Value through Innovation19 April 2014

Rapid growth of the medicine market - Medicines frequently financed privately

Not many sectors of the Brazilian economy have grown as rapidly and consistently as the medicine market. Since 2005, expansion rates in this sector have been well into double digits. In 2011, the market grew by 19 %, with a turnover of USD 26 billion and 2.3 billion medicine packs.

Although the numbers seem encouraging, the healthcare system in Brazil still poses a challenge for the government and other interested parties, as most of the active pharmaceutical ingredients are imported. In this context, another characteristic of the Brazilian market is important: the Brazilian consumer today bears almost 80 % of the country’s medicine costs – in other words, almost eight out of ten medicines purchased are paid out of consumers’ own pockets. Overall, the public healthcare system bears 60 % of total healthcare costs.. Since 2011, this expenditure has been linked to GDP growth, with BRL 92 billion reserved for 2012.

The resulting increase in demand for low-price products leads to growth of the generics market, which currently accounts for 20 % of the Brazilian pharmaceutical market. In a country where the conditions of lower social classes are steadily improving, the generics market opens the door to using medicines which hitherto were not considered a priority.

Estimates indicate that Brazil will in 2015 move up from 9th to 3rd position in the global market of generic medicines, behind the USA and China. Generics not only cost on average 50 % less than reference medicines, but also belong to Brazilian government programmes, especially Saúde não Tem Preço. Under this programme, medicines are distributed to patients free, or at very low prices. Most of the products included in this programme were intended for the treatment of chronic diseases, such as diabetes and hypertension. Generics account for 65 % of the products distributed free under this programme, which benefited over seven million people in 2011.

Access to medicines
In this scenario, in which government participation in the supply of medicines to poor patients increases, the word access becomes increasingly relevant. In view of this fact, Boehringer Ingelheim do Brasil has developed innovative business models that give people easier access to its medicines and has continuously invested in a robust and comprehensive portfolio.

In 2011, the company signed an agreement with official government laboratories for transferring the technology of the medicine Sifrol® (pramipexole dihydrochloride), benefiting about 220,000 patients diagnosed with Parkinson’s disease in Brazil. Through this project Boehringer Ingelheim will for five years be the official government supplier of this product, which leads to a prolonged product life cycle in Brazil. And this is only the beginning of a long-term relationship between Boehringer Ingelheim, official laboratories and the Ministry of Health.

Programme for faster diagnosis
Spiriva® (tiotropium bromide), which is indicated for the treatment of chronic obstructive pulmonary disease (COPD), is another example of the presence of the Brazilian Boehringer Ingelheim subsidiary in the public sector. In government hospitals, patients with COPD symptoms may take months to be diagnosed due to the long waiting times to undergo the spirometry test, which measures patient’s pulmonary function, or even due to a lack of pneumologists.

In order to address this bottleneck, Boehringer Ingelheim do Brasil set up a programme which trains spirometry specialists in order to cut the waiting times and ensure patients quick access. Within three months, this team has already performed almost 16,000 tests, diagnosing over 11,000 patients. This and other efforts should bring Spiriva® an even more promising future.

In addition, Boehringer Ingelheim is offering training to health community agents who inform the population about the first signs of a stroke and who are instructed in providing patients with appropriate support. In 2011, two training sessions, with 620 participants, were conducted. These health community agents have a major influence on health practices in social groups in which they operate. The Brazilian government is furthermore convinced about the importance of the Boehringer Ingelheim products Actilyse ® and Metalyse® and has decided to include them in a new treatment protocol for coronary diseases for emergency networks. Thus Boehringer Ingelheim, together with Brazil, is improving the population’s access to the best treatment methods for the leading cause of death in the country.