Global Pharmaceuticals Marketing Channel Reference EDITION

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1 Global Pharmaceuticals Marketing Channel Reference EDITION 2015

2 ABOUT IMS HEALTH IMS Health is a leading global information and technology services company providing clients in the healthcare industry with comprehensive solutions to measure and improve their performance. End-to-end proprietary applications and configurable solutions connect 10+ petabytes of complex healthcare data through the IMS One TM cloud-based master data management platform, providing comprehensive insights into diseases, treatments, costs and outcomes. The company s 15,000 employees blend global consistency and local market knowledge across 100 countries to help clients run their operations more efficiently. Customers include pharmaceutical, consumer health and medical device manufacturers and distributors, providers, payers, government agencies, policymakers, researchers and the financial community. As a global leader in protecting individual patient privacy, IMS Health uses anonymous healthcare data to deliver critical, real-world disease and treatment insights. These insights help biotech and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders to identify unmet treatment needs and understand the effectiveness and value of pharmaceutical products in improving overall health outcomes. Additional information is available at IMS Health Global Pharmaceuticals Marketing Channel Reference 2015 extract

3 Global Overview About This Publication Snapshots With the acquisition of the Cegedim marketing channel audits and the CSD Global and Local Promotion Databases, IMS Health now offers marketing channel performance metrics in 35 countries. Leveraging the acquired promotional databases of Cegedim, this publication provides an overview of 2014 pharmaceutical industry marketing trends worldwide and at the country level. The following metrics are highlighted in this edition: Investment by marketing channel Investment by corporation, brand, therapy area Digital channel investment Sales force rep equivalents (FTE) Tablet detailing Please refer to the following pages for an overview of IMS Health s promotion data assets and the methodology section of the appendix (page 204). Please contact your IMS Health sales representative for further information and questions about this report. IMS Health Global Pharmaceuticals Marketing Channel Reference 2015 extract 1

4 Table of Contents 04 Marketing Channel Measurement 06 Global Overview 08 Review of the Year 20 Key Countries 171 Other Countries 204 Appendix 204 Marketing Channel Audits Methodology 212 OneKey 222 Abbreviations & Glossary 2 IMS Health Global Pharmaceuticals Marketing Channel Reference 2015 extract

5 Global Overview Snapshots 20 Key Countries 21 USA 31 France 41 Germany 51 Italy 61 Spain 171 Other Countries 172 Denmark 174 Finland 176 Norway 178 Sweden 180 Belgium 182 Czech Republic 71 UK 81 Japan 91 China 101 Brazil 111 Mexico 184 Greece 186 Ireland 188 Portugal 190 Romania 192 Canada 194 Colombia 121 Russia 131 Turkey 141 Poland 151 Australia 161 South Korea 196 India 198 Taiwan 200 Algeria 202 Morocco IMS Health Global Pharmaceuticals Marketing Channel Reference 2015 extract 3 3

6 MARKETING CHANNEL MEASUREMENT Marketing Channel Measurement is a key asset of IMS Health s Global Services organisation. Cegedim + IMS Health promotion assets: The essentials WHAT? WHERE? Monitored Promotional Sales Force and Marketing Channels Interaction & Investment levels Recalled messages Measured impact and effectiveness GPs and all major specialist groups Share of Voice, Share of Investment and much more! USA, Canada, Japan, EU5, Brazil, Russia, India, China, Turkey Argentina, Colombia, Mexico Australia, Korea, Taiwan, New Zealand Denmark, Finland, Norway, Sweden Belgium, Czech Republic, Greece, Ireland, Poland, Portugal, Romania Algeria, Egypt, Morocco, Saudi Arabia 4 IMS IMS Health Health Global Global Pharmaceuticals Marketing Channel Channel Reference extract

7 WHY? HOW? WHEN? Benchmark your brands and competitors Identify competitive strengths, weaknesses, opportunities and threats Determine best marketing practice Plan and adapt your promotional strategy Online daily diary questionnaire with over 30,000 panellists recruited with OneKey physician database where available (see appendix) Global or local database access, online analytics tools, flat files, bespoke reports Ad-hoc / Zoom style questions can be added quickly Monthly & quarterly database updates (10-30 days following update month / quarter) Weekly bespoke reports available Back data? Of course! 5 years is standard but we have more just ask! IMS Health Global Source: Pharmaceuticals IMS Health Strategic Marketing Data Channel Promotion Reference Database, 2015 Year extract

