A Reality Check on Emerging Markets

Recent reports discuss the future of pharma's emerging markets.
Jul 02, 2008

Emerging markets, particularly the "BRIC" countries (Brazil, Russia, India, and China), are playing an increasingly important role in pharmaceutical industry growth. Although these markets still account for only a relatively small portion of the global pharmaceutical market, recent and projected growth is strong.

The BRIC countries, along with Indonesia, Mexico, and Turkey, are expected to account for as much as one-fifth of global pharmaceutical sales by 2020, according to a recent PricewaterhouseCoopers (PwC) report (1). In 2004, these markets accounted for only 8% of the global pharmaceutical market. The established markets of the G7 countries (Canada, France, Germany, Italy, Japan, the United Kingdom, and United States) accounted for 79% of the global sales market in 2004, according to PwC.

IMS Health defines what it terms the "pharmerging markets" as the BRIC countries, Mexico, South Korea, and Turkey. By 2011, these pharmerging markets are expected to contribute about 27% to overall global pharmaceutical growth and hold 16% of the market, compared with a projected 38% market share held by the US, according to IMS.

Table I: Pharmaceutical sales among the BRIC countries
The BRIC nations' pharmaceutical sales grew significantly between 2006 and 2007 (see Table I), according to IMS. Brazil's sales went up nearly 10% to $15.7 billion. China's pharmaceutical sales grew over 25% to $17.6 billion. India's sales went up 13% to $9.2 billion. Russia's sales grew by approximately 20% to $7.9 billion. By 2011, IMS projects that China will step out of its current "emerging" classification and move into fifth place in the global pharmaceutical market with the UK in the number six position. The largest pharma markets in 2011 will be, in order: the US, Japan, France, Germany, China, and the UK, according to IMS.

The 2007 growth rates were well above the growth rates of the global and US markets. In 2007, US pharmaceutical prescription sales increased 3.8% to $286.5 billion, and global pharmaceutical prescription sales increased 6.4% to $711.8 billion in 2007.

Although the growth rates of the market leaders are much slower than those of the emerging markets, the value of the leading markets is hardly comparable to that of the BRIC countries. Product mix and the corresponding value of these products are important considerations. The top therapeutic categories in the US are antidepressants, lipid regulators, codeine and combination pain medications, angiotension-converting enzymes inhibitors, and beta blockers, according to IMS. The top five products in 13 key global markets (Argentina, Australia, Brazil, Canada, France, Germany, Italy, Japan, Mexico, New Zealand, Spain, UK, and the US) between March 2007 and March 2008, were "Lipitor" (atorvastatin calcium), "Nexium" (esomeprazole magnesium), "Plavix" (clopidogrel bisulfate), "Seretide/Advair" (fluticasone propionate; salmeterol xinafoate), and "Enbrel" (etanercept). These same 13 countries had retail pharmacy sales (including prescription and certain over-the-counter sales) of $424.9 billion between March 2007 and March 2008, according to IMS. In contrast, top product sales among the BRIC countries include several more basic or commoditized products, including antibiotics, over-the-counter (OTC) pain and cough medications, and herbal or traditional remedies, although in certain countries such as Brazil, lifestyle drugs make the top product listing (see Table II).

"You almost have to look at each country differently to understand its environment," says Diana Conmy, corporate director of IMS Market Insights Conmy. "In China, for example, you have a lot of traditional Chinese medicine that skews their top 10 product list. In the other BRIC countries, there are large OTC markets because their healthcare systems are not as well developed, and people are used to self-medicating. In Brazil, there are lots of generic products and what we consider lifestyle products such as Viagra that show up in the top 10. Each environment is unique."

Table II: Top pharmaceutical products* in BRIC countries
As the economies of the emerging markets improve, the nature of their pharmaceutical demand will change. "As GDPs increase and quality of life gets better, they begin to acquire more chronic diseases, and typically more Western diseases," says Conmy. "So you see a higher prevalence of obesity, which leads to a higher prevalence of diabetes. And as people live longer, there are more incidences of cancer, heart disease, and so on. Essentially, as countries develop, their disease profiles change over time. That provides opportunity for drugmakers."

Aging populations also provide a potential consumer base, but these and other opportunities have to be weighed against access in these countries. "As we've seen in the US, Japan, and Europe, the transition of the aging is beneficial to chronic conditions such as heart disease, high blood pressure, diabetes, etc., which are more prevalent in the elderly," says Conmy. "But at the same time, it's important to remember that the majority of people in China as well as India do not have health coverage and are not yet part of the pharmaceutical consumer market, especially for prescription drugs."


1. PricewaterhouseCoopers, "Pharma 2020: The Vision," (New York, 2007).