Retail Pharmacy in South Africa An IMS Perspective Ruth Deakins Senior Offerings Manager
Summary Retail pharmacy as a sector is facing a challenging operating environment, however will remain a key channel to the patient The aim of today s presentation is to walk through aspects of performance across the segment Retail in this instance is defined in the most part as independent pharmacy & small groups, national managed chains & supermarket pharmacy Total private market includes private hospital, courier, other private outlets and non-collaborating wholesalers (wholesalers that do not supply IMS with data) We will view the market in 2 categories schedule 1&2 (OTC indicator) and schedule 3-6 (prescription-bound)
Prescription-bound medicines account for 75% of the retail segment With schedules 1 & 2 accounting for 25% (increases to 36% if unscheduled products captured are included) TOTAL PRIVATE MARKET PRIVATE PHARMACY MARKET 4% 2% 5% 2% 15% 11% 45% SCHEDULE 4 SCHEDULE 3 SCHEDULE 2 SCHEDULE 5 SCHEDULE 1 13% 20% 33% SCHEDULE 4 SCHEDULE 3 SCHEDULE 2 SCHEDULE 5 SCHEDULE 1 24% SCHEDULE 6 28% SCHEDULE 6
VALUE SALES (RANDS MILLIONS) S1&2 Retail pharmacy is demonstrating lower growth than the total private market as a whole However retail pharmacy remains the largest channel to patient MARKET GROWTH (VALUE) 6 000 5 000 4 000 3 000 2 000 1 000 9.6% Growth 8.2% Growth The adjacent graphs show the growth and share dynamics for the Schedule 1 and 2 market On a value basis, retail pharmacy is growing slightly behind the private market as a whole Retail pharmacy accounted for 81% of the total market value in 2013 which dropped to 80% in 2014 0 MAT 08 2013 MAT 08 2014 TOTAL MARKET RETAIL PHARMACY
VOLUME SALES (MILLIONS) S1&2 V Volume growth rates however are comparable 180 160 140 120 100 80 60 40 MARKET GROWTH (VOLUME) 4.0% Growth 2.6% Growth The adjacent graphs show the growth and share dynamics for the Schedule 1 and 2 market Retail pharmacy is also growing at a slower rate than the private market as a whole Retail pharmacy accounts for 80% of the total market which has declined by 1% since 2013 20 0 MAT 08 2013 MAT 08 2014 TOTAL MARKET RETAIL PHARMACY
VALUE SALES (RANDS MILLIONS) S3-6 Lower growth seen in the prescription-bound space 25 000 20 000 15 000 10 000 5 000 MARKET GROWTH (VALUE) 4.6% Growth 7.3% Growth The adjacent graphs show the growth and share dynamics for the Schedule 3-6 market in value terms On a value basis the pharmacy market outgrew the total private market Just over half of the total private market by value sits in the retail pharmacy segment 0 MAT 08 2013 MAT 08 2014 TOTAL MARKET RETAIL PHARMACY
VOLUME SALES (MILLIONS) S3-6 However volume growth is slightly higher in retail space Slightly higher volume growth observed in retail channels 180 160 140 120 100 MARKET GROWTH (VOLUME) 2.2% Growth 3.7% Growth The adjacent graphs show the growth and share dynamics for the Schedule 3-6 market On a volume basis the pharmacy market outperformed the remaining private market% 80 60 40 20 0 MAT 08 2013 MAT 08 2014 TOTAL MARKET RETAIL PHARMACY