8 Global Overview 6 IMS IMS Health Health Global Global Pharmaceuticals Marketing Channel Channel Reference extract

9 Global Pharmaceuticals Marketing Channel Reference Global Overview Total Investment $70.7bn -1.4% vs

10 Commentary Review of the year 2014 Worldwide, the use of digital channels increased by over 30% in At nearly $71 billion constant US dollars, worldwide industry investment in pharmaceuticals sales force and marketing channels dropped slightly by -1.4% in The leading 10 multinational companies ranked by total measured promotional expenditure, showed widely varied evolution in investment during the 12 months to December For example, AstraZeneca and Johnson & Johnson increased marketing investment by double digits while others, such as Lilly and Novartis cut spending dramatically. Investment in worldwide sales force the largest single channel by cost was flat in Several factors are notable when analyzing the current pharmaceuticals marketing landscape: Reductions in sales force levels have slowed following several years of consolidation related to the patent cliff. High levels of new compound approvals over the past 4 years reaching 50 in 2014, have driven investment in related, specialist targeted marketing Sales force upgrades, with a focus on an integrated multichannel approach and provision of rich clinical content reveal a progressive shift away from influence and advertising towards high value engagements across multiple touchpoints. 8 IMS Health Global Pharmaceuticals Marketing Channel Reference 2015 extract

11 Global Overview Snapshots Marketing investment did vary dramatically by geography in 2014 as the country level sections of this report will reveal. Major emerging countries saw jumps in expenditure including China (+11%) and Brazil (+20%). Likewise, Australia and Turkey both saw increases in spending of more than 10%. Russia was flat however and other major European markets saw significant cuts in spending with Germany down -11% and Spain off by -9%. Meanwhile, marketing investment in the USA returned to positive territory with measured expenditure up by nearly 3%. Worldwide, the use of digital channels including online detailing, ing and streaming video increased yet again in 2014 with investment in these three channels up over 30% at $2.3 billion constant US dollars. Measured in-call use of tablets and other connected mobile devices, often referred to as e-detailing saw higher levels of penetration in smaller and emerging markets. Roughly 20% of face-to-face rep calls in Belgium are supported by such devices the highest level of penetration across 30 audited countries. Mexico, Brazil and Denmark followed in the rankings, with 14% e-detailing penetration or higher. IMS Health Global Pharmaceuticals Marketing Source: IMS Channel Health Reference Strategic Data 2015 Promotion extract Database, Year

12 Global Overview Snapshots 2014 $70.7bn Total Investment -1.4% vs 2013 Sales Force Rep Equivalents , ,112 Change +0.8% 0.0% CHANGE -2.7% -25.5% +5.0% vs 2013 Detailing Samples Meetings Advertising 10 IMS Source: Health Global IMS Health Pharmaceuticals Strategic Data Marketing Promotion Channel Database, Reference Year

13 Snapshots Global Overview Global Overview Digital Investment $2.3bn 3.2% of total investment Detailing $44.2bn 62.5% of total investment 6.3% face to face calls use a tablet as detailing support 6.3% +30.9% +19.7% +11.9% +32.2% Clinical Trials DTC Mailing/others Digital Source: IMS Health Strategic Data Promotion Database, Year

14 Global Overview Investment by Channel Full Year 2014 Total Investment $bn % by channel % change Detailing % -0.0% 2014 $70.7bn Total Investment -1.4% vs 2013 Samples % -2.7% Meetings % -25.5% Advertising % +5.0% Clinical Trials % +30.9% DTC % +19.7% Mailing/Others % +11.9% Digital % +32.2% Total All Channels % -1.4% 12 IMS Source: Health Global IMS Health Pharmaceuticals Strategic Data Marketing Promotion Channel Database, Reference Year

15 Global Overview Investment by Corporation, Brand & Therapy Area Digital investment by Brand Full Year 2014 Investment by Corporation Corporations Investment ($K) % % Change Pfizer 4,192, % +1.7% AstraZeneca 3,972, % +24.6% Merck & Co 3,467, % -13.6% GlaxoSmithKline 2,580, % +4.0% Actavis 2,546, % -2.8% Boehringer Ingelheim 2,516, % -8.9% Novartis 2,384, % -21.0% Johnson & Johnson 2,265, % +22.9% Takeda 1,942, % -3.3% Lilly 1,866, % -21.3% Investment by Therapy Area Investment by BRAND Brands Investment ($K) % % Change Xarelto 1,054, % +11.0% Eliquis 1,029, % +52.8% Forxiga 725, % % Crestor 723, % -16.0% Symbicort 719, % +3.1% Januvia 707, % -17.6% Pradaxa 674, % -9.9% Abilify 606, % +5.6% Lyrica 592, % +1.1% Tradjenta 574, % -20.0% DIGITAL INVESTMENT BY brand 4.6% 3.4% 3.1% 3.0% 3.0% 82.9% A10N R03F N06A B01F A10P All Others Naramig Nexium Januvia Pradaxa Xarelto Eliquis Invokana Deberza Crestor Relvar 39,077 31,768 30,085 27,768 27,586 25,554 25,055 24,944 23,002 22,236 $k Source: IMS Health Strategic Data Promotion Database, Year

