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Pharmaceutical Distribution in Europe: The Emergence of Direct-to-Pharmacy Supply

Published by: Urch Publishing

Published: Feb. 1, 2008 - 102 Pages


Table of Contents


Chapter 1: The Nature of the European Pharmaceutical Supply Chain

The pharmaceutical supply chain

Pharmaceutical manufacturers in the EU

Pharmacies in the EU

Wholesalers in the EU

The hospital sector

Prewholesaling

History of the pharmaceutical supply chain

Dynamics in the supply change

Relationships within the supply chain

Vertical integration

New changes in the supply change

Outlook for the supply chain

Global lessons for the supply chain

Case study: Consolidation among Japanese pharmaceutical wholesalers

European status of the supply chain

Stability of the European supply chain

Product shortages in the supply chain

Case study: Vaccine shortages and the effect on the supply chain

Case study: Supply chain disruption in Latin America

Traceability throughout the supply chain

Counterfeit products

Internet trading and pharmaceuticals

Parallel trade

The view of pharmaceutical manufacturers

The view of parallel importers

Legalities of parallel trade

Exhaustion of intellectual property rights

Repackaging and relabelling of products

Consumer views of intellectual property rights

The European Union

History of the EU

The set-up of the EU

EU law

Primary legislation

Secondary legislation

Case-law

Decision-making in the EU

The institutions of the EU

The European Economic Area (EEA)

The creation of the EEA

EU Enlargement and the EEA

The Euro

The Euro and pharmaceuticals

Chapter 2: Challenges for medicine wholesalers in Europe

The role of the pharmaceutical wholesaler

Channels of distribution

Wholsalers and the Single European market

Wholesaler opposition to supply quotas

Case study: Bayer's Export Policy for Adalat

Case study: Syfait versus GlaxoSmithKline

Wholesaler views of Direct-to-Phamacy distribution

Crossborder mergers and acquisitions

Case study: Double acquisition by Phoenix ensures successful market entry into Croatia

EU harmonisation and the outlook for pan-European wholesaleing

The major players in pan-European wholesaleing

Celesio AG

The PHOENIX Group

OPG Group

Alliance Boots

European regulations for wholesalers

Guidelines on Good Distribution Practice of Medicinal Products for Human Use (94/C 63/03)

Lack of harmonisation and the supply chain

Wholesaler technology solutions

Electronic data interchange

Collaborative planning forecasting and replenishment

Enterprise resource planning

Wholesalers develop value added services

Case study: GEHE Pharma Handel chosen as "Best-Practice-Enterprise" for value added services

Case study: PHOENIX wins pharmacy partner award

Order fulfilment packages

Database technology

Electronic point-of-sale technology

Bar coding

Case study: US highlights benefits of bar code and RFID technologies

Case study: Pfizer France reviews the RFID system for Viagra

Case study: AstraZeneca opts for mass serialisation to prevent counterfeiting

European wholesaler opinions on technological solutions

Warehouse technology

Dispensing technology

Techology in the future of pharma distribution

Consumers and e-commerce

Case study: DocMorris

Pharmaceutical distribution in UK

Pharmaceutical distribution in France

Case study: Industry support of the Masters Degree in Pharmaceutical Distribution at University of Limoges

Pharmaceutical distribution in Germany

Pharmaceutical distribution in Italy

Case study: IBS introduces supply chain management solutions into the Italian pharmaceutical market

Pharmaceutical distribution in Spain

Pharmaceutical distribution in Switzerland

Case study: Galenica expands its service offerings

Chapter 3: Manufacturers start to control the ditribution of pharmaceuticals

Pharmaceutical manufacturers in Europe

The pharmaceutical industry and the supply chain

The role of pharmaceuticals

Drug development and innovation

Cost containment

The pharmaceutical market

Lack of harmonisation in the EU pharmaceutical market

Counterfeiting

Pharmaceutical industry efforts to combat counterfeiting

Manufacturers exert control over the supply chain

The Office of Fair Trading investigation

Implications of changes in the supply chain

Service standards to patients

Rationale behind changes in the supply chain

Pfizer's feedback on Direct-to-Pharmacy distribution

Case study: Pfizer UK's Direct-to-Pharmacy website

Reaction to the Office of Fair Trading enquiry

AstraZeneca changes its supply chain arrangements

Sanofi-Aventis changes its supply chain arrangements

Napp Pharmaceuticals changes its supply chain arrangements

Novartis considers changes to supply chain arrangements

Eli Lilly considers changes to supply chain arrangements

Astellas adopts direct distribution for Transplant Medicines

Patients and healthcare

Case study: The International Alliance of Patients' Organizations

Pharmaceutical manufacturers and the developing countries

Collaborations with healthcare providers

Case study: Novartis makes agreement with the World Health Organization for distribution of malaria treatment

Case study: Diversion of anti-retroviral drugs destined for Africa

Anti-diversion tactics

Chapter 4: Pharmacy and the Future of Medicines Distribution

Pharmacies in Europe

Additional pharmacy services

Differences in pharmacy regulations

Hospital pharmacy in Europe

Wholesaler Margins and VAT

Rebates and discounts

Distribution of OTCs

Generics

Independent pharmacies

Pharmacy chains

Wholesaler involvement in pharmacy chains

Pharmacy purchasing groups

Supermarkets

Drugstore chains

Mail-order pharmacy

Removing restrictions in the European pharmacy sector

Case study: European Commission challenges Italian legislation concerning pharmacies

Case study: European Commission challenges Spanish legislation concerning pharmacies

Case study: European Commission challenges Austrian legislation concerning pharmacies

Sale of non-prescription products outside pharmacies

Implications of liberalisation in the European pharmacy sector

Liberalisation of the pharmacy sector and accessibility

Liberalisation of the pharmacy sector and market dominance

Liberalisation of the pharmacy sector and quality of service

Pharmacies and changes in the supply chain

REFERENCES




List of Figures

Figure 1.1 Outline of the Supply Chain

Figure 1.2 Number of pharmacists (per 1000 population)

Figure 1.3 Total revenue of European pharmaceutical wholesalers (without VAT)

Figure 1.4 Worldwide Vaccine Market

Figure 1.5 Share of parallel imports in European pharmacy markets

Figure 2.1 Number of Full-line Wholesalers

Figure 2.2 Average gross margin of wholesalers in 9 West Europe Countries

Figure 2.3 Celesio AG Wholesale Revenue by Market (2006)

Figure 2.4 Celesio AG Pharmacy Revenue by Market (2006)

Figure 2.5 Phoenix Group Turnover (2002 - 2007)

Figure 2.6 Breakdown of OPG Sales (2006)

Figure 2.7 Alliance Boots Wholesale Division Revenue (Q1,2,3 2006)

Figure 2.8 Percentage of electronic orders from pharmacies to wholesalers

Figure 3.1 Pharmaceutical R&D Expenditure in Europe 1195 - 2006

Figure 3.2 Pharmaceutical R&D Expenditure across Europe

Figure 3.3 NHS expenditure per person in the UK

Figure 3.4 Community prescribing in the UK: Prescriptions Per head

Figure 3.5 Patient satisfaction with quality and effectiveness of healthcare received

Figure 3.6 Patient satisfaction with ability to access information on new medicines or treatments

Figure 4.1 Number of Public Pharmacies (12 European Countries)

Figure 4.2 Pharmacy sales per inhabitant Europe (€)

Figure 4.3 Number of Hospital Pharmacies in 8 Countries

Figure 4.4 VAT rates applied to prescription medicines across Europe

Figure 4.5 Share of generics in European pharmaceutical markets

Figure 4.6 Percent change in number of pharmacies N, E, N, A, F, S(1995 - 2005)

Figure 4.7 UK Pharmacy respondent views on potential costs of setting up a separate Pfizer account for DTP




List of Tables

Table 1.1: Types of manufacturer medicines

Table 1.2: The institutions of the EU

Table 1.3: Adoption of the euro

Table 2.1: OPG's activities in Europe

Table 2.2: Summary of GDP Guidelines

Table 2.3: The BAPW's Gold Standard of Good Distribution Practice by Pharmaceutical Wholesalers as endorsed by the MHRA

Table 2.4: Process of adoption of IBS supply chain management solution by Itriafarma

Table 3.1 Key areas of focus for the International Medicinal Products Anti-Counterfeiting Taskforce (IMPACT)

Table 3.2: Overall risks due to DTP identified by OFT

Table 3.3: Implications of reduced service standards due to DTP (adapted from OFT, 2007)

Table 3.4: Anti-diversion tactics employed by pharmaceutical manufacturers and cited by WHO

Table 4.1: Goals of the EAHP

Table 4.2: Summary of liberalised pharmacy sector in "case study" countries chosen by ÖBIG

Table 4.3: Summary of regulated pharmacy sector in "reference study" countries chosen by ÖBIG


Abstract

"Each day millions of patients across Europe rely on the supply chain to deliver the medicines they need"

Pharmaceutical Distribution in Europe - The Emergence of Direct-to-Pharmacy Supply from URCH Publishing, is a market report that comprehensively reviews the business of medicines distribution in Europe.

The traditional model of pharmaceutical supply chain in Europe is under threat as major pharmaceutical manufacturers in the UK attempt to change the way they distribute their products. The adoption of a Direct-to-pharmacy (DTP) model by some of the industry's most powerful players in the UK signifies a new trend that could spread across Europe.

REPORT STRUCTURE
The report is logically divided into four chapters.

Chapter 1 provides a comprehensive history and overview of the key issues related to the pharmaceutical supply chain in Europe, including European law, parallel trade and the recent EU enlargement.

Chapter 2 fully reviews the role of pharmaceutical wholesale companies. Issues tackled include regulations, technologies used, plus reviews of the major players such as Celesio, Phoenix Group and OPG and the market in France, Germany, Italy and the UK.

Chapter 3 discusses how pharmaceutical manufacturers organise the distribution of their products. The current vogue for direct-to-pharmacy is analysed, as is reaction to the UK's OFT report. Recent changes by major manufacturers to their supply chain are summarised.

Chapter 4 looks at the pressures that the pharmacy sector is under. Liberalisation still in its infancy in some countries and pharmacists are being encouraged to expand their role beyond just dispensing. Changes to the supply chain could have a profound effect on established business models.

The report provides an objective perspective on important industry questions, such as:
  • Will direct-to-pharmacy become the dominant method of drug distribution
  • Do pharmacists have a future beyond the administration of dispensing?
  • Are counterfeit medicines now a major issues that the industry has to deal with?
  • What is the current thinking on the role of parallel trade in the European market?
Key features of the report include:
  • Contains 20 Case studies including these companies, Bayer, DocMorris, Galencia, IBS, Novartis, Phoenix and Pfizer,
  • Unbiased synopsis of the UK's Office of Fair Trading's (OFT) report into the medicines' supply chain
  • Overview of the European pharmaceutical supply chain and the stakeholders involved in medicines distribution
  • Insight into the aggressive Pan-European expansion strategies of some wholesalers
  • Summary of regulations governing pharmaceutical wholesaling and pharmacy
With 14 Tables and 26 Figures this report is essential reading for anyone working in the pharmaceuticals supply chain including manufacturers, wholesalers, distributors and pharmacists.

Companies and organisations mentioned in the report include:
3i, Alliance Unichem, Amedis UE AG, Apteka, Associazione Distributori Farmaceutici, Astellas Pharma, AstraZeneca, Authentix, Azienda Speciale Farmacie Comunali Riunite, Bayer, British Association of Pharmaceutical Wholesalers, Celesio AG, Chambre Syndicale de la Répartition Pharmaceutique, Chiron, Dainippon Sumitomo Pharma, Der Bundesverband des pharmazeutischen Großhandels, DocMorris, EAEPC, Eli Lilly, Europharm, Farmaceutica Bolognese, Farmacija d.d, FDA, Galenica Group, Galexis, GEHE Pharma Handel, Groupement International de la Répartition Pharmaceutique, HgCapita, Independent Pharmacy Federation, International Pharmaceutical Excipients Council, Itriafarma, Mediceo Paltac Holdings, Medifarm Velebit, MediService, Merck, Neuhaus Partners, Norsk Medisinaldepot, Novartis, OPG Group, Pfizer, Pharmexx, PhRMA, PHOENIX group, Plus Pharmacie, Retail Working Group, Sanofi-Aventis, Surgency, Syncra Systems, Takeda, Tamro, Unione Farmaceutica, Viafarma, Voigt AG

USE THIS REPORT TO:
  • Identify key areas that will change in the pharmaceutical market structure over the next five years.
  • Support internal planning and decision-making with an external perspective founded on detailed analysis and transparent market forecasts.
  • Understand how the regulatory environment could change to reflect new business models.
Remember URCH Publishing's healthcare management reports are designed to help business executives make properly informed and timely business decisions.

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