Global outlook: Healthcare

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1 Global outlook: Healthcare March 2014 healthcare 1

2 Today s presenters Ana Nicholls Managing Editor, Industry Briefing Economist Intelligence Unit Lauren Brayshaw Marketing executive Economist Intelligence Unit 2 2

3 Contents healthcare Explanation of global outlooks The global economy Overview for healthcare spending Overview for pharma spending Regional outlooks Value-based healthcare PAYERS 3 INSURERS SPONSORS

4 Explanation of our global outlooks The Economist Intelligence Unit s global outlooks: Form part of the our industry briefing service, available on Cover six industries: automotive, consumer goods, energy, financial services, healthcare and telecoms; Are compiled from our 60+ country forecasts and reports, aggregated into regions; Are designed to help companies plan ahead, by analysing growth drivers and potential risks in each region; Are published quarterly, updating our forecasts and tracking notable trends in each industry. For healthcare, forecasts are in nominal dollars and driven by factors such as GDP growth, population growth and political trends. PAYERS 4 INSURERS SPONSORS

5 The global economy Synchronised upturn in the major developed economies US recovery is deepening; broad-based Europe is growing, though fitfully Japan: Abenomics helping, but no panacea China, India, Brazil: slowdown is both cyclical and structural Sub-Saharan Africa Mid East/N Africa Latin America Asia Transition economies GDP growth, %, Tighter financial conditions globally Less liquidity from the Fed Western Europe North America 1.9 Is there risk of an emerging World markets crisis?

6 Overview of health spending: global healthcare In all regions, health spending is rising as populations grow and age, technologies improve and patients become better informed. Global health spending rose by 2.6% in nominal dollar terms in 2013, a slight acceleration from We expect average growth of 5.3% a year in Given population growth, spending per head will rise by 4.5% a year. But global spending growth slower than in past decade (7%), and will lag GDP falling from around 10.6% to 10.3%. 10,000 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 Health spending, US$ bn World N America Asia Europe In order: Latin America, Transition economies, Middle East/Africa PAYERS 6 INSURERS SPONSORS

7 Overview of health spending: regional Fastest growth will be in the Middle East/Africa, followed by Asia. China, India, Nigeria and Indonesia likely to see double-digit growth. Slowest growth will be in Western Europe, with heavy government debts and constraints on tax revenue. Asian spending still low as a percentage of GDP, but in total dollars will overtake Europe in North American growth will be strong, buoyed by health reforms. Latin America is already quite a heavy spender but political pressures are increasing Health spending, annual average growth, % PAYERS 7 INSURERS SPONSORS

8 Overview of pharma spending: global healthcare Pharma spending is rising faster than health spending. Partly consumer demand, partly higher prices of innovative drugs. But not true in Western Europe, where pharma being squeezed. Asia has already overtaken Europe in terms of total spend Pharma spending, US$ bn World Globally we expect average growth of 6.7% pa in With population growth, spend per head will rise by 5.9% pa. By 2018 Western Europe s share of global market will be 17%, while Asia-Pacific s will near 29%. North America s stable at over 41% N America Asia Europe In order: Latin America, Transition economies, Middle East/Africa PAYERS 8 INSURERS SPONSORS

9 Overview of pharma spending: regional Fastest growth forecast to be in the Transition Economies. But already heavy spenders on pharma 25% of health spending. Asian growth is also likely to strengthen. In China and Russia, where sales will more than double in US-dollar terms by Slowest growth will be in Western Europe, but still a recovery after recent slumps. North America and Latin America should see similar growth rates, but in the first this will be acceleration and in the second a slight slowdown Pharma spending, annual average growth, % PAYERS 9 INSURERS SPONSORS

10 Regional outlook: North America Growth in health and pharma spending similar in the US and Canada, but for Canada this is a slowdown and for the US an acceleration. US health reforms the big driver, but so far just 4.2m signed up. Canada s spending likely to rise in line with GDP. Few federal mechanisms to bring down spending Annual average growth, %, US Canada Health Pharma Express Scripts data show that US pharma markets are polarising. Branded drug prices are rising fast while generic prices fall. Particularly strong price growth for cancer therapies (up 21%). But volume growth for generics means that in terms of overall sales it is the middle that is being squeezed. Traditional therapies for high cholesterol, heart disease etc. PAYERS 10 INSURERS SPONSORS

11 Regional outlook: Western Europe In all cases apart from the UK, pharma is coming from a decline while health spending has been constrained. Pharma has been squeezed by price-cuts, patent expiries, progeneric policies. Annual average growth, %, Most severe effects in Greece, where IMF is trying to restrict health spending to 6% of GDP. Pharma spending in general is likely to remain slower than health spending. Exception likely to be Spain, with OTC boost and debt repayments. Political backlash against rationing and in some cases co-payments. Regulators being forced to ease access to medicines. Greece France UK Spain Germany Pharma Health Fiscal deficits starting to narrow again, allowing more room for spending rise, although region remains indebted PAYERS 11 INSURERS SPONSORS

12 Regional outlook: Asia Health and pharma spending growth rapid, but slower. Pharma expected to rise faster than overall healthcare spending. Expansion will be driven largely by China, thanks to the rollout of public health programmes. By 2016 China s pharmaceutical market will be bigger than that of Japan, where growth will be minimal, owing to rising use of generics and market competition. India, Indonesia, Malaysia, South Korea and Thailand will also see double-digit growth, despite efforts to bolster cheap local production and reduce drug prices. Pharma Health Annual average growth, %, Japan Australia Indonesia India China PAYERS 12 INSURERS SPONSORS

13 Regional outlook: Latin America Forecasts heavily affected by exchange rate shifts to dollars. Drag is Argentina, where we have downgraded our US dollar forecast sharply to reflect currency weakness. The large Brazilian and Mexican markets will also be slightly dampened by a strong supply of cheap generics. Both countries are also making efforts to increase local supplies of branded drugs. The fastest growth will be in Chile, although the government is making efforts to control spending. Pharma Health Annual average growth, %, Argentina Mexico Brazil Colombia Chile PAYERS 13 INSURERS SPONSORS

14 Value-based healthcare healthcare BENEFITS Cost-containment: maximum value for money, funding goes further. Outcomes improve: evidence-based approach to treatment, best practice spreads. Integrated care pathways: greater efficiency, clearer workload, faster patient throughput. Main beneficiaries = Payers and patients New EIU report available from: DISRUPTIVE EFFECTS Pricing pressures: uncertainty over ROI May deter innovation and R&D investment Changes to care pathways, payments, relationships. Increased paperwork/investment in IT systems Onus on providers/suppliers (inc pharma, medtech) PAYERS 14 INSURERS SPONSORS

15 About EIU Healthcare healthcare In 2012, the Economist Intelligence Unit, a world-leading provider of industry, country, and market insight to multinational corporations, acquired two healthcare businesses, Clearstate and Bazian. Bazian specialises in evidence-based analysis of drugs, devices and healthcare services. It works with organisations such as NICE to evaluate new technologies and treatment methods. Clearstate is the market leader in Asia-Pacific in providing data and analysis on the medtech and pharmaceutical industries through its network of 28,000 medical professionals and 20,000 hospitals across Asia. These acquisitions complement the EIU s existing analysis of the healthcare and pharmaceuticals industries in 60 major markets. Dr Vivek Muthu Healthcare Director, Economist Intelligence Unit Chief Executive, Bazian 20 Cabot Square, London E14 4QW Tel: PAYERS 15 INSURERS SPONSORS

16 16 healthcare

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