Pharmaceutical Distribution in Europe

Content

• Executive Summary
• 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 BIG
  • Table 4.3: Summary of regulated pharmacy sector in "reference study" countries chosen by BIG