16 Global Overview Number of reps BY region and % change % vs ,112 North America 71,245 70, % +1.6% 51,410 52,240 Latin America Europe Top 5 76,632 73, % 60,143 58, % Other Europe +9.5% 126, ,992 Asia Pacific 54,984 52, % Japan IMS Source: Health Global IMS Health Pharmaceuticals Strategic Data Marketing Promotion Channel Database, Reference Year

17 Global Overview Sales Force Rep Equivalents (FTE) FTEs Top 10 Corporations, % change & Call Quality Score 2014 Total all corporations : FTEs % change vs 2013 Call Quality Score Average 17,867 16,594 15,912 15,017 13,697 12,581 11,214 11,045 9,736 8,812 Pfizer Merck & Co Novartis AstraZeneca Sanofi GlaxoSmithKline Bayer Boehringer Ingelheim Johnson & Johnson Bristol Myers Squibb +0.8% % % % % % % % % % % Source: IMS Health Strategic Data Promotion Database, Year

18 Global Overview Use of tablet detailing support by country Top 15 countries - Full year 2014 % of Face to Face calls using a Tablet as detailing support 20.5% 17.0% 16.3% 14.4% 13.8% 11.5% 11.3% 11.2% 11.1% 10.8% 10.1% 8.4% 7.6% 6.8% 6.5% 6.3% Belgium Mexico Brazil Denmark Australia Norway UK Finland Portugal Spain Turkey Sweden USA Ireland Colombia Avg All Countries 16 IMS Source: Health Global IMS Health Pharmaceuticals Strategic Data Marketing Promotion Channel Database, Reference Year

19 Digital INVESTMENT Total investment and trends 2013 Total Investment $1,736m 2.4% of total investment Total Investment $2,295m 3.2% of total investment Overall change +32.2% Global Overview Global Overview e-meetings +54.3% vs ing +16.3% vs ,353 e-detailing +37.2% vs 2013 Source: IMS Health Strategic Data Promotion Database, Year

20 Global Overview Total Digital INVESTMENT and % Change 2014 North America +32.2% vs 2013 $2.3bn +28.2% $1,275.1m +1.7% $9.0m Latin America Europe Top % $92.4m +37.9% $15.2m Other Europe +17.7% $12.8m Asia Pacific +43% $890.6m Japan 18 IMS Source: Health Global IMS Health Pharmaceuticals Strategic Data Marketing Promotion Channel Database, Reference Year

21 Digital Investment Top 5 Corporations by Region - Year 2014 Global Overview North America Europe Top 5 Japan Total Digital Investment $k Corporation % Share % Change Total Digital Investment $k Corporation % Share % Change Total Digital Investment $k Corporation % Share % Change 107,861 PFE ,900 MRK ,406 GSK ,818 NVT ,319 AZ ,482 AZ ,713 MRK ,709 GSK ,129 MRK ,858 VAL ,621 J&J ,927 PFE ,118 AZ ,259 PFE ,457 DSP Latin America Other Europe Asia Pacific Total Digital Investment $k Corporation % Share % Change Total Digital Investment $k Corporation % Share % Change Total Digital Investment $k Corporation % Share % Change 1,255 MRK ,297 SAN ,110 HMI AZ ,166 GSK ,008 PFE NVT ,162 PFE MRK LLY AZ NVT SAN ADA AZ Source: IMS Health Strategic Data Promotion Database, Year

22 IMS Health 90/92 Route de la Reine Boulogne Billancourt Cedex France For further information: Christopher Wooden Vice President, Global Sales, ChannelDynamics Phone: IMS Health Incorporated and its affiliates. All rights reserved. Trademarks are registered in the United States and in various other countries.

41 T Korea, Rep. 52.3. 42 T Netherlands 51.4. 43 T Japan 51.1. 44 E Bulgaria 51.1. 45 T Argentina 50.8. 46 T Czech Republic 50.4. 47 T Greece 50.

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