VOLUME SALES CONTRIBUTION VALUE SALES CONTRIBUTION S1-6 Independent pharmacy remains the largest retail pharmacy channel However chain & supermarket presence is expected to grow 100% 90% TRADE CHANNEL BREAKDOWN 100% 90% TRADE CHANNEL BREAKDOWN 80% 70% 60% 50% 40% 30% 20% 10% 0% MAT 08 2013 MAT 08 2014 INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES PRIVATE HOSPITAL GROUPS PRIVATE HOSPITAL & PHARMACY BUYING GROUP RETAIL BUYING GROUP OUTLETS & SMALL WHOLESALERS 80% 70% 60% 50% 40% 30% 20% 10% 0% MAT 08 2013 MAT 08 2014 INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES PRIVATE HOSPITAL GROUPS PRIVATE HOSPITAL & PHARMACY BUYING GROUP RETAIL BUYING GROUP OUTLETS & SMALL WHOLESALERS
S1-6 This is illustrated by exploring growth rates across channels Independents maintain the largest market share nationally INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS PHARMACY MARKET TRADE CHANNEL VALUE SHARE AND GROWTH SUPERMARKET GROUP PHARMACIES NATIONAL MANAGED CHAIN PHARMACIES Independents have the highest market share in the schedule 1 2 market However, stronger growth is seen from national managed chains and private hospital groups For a robust and unbiased understanding of the dynamics within the pharmacy market, analysis needs to be done at a provincial level 0.0% 20.0% 40.0% 60.0% 80.0% MS GROWTH
S1&2 Provincial mining demonstrates variances in growth Gauteng, WC, KZN & EC account for 77% of the market value MAT AUG 2014 PROVINCIAL MARKET SHARE 6.0% MAT ON MAT VALUE GROWTH GAUTENG 5.0% WESTERN CAPE 4.0% KWAZULU NATAL 3.0% 6.0% 8.3% 37.8% EASTERN CAPE MPUMALANGA 2.0% 1.0% 14.0% 17.1% FREE STATE NORTH WEST 0.0% LIMPOPO -1.0% NORTHERN CAPE GROWTH
TRADE CHANNEL CONTRIBUTION S1&2 Retail channel make-up varies somewhat across provinces Independent pharmacy dominates in most provinces 100% 90% 80% 70% 60% 50% MAT AUG 2014 TC VALUE SALES In 8 of the 9 provinces, roughly 99% of all MAT value sales are accounted for by independents, national chains and supermarkets Only the Eastern Cape has an additional 6% of sales stemming from private hospital groups 40% 30% 20% 10% 0% INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES Gauteng is dominated by sales within chains and supermarkets Mpumalanga and the Free State has the highest value of sales originating from sales into independent pharmacies Gauteng accounts for 38% of the national value of sales Northern Cape contributes only 2%
S1&2 However chains & supermarkets demonstrate stronger growth across the board 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% -10.0% -20.0% VALUE MAT AUG 2014 GROWTH INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES PROVINCE GROWTH Gauteng and Northern Cape shows the strongest provincial growth. Eastern Cape is the only province with overall negative growth Adverse growth is seen for independents in the Eastern Cape and Mpumalanga, driving down overall provincial growth Across the board, (with the exception of Gauteng), supermarket pharmacies are driving growth. This is exceptionally strong for North West National Managed Chains are also significantly responsible for provincial growth
S3-6 We observe a slightly different picture in the prescriptionbound space Gauteng, WC, KZN & EC account for 81% of the market value MAT AUG 2014 PROVINCIAL MARKET SHARE GAUTENG WESTERN CAPE 9.0% 8.0% 7.0% 6.0% MAT ON MAT VALUE GROWTH 5.1% 6.4% 42.0% KWAZULU NATAL EASTERN CAPE MPUMALANGA 5.0% 4.0% 3.0% 2.0% 13.8% FREE STATE 1.0% 19.0% NORTH WEST 0.0% -1.0% LIMPOPO NORTHERN CAPE GROWTH
TRADE CHANNEL CONTRIBUTION S3-6 The channel mix is similar when compared with S1-2 Supermarkets lose some ground in this view 100% 90% 80% 70% 60% 50% MAT AUG 2014 TC VALUE SALES In 8 of the 9 provinces, roughly 98% of all MAT value sales are accounted for by independents, national chains and supermarkets Only the Eastern Cape has an additional 12% of sales stemming from private hospital groups 40% 30% 20% 10% 0% INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES Gauteng is dominated by sales within chains and supermarkets Mpumalanga and the Free State has the highest value of sales originating from sales into independent pharmacies Gauteng accounts for 42% of the national value of sales Northern Cape contributes only 1.5%
S3-6 However growth in the prescription-bound space is also driven by chains & supermarket groups Supermarkets and Chains are driving growth 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% VALUE MAT AUG 2014 GROWTH Gauteng and Northern Cape shows the strongest provincial growth. Positive value growth is seen in all provinces for the higher scheduled drugs Exceptionally strong growth is seen in the chains and supermarket pharmacies in Northern cape -10.0% INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES PROVINCE GROWTH
DIST CHANNEL VALUE SALES S1-6 In terms of supply into the retail segment, full-line wholesalers remain the key provider However we see strong growth in the short-line segment 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Full line wholesalers dominate this market with 60% worth of value of sales However the strongest growing distribution channel is actually short line wholesalers growing at an above average 20% Full line wholesalers growing at < 1% Distributors declining in growth FULL LINE WHOLESALERS SHORT LINE WHOLESALERS MANUFACTURER DIRECT SALES DISTRIBUTORS
Short-line wholesalers are making in-roads across several provinces, including Gauteng Full line wholesalers remain the largest channel in the market 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Gauteng has the highest percentage of sales going through short line wholesalers Eastern Cape has the lowest contribution from Short Line wholesalers Distributors have the highest contribution in the Western Cape FULL LINE WHOLESALERS SHORT LINE WHOLESALERS MANUFACTURER DIRECT SALES DISTRIBUTORS
This trend is mirrored in terms of growth rates achieved Short line wholesalers are driving growth 80.0% 60.0% 40.0% 20.0% 0.0% -20.0% -40.0% VALUE MAT AUG 2014 GROWTH FULL LINE WHOLESALERS SHORT LINE WHOLESALERS MANUFACTURER DIRECT SALES DISTRIBUTORS PROVINCE GROWTH Manufacturer Direct Sales are growing strongly in Limpopo Short Line wholesalers are driving growth across all provinces except the Western Cape While Full Line wholesalers dominate the market in share, their growth has not been strong nationally Distributors are also declining in growth across most provinces
S1&2 Adcock Ingram is ranked #1 in terms of schedule 1 & 2 With the top 10 corporations accounting for 77% of sales MARKET SHARE GROWTH SCHEDULE 1-2 MARKET 100% 4% ADCOCK INGRAM 24% 4% ASPEN 17% 2% JOHNSON & JOHNSON 9% 7% NOVARTIS 6% 8% INOVA PHAR(PTY)LTD 5% 4% CIPLA MEDPRO 6% -2% RECKITT BENCKISER 4% 5% Pharma Dynamics saw a strong growth performance in the last MAT Cipla Medpro gained significant market share from 5 years ago This intimates a significant move towards generic medicines MERCK & CO 3% -11% PHARMA DYNAMICS 2% 21% PFIZER CORPORATION 2% 3%
S1&2 Pain & cold preparations top the bill in all provinces N2B and R5A are the highest value ATC classes within the OTC market across all provinces GAUTENG WESTERN CAPE KWAZULU NATAL EASTERN CAPE MPUMALANG A FREE STATE NORTH WEST LIMPOPO NORTHERN CAPE N02B NON- NARCOTIC ANALGESICS R05A NON ANTI-INFEVT COLD PREP R05A NON ANTI-INFEVT COLD PREP N02B NON- NARCOTIC ANALGESICS R05A NON ANTI-INFEVT COLD PREP N02B NON- NARCOTIC ANALGESICS N02B NON- NARCOTIC ANALGESICS R05A NON ANTI-INFEVT COLD PREP N02B NON- NARCOTIC ANALGESICS R05A NON ANTI-INFEVT COLD PREP N02B NON- NARCOTIC ANALGESIC S R05A NON ANTI- INFEVT COLD PREP N02B NON- NARCOTIC ANALGESICS R05A NON ANTI-INFEVT COLD PREP R05A NON ANTI-INFEVT COLD PREP N02B NON- NARCOTIC ANALGESICS N02B NON- NARCOTIC ANALGESICS R05A NON ANTI-INFEVT COLD PREP R06A ANTIHISTAMI NES SYSTEMIC R06A ANTIHISTAMI NES SYSTEMIC R06A ANTIHISTAMI NES SYSTEMIC R05C EXPECTORAN TS R05C EXPECTORANT S R05C EXPECTORA NTS R05C EXPECTORAN TS R05C EXPECTORAN TS R05C EXPECTORAN TS R05C EXPECTORAN TS R05C EXPECTORAN TS R05C EXPECTORAN TS R06A R06A R06A ANTIHISTAMI ANTIHISTAMIN NES ES SYSTEMIC SYSTEMIC R01A R01A R05D COUGH R05D COUGH R01A TOPICAL TOPICAL TOPICAL SEDATIVES SEDATIVES NASAL PREPS NASAL PREPS NASAL PREPS ANTIHISTA MINES SYSTEMIC R01A TOPICAL NASAL PREPS R06A ANTIHISTAMI NES SYSTEMIC R06A ANTIHISTAMI NES SYSTEMIC R06A ANTIHISTAMI NES SYSTEMIC R01A TOPICAL R01A TOPICAL R01A TOPICAL NASAL PREPS NASAL PREPS NASAL PREPS
S1&2 Corenza C & Adco-Dol continue to dominate Top 15 schedule 1 and 2 products contribute 30% of the market MARKET SHARE GROWTH Selected Market 100% 4% CORENZA C 3% 2% ADCO-DOL 4% -1% ACC 200 2% 1% BENYLIN FOUR FLU 2% 3% ANDOLEX-C 2% 5% SINUTAB 1% 35% ALCOPHYLLEX 1% 5% ILIADIN 1% -6% NUROFEN 1% 19% TRANSACT 2% -3% ADVIL CS 1% 2% SOLPHYLLEX 1% -6% SINUCON 1% 6% BACTROBAN 1% 0% FLUSIN 1% -4% ALLERGEX 1% 11% TEXA 1% 9% MOVICOL 1% -2% VERMOX 1% 18% ASTHAVENT 1% -1%
S1&2 Product rankings vary somewhat across retail channels INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES 1 ADCO-DOL 1 CORENZA C 1 ADCO-DOL 2 BENYLIN FOUR FLU 2 ADCO-DOL 2 CORENZA C 3 CORENZA C 3 ACC 200 3 HYOSPASMOL 4 ANDOLEX-C 4 MOVICOL 4 BENYLIN FOUR FLU 5 ACC 200 5 ANDOLEX-C 5 SINUTAB 6 SINUTAB 6 TRANSACT 6 ALLERGEX 7 ALCOPHYLLEX 7 NUROFEN 7 ANDOLEX-C 8 ALLERGEX 8 DESELEX 8 ACC 200 Corenza C features within top 3 across all three channels Movicol does not feature in independents Top 10 There is a strong overlap in top performing products across all three channels but the rankings are quite different 9 TRANSACT 9 COPA-DOL 9 SINUCON 10 NUROFEN 10 TEXA 10 ACURATE
S1&2 However a heavy decline in Corenza C sales is observed in the independent channel SUPERMARKET GROUP PHARMACIES 3.0% 3.6% NATIONAL MANAGED CHAIN PHARMACIES 0.2% 3.4% INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS -6.1% 2.1% -8.0% -6.0% -4.0% -2.0% 0.0% 2.0% 4.0% 6.0% MARKET SHARE GROWTH
Top performing S1 S2 products provincially Product spread also differs across the 4 top provinces Gauteng TOP 10 Product Sales ADCO-DOL 1% 3% CORENZA C 1% ACC 200 ANDOLEX-C 1% TRANSACT 3% NUROFEN DESELEX 2% ILIADIN BENYLIN FOUR FLU 2% 2% MOVICOL 2% 2% WC TOP 10 Product Sales 1% 1% 2% 2% 2% 2% 4% 4% 3% 3% ADCO-DOL CORENZA C MOVICOL ACC 200 TEXA ANDOLEX-C TRANSACT ASTHAVENT ALLERGEX ILIADIN ADCO-DOL KZN TOP 10 Product Sales BENYLIN FOUR FLU CORENZA C 2% 1% 3% SINUTAB ANDOLEX-C 2% ALLERGEX 3% TRANSACT 2% VERMOX TEXA 2% BACTROBAN 2% 2% 3% EC TOP 10 Product Sales 1% 1% 1% 7% 1% 1% 2% 2% 2% 4% ADCO-DOL BENYLIN FOUR FLU CORENZA C VERMOX ALLERGEX ANDOLEX-C TEXA ACC 200 BACTROBAN CIPLA-ACTIN
S3-6 Aspen remains a dominant player in the prescription-bound market 10 corps account for 67% of sales within the S3-6 market MARKET SHARE GROWTH Schedule 3 6 Market 100% 3% ASPEN 17% 2% SANOFI 8% 2% NOVARTIS 7% 4% CIPLA MEDPRO 6% 6% PFIZER CORPORATION 6% -2% ADCOCK INGRAM 6% 4% ASTRAZENECA CORP 5% -7% Pharma Dynamics saw a strong growth performance in the last MAT Cipla Medpro gained significant market share from 5 years ago and also sees strong value growth AZ patent expiries are driving sharp decline MERCK & CO 5% 1% BAYER HEALTHCARE 5% 0% PHARMA DYNAMICS 3% 18%
S3-6 Depression and gastro-intestinal disorders are the most prevalent disease areas in the prescription-bound space GROWTH Selected Market 4% N6A ANTIDEPRESS.& MOOD STAB. 8.7% A2B ANTIULCERANTS 11.4% M1A ANTIRHEUMATIC NONSTEROID 8.9% N2B NON-NARCOTIC ANALGESICS 5.4% A10C HUMAN INSULIN+ANALOGUES 11.2% N3A ANTI-EPILEPTICS 8.5% C10A CHOLEST&TRIGLY.REGULATOR -4.3% G3A HORMONAL CONTRACEPT SYST 6.1% J5C HIV ANTIVIRALS 16.6% J1C BROAD SPECTRUM PENICILL 2.5%
S3-6 Nexiam remains the top selling prescription-bound product in South Africa MARKET SHARE GROWTH Selected Market 100% 4% NEXIAM 2% -9% CONCERTA 1% 20% GSK AUGMENTIN 1% 1% FOXAIR 1% 14% ALTOSEC 1% 11% CRESTOR 1% -40% LANTUS 1% 12% NOVOMIX 30 1% 14% CIALIS 1% 3% YAZ 1% 4% TRAMACET 1% -5% DUROMINE 1% 18% RITALIN 1% 15% ARCOXIA 1% 6.1% MYPRODOL 1% 3% PREXUM PLUS 1% 5% VENLOR 1% 14% YASMIN 1% -4% MYBULEN 1% 14%
Top performing S3 S6 products Product portfolios vary across trade channels INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES 1 NEXIAM 1 NEXIAM 1 MYPRODOL 2 CONCERTA 2 CONCERTA 2 CONCERTA 3 CELEBREX 3 FOXAIR 3 MYBULEN 4 AUGMENTIN GSK 4 CELEBREX 4 GEN-PAYNE 5 CRESTOR 5 AUGMENTIN GSK 5 FOXAIR 6 ALTOSEC 6 ASPAVOR 6 NEXIAM 7 FOXAIR 7 ALTOSEC 7 CELEBREX Nexiam is the leader in both chains and independents Myprodol is the market leader in Supermarkets N6A (Antidepressants) and A2B (Antiulcerants) are the top two disease areas across chains and independents, with N2B being the top disease area in supermarkets (due to sales of Myprodol) 8 LANTUS 8 LANTUS 8 ALTOSEC 9 DUROMINE 9 CRESTOR 9 AUGMENTIN GSK 10 CIALIS 10 ATRIPLA 10 ASPAVOR
S1&2 Generics are used in ~50% of cases We see a consistent trend across channels 100% 90% 80% 70% 60% 50% 40% Based on the latest MAT value sales in the schedule 1-2 market, there is not a significant difference in generic usage across trade channels Supermarket pharmacies however slightly more generically utilised 30% 20% 10% 0% INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES GENERIC NONGENERIC
S3-6 We see lowest instances of generic choice in chain pharmacies across schedules 3-6 Generic usage varies across trade channels for higher schedules 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% Based on the latest MAT value sales in the schedule 3-6 market, there are varying degrees of generic usage across trade channels Supermarket pharmacies however remain slightly more generically utilised National managed chains have the lowest generic percentage of the three trade channels 0% INDEPENDENT PHARMACIES & SMALL INDEPENDENT GROUPS NATIONAL MANAGED CHAIN PHARMACIES SUPERMARKET GROUP PHARMACIES GENERIC NONGENERIC