Colombia Pharmaceuticals and Healthcare Report Q1 2009

Colombia's drug market expenditure in 2008 was estimated at COP6,654bn (US$3.05bn) and is predicted to grow to COP13,022bn (US$6.77bn) in 2013. Early in the forecast period Colombia will face declining demand from the US and shrinking FDI inflows. However, we reiterate that the country has considerable growth potential and remains an attractive market. Thus growth should accelerate towards the end of the forecast period.

Out-of-pocket spending has traditionally driven the Colombian market, however the government has committed itself to achieving universal healthcare coverage by 2010, through a combination of private and publicly run insurance. Since the Colombian healthcare system was decentralized in 1993, there has been a significant increase in private health insurance uptake, in line with decreasing out-of-pocket spending. According to the World Health Organization (WHO), private health spending rose from US$428mn in 1995 to US$850mn by 2006. During this period, out-of-pocket spending fell from 84.7% to 43.9%.

There is a risk that poor regulation of clinical investigations and the lack of transparent recruitment processes may result in multinational drugmakers being associated with dubious practices. The dangers in this field were recently highlighted in Argentina, when the safety protocols of a Phase III trial of GlaxoSmithKline's (GSK) latest vaccine, Synflorix, for pneumonia in children aged three and under, which is caused by the bacteria Streptococcus pneumoniae and Haemophilus influenzae, resulted in the death of 12 babies. Synflorix is also being trialled in Colombia and other Latin American countries. This particular clinical trial given rise to mixed opinions among members of the Argentine Federation of Health Professionals (FEPROSA) over the exact causes of death among participants. Additionally, the recruitment of volunteers has been questioned by FEPROSA, since the families involved are said to have been illiterate, and therefore unaware of crucial details of the study.

A significant health issue in Colombia is HIV/AIDS. According to BMI's Burden of Disease Database (BoDD), the number of disability-adjusted life years (DALYs) lost to HIV/AIDS in Colombia will rise from 232,613 in 2008 to 402,421 by 2030. Despite this trend, the Colombian government has no clear directive to improve HIV awareness and prevention. A key concern of UNAIDS is that the absence of a transparent national strategy has left private health insurers with little or no incentives to provide relevant treatments for affected patients.

Additionally, UNAIDS revealed that, although a relatively small proportion of the population in Colombia (0.38%) was diagnosed with HIV in 2008, this amounts to 170,000 people, with only 11% of these able to access adequate treatment. BMI cautions that, while the inability of many to obtain proper treatment may be due to other factors - including those who do not seek or cannot afford treatment - it may also be partially attributed to the insurer's refusal of medication and care.