Accenture Life Sciences
`Five Branded Generics Strategies to
`Master for Global Pharmaceuticals
`in Emerging Markets
`
`By Tina Gilbert, Arda Ural and Myriam Lopez
`
`Exhibit 1137
`IPR2017-00807
`ARGENTUM
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`2 | Five Branded Generics Strategies to Master for Global Pharmaceuticals in Emerging Markets
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`Introduction
`
`Emerging markets can be tricky for pharmaceutical players that
`are more comfortable operating in a developed market environment,
`but coming to terms with the unique challenges these markets
`hold may separate winners from losers—especially as the
`competitive battlefield shifts to a more global footing. Emerging
`markets are home to more than 70 percent of the world’s population,
`covering 46 percent of its landmass and are generating 31 percent
`of its GDP1. Thus, they represent the next big growth engine for
`the industry. What’s more, a recent study2 forecasts that by 2016,
`emerging markets—including Brazil, China, India, Indonesia,
`Mexico, Russia, and Turkey—will account for 30 percent of
`international pharmaceutical spending. As a result, cracking
`developing markets has become an agenda-topper for many
`industry CEOs. Emerging markets are further complicated by the
`fact that no two countries are the same. Brazil has different
`market and consumer dynamics than China or India due to socio-
`demographic, economic, governmental and regulatory factors.
`
`Pharmaceutical market dynamics are
`fundamentally different in emerging
`markets compared to developed ones.
`The underlying reasons for these differences
`include different or virtually nonexistent
`reimbursement systems, limited access
`to healthcare and unique pricing and
`distribution aspects. In addition, multinational
`companies (MNCs) face compliance risks
`that require management in accordance with
`strict policies, including the U.S. Foreign
`Corrupt Practices Act (FCPA) and its UK
`equivalent. In some cases, failure to comply
`has led to high turnover among emerging
`market general managers, especially in
`countries that have entrenched, corrupt
`business practices.
`
`But perhaps the most important difference
`in these markets is that big pharma
`companies often feel a need to compete
`more aggressively with a class of products
`
`known as branded generics. These are
`generic versions of products sold either
`by the original manufacturer of the patented
`drug or by generic manufacturers that
`build up brand equity for their generic
`versions of the medication, which they
`introduce right after the patent expires
`on the original product. The original
`manufacturers attempt to build on the
`name recognition of the branded drug
`to maintain market share in face of the
`generic manufacturer(s). On the other hand,
`generic manufacturers strive to build their
`brand equity with support from their sales,
`marketing and medical organizations.
`
`Given these realities, global pharmaceutical
`companies, with a core competency in
`commercialization and R&D, need to either
`compete with or against the branded generics
`to be successful in the emerging markets.
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`Why branded generics
`matter in emerging markets
`
`The genesis of branded generics in emerging markets is a pragmatic
`response to some hard local market realities. Historically,
`pharmaceutical companies—much as they do in developed
`economies—have attempted to enforce intellectual property
`(IP) rights in these regions as their economies became more
`globally integrated. From the start, however, big pharma players
`often had to compete against generic versions of their own
`medications, which in many developed countries are protected
`by law. The Indian market, for example, is inundated with
`copycat generic drugs and low-cost chemically similar versions
`due to historically weak patent laws and government-induced
`pricing controls.3
`
`The favorable margins of branded generics
`can provide room for a meaningful amount
`of promotional spending. Our research
`shows that emerging market healthcare
`providers trust branded generic products the
`same way they rely on other novel medications
`because they have been in use for a long
`time—in some cases for decades. And given
`the often-global reputations of the MNCs,
`there is also an element of intrinsic trust
`in both the quality of branded generics and
`the companies that sell them.
`
`These market conditions, coupled with
`lower consumer disposable income levels
`and the inability of emerging market
`governments to afford novel medications4
`at developed country prices, helped to foster
`a new, branded generics product segment.
`
`Just how well do branded generics measure
`up against branded and pure generic products
`from a profitability perspective? The
`popularity of branded generics over pure
`generic products also varies by country with
`branded ones enjoying a higher price leading
`to more favorable margins when compared
`to pure generics. In India, branded generics
`and originator (off patent) brands dwarf
`pure generic products, whereas in many
`developed markets such as the United Kingdom
`and United States, unbranded generics make
`up about half the overall category total.
`Branded generics typically offer higher
`margins than either over-the-counter (OTC)
`or pure generic offerings.
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`Key success factors
`with branded generics
`in emerging markets
`
`While the branded generics play in emerging markets offers
`pharma players opportunities to expand, success is not certain.
`To improve the odds, MNCs should consider the following five
`winning elements of successful branded generics strategies.
`
`
`Enhance contracting
`capabilities
`Create high-volume sales
`opportunities to overcome low
`margins on off-patent products
`Ability to manage Accounts
`Receivables and credit risk
`
`Establish sustained local
`capabilities with strong
`local talent
`Local manufacturing is a show of
`goodwill to local authorities
`High demand for local talent is
`making hiring/retention expensive
`
`Bolster the sales force
`with multi-channel
`engagement
`Create trust and recognition
`among healthcare providers
`Provide lower-cost solutions
`for lower priced markets
`
`Engage in portfolio
`marketing
`Physician engagement and
`brand equity are critical for
`success
`Enable sales teams to promote
`multiple products with
`physicians
`
`Key Success
`Factors with
`Branded Generics
`in Emerging
`Markets
`
`Recalibrate regulatory
`affairs
`Ability to file for the fastest route
`for approval to outpace generics
`Know how to navigate
`government relationships
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`1.
`Establish sustained
`local capabilities
`with strong local
`talent
`
`Establishing local capabilities in emerging
`markets can be a challenge for global
`pharma players, but the benefits can be
`significant. Local production can help
`organizations shorten supply chains, avoid
`currency fluctuations and better understand
`a market’s unique aspects, including
`distribution oddities. Furthermore, setting
`up local R&D capabilities can help companies
`attune their product portfolios to meet the
`urgent needs in the country, and hiring and
`retaining local talent can enable firms to
`benefit from emerging markets’ resources.
`While these opportunities are not exclusive
`to branded generics, they are important for
`a successful branded generics strategy.
`
`Manufacturing and distribution
`In developed markets, supply chains often
`function best when guided by a central
`command center that has a clear view of
`the global supply and demand capacity of
`a company’s product portfolio. This setup
`works well for many MNCs, which typically
`employ a refined sales and operations
`planning (S&OP) process enabled by
`enterprise resources planning (ERP) systems.
`This combination enables them to allocate
`capital efficiently, acquire raw materials,
`optimize their manufacturing architecture
`and move inventory while optimizing the
`cash position.
`
`However, in an emerging market setting,
`the central command center approach
`often faces some unique challenges. For
`example, supplying the market cheaply and
`quickly can be an important success factor
`in these markets because it can foster an
`environment in which the shelves in the
`pharmacies remain stocked. Across many
`
`emerging markets, pharmacies are owned
`and operated by individuals and thus
`offer a less predictable order horizon than
`pharmacy chains. Even where there are
`large pharmacy chains, such as in Latin
`America, Russia, and China, companies
`sometimes move smaller quantities on a
`constant basis, which calls for more of a
`just-in-time approach to distribution. Given
`the fact that accounts receivable (A/R) is
`often a major stumbling block and a risk
`of doing business in all emerging markets,
`with days sales outstanding (DSO) levels
`reaching as high as 180 days or more,
`the agility of the supply chain can play a
`much more critical role here than it does
`in developed markets that benefit from
`established processes and systems.
`
`Retail pharmacies in developed markets
`typically both distribute and dispense
`medicine. In emerging markets, pharmacists
`can be active care providers and can often—
`if the consumer is willing to pay—offer
`for-prescription remedies in absence of
`any medical training. As a consequence,
`they can play an influential role as to which
`medications are dispensed, even if the
`patient does not have a prescription—a
`situation that occurs very frequently.5 The
`pharmacist thus suggests, and in many
`cases decides, which generic product to
`dispense, if an option is available. In effect,
`if the patient cannot afford the branded
`original product due to its higher price, the
`pharmacist can offer the next-best product,
`such as a branded generic supplied by a
`local manufacturer. And while having a trained
`pharmacist intervene in the medication
`regimen can provide certain benefits, especially
`for chronic conditions such as hypertension
`or diabetes, it is not uncommon to see even
`pharmacist assistants playing this critical role.
`
`Given this local decision point, MNCs should
`explore ways to incentivize and train
`pharmacists to dispense their own branded
`generics instead of locally produced
`alternatives in these situations. Economically,
`branded generics can be more profitable
`for pharmacists, since they typically offer
`better payment terms and larger discounts
`when compared to novel branded medications.
`
`However, MNCs could be at a disadvantage
`here, since they—unlike some local producers—
`can face stricter reporting standards
`regarding their accounts payable terms.
`
`MNCs should endeavor to understand
`that the distribution picture could change
`dramatically from country to country. In
`Mexico, for example, supermarkets have
`begun to carry pharma products, and drug-
`store chains are also emerging. Distributors
`in Russia tend to enjoy high levels of influence
`due to the market’s network of regional
`formularies, and the Indian distribution
`network and marketplace are both highly
`fragmented. Dealing with these dynamics
`can be a challenge for MNCs trained to
`operate in developed markets, but unless
`they understand and act to overcome them,
`their branded generics initiatives could
`be less effective than anticipated. Critical
`factors for creating an effective emerging
`market distribution network strategy include
`cultivating a deep understanding of consumer
`needs in areas such as credit and supply
`predictability, as well as providing adequate
`assurances that this is a genuine product,
`not a counterfeit.
`
`Having a local manufacturing or distribution
`center presence can be the key to continued
`participation in a number of emerging
`economies, and some governments even
`require companies to establish in-country
`operations to gain access to the market at
`all. Other countries, such as Brazil, make it
`very difficult for companies without local
`operations to compete by imposing import
`duties or tariffs that often boost import
`prices far beyond those charged by local
`competition.6 As a result, localization
`has been a key element of the Brazilian
`pharmaceutical market, and numerous
`global pharmaceutical companies are
`now using Brazil as a production platform.
`Additional benefits of local production can
`include local and national tax advantages
`and lower production costs. The cost to
`manufacture a drug in India, for example,
`is about 40 percent lower than in a developed
`country.7 Russia and China are also evolving
`into even stronger examples of the need for
`local manufacturing.
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`with establishing local R&D capabilities.
`Many other factors can play into this equation,
`including nationalistic protectionism, which
`promotes investments in local technologies
`by blocking the entry of MNCs and negative
`popular perceptions of government officials
`caused by their pricing, payment and
`coverage decisions that focus on containing
`healthcare costs.
`
`Local talent
`Since both MNCs and local branded generic
`manufacturers invest heavily in emerging
`markets, the war for talent is a key success
`factor. However, this pervasive demand for
`talent can make the cost of hiring individuals
`with the right skill sets disproportionately
`expensive. In some cases, this trend has
`