&R schema.
Insurance System, with • Market Access is done via
coexistence of private and tenders and public bids
public schema. mainly.
• Stability. • Insurance companies
favouring local players.
• Poor market attractiveness
(CAGR expected to be low).
Opportunities Threats
• Education for medium size and • Chile is on the warning list for
local pharma labs and non ICH and GSP rules total
distributors (outsourcing), compliance.
specially because a large number • Pharma distribution is owned by
of production is exported. few private groups.
• Low prices (lowest in the region)
10. SWOTs per country. Colombia
Strenghts Weaknesses
• Mix of local and foreign • Generics and copy-cut
players. dominants
• Trading agreement with US • No P&R schema (only for
now opening entry to new 5% of listed drugs)
players and increasing • Insurance companies
market value. favouring local players.
• CAGR expected to be above • Regulations are not clear
double digit in next four enough.
years. • Too much OOP expend.
Opportunities Threats
• Education for foreign exporters • Political theatre is not yet clear.
(there are some good ones), but • Many population with no
focused on generics and copy practical access to health
cats. system.
• Insurance Companies for foreigh • Poor distribution chain.
firms.
• Orphan drugs
11. SWOTs per country. Brazil
Strenghts Weaknesses
• Mix of local and foreign players. • Generics and copy-cut dominants
• 2nd largest market in the region. • Too much OOP expend.
• CAGR for the pharmaceutical • Fragmented market as per the
market expected to be above payers schema (market access),
double digit in next four years. local; regional, nationwide –
• Abundant resources (MDs, almost 25% of the expend is private
students, start ups). and OOP-.
• Political momentum • TRIPS provisions not always
• P&R stringent but clear respected
• Clear goverment agenda
(Milenium Objectives)
Opportunities Threats
• Biotech and small firms (local ones) • Generics favoured and patent
• HIV and Oncology manufacturers infringement (TRIPs breach)
• Orphan drugs • Many population with no practical access
to health system.
• Poor distribution chain.
12. SWOTs per country. Mexico
Strenghts Weaknesses
• Largest market in the region. • Counterfeiting and smuggling to
• CAGR for the pharmaceutical USA
market expected to be above • Too much OOP expend.
double digit in next four years. • No P&R schema.
• Foreign trade agreements and • Entry barriers for foreign
NAFTA. manufacturers.
• Awareness of Market Access
policies
• High healt expend by head
Opportunities Threats
• Foreign small manufacturers • Politics
• Insurance Companies • Lack of reliable data.
• Monterrey accumulates many of the • Many population with no practical access
pharma industry. to health system.
• Exporters to other markets –as market • Distribution chain owned by few players,
access-. even from abroad.
13. Summary
• Market attractiveness varies enormously within the considered region
• LATAM is heading to open its market but still some countries are heavily
Protective (Chile).
• CopyCats and Generics are starting to flood the market –all countries-.
• Spain and Portugal are facing with increasing aging population, so, it is
Expected that Health Expenditure Growth would be inmense in following
Years
• In contrast, LATAM, specially Brazil and Colombia, has plenty of young
Population, who will demand better and more qualified Health Coverage.
• Local players are strong in some countries, whilst in others are on the
Verge of dissapear (Portugal) or simply distributing products.
• Orphan drugs and biotech are really an opportunity in Spain and Brazil
• Pharmaeconomics are used for the sake of decissions in a very limited scale in
Chile, Colombia, Argentina, and at a large scale in Spain, Portugal, Brazil –
starting to develop- and increasingly, Mexico.
• Market attractiveness makes me think the better countries to start with
Are…Spain, Brazil, Mexico, letting the others go at this stage.
• But Parexel could also leverage existing knowledge in ICH / GSP into the
region, to attract future businesses.
17. Functional Matrix. Hospital health administrators
Administration
Prescription Pharmacy Budget
and price
Drug evaluation evaluation and Management and
management
track Control
(tenders as well)
Specialized Pharmacists/regional
evaluators
Pharmacy Manager/regional board
chair
Medical Director/Ward Unit
Director
Finance and Admin Managers
(CFO)
Regional Administration and GPOs
Project focus within dashed line
18. Hospital Drug Evaluation Process
Multi-Tiered process though not sequential
Regional Level: Across Hospitals: Intra-hospital:
• Regional Agencies Spanish Hospital Pharmacists Society Specialty Board
*Joint Commission (Genesis) Pharmacy Board
*Non-binding recommendations Very Influential guides Protocols review
Binding documents
Genesis Group is becoming a very powerful C.O.P. to standardise drug review and evaluation
19. Hospital Working Model and Lines of Influence:
Hospital Drug evaluation process
(Customer Process)
Solid lines= strong interaction
External
Dashed lines= weak interaction
influences
Green
New Ligth to
petitory
Drug 1-6 months
ATB/Oncology
Pharmacy
Commision
Board
Outcomes R.
Sales Reps K.A.M.
Product Physician/Mktg Outcomes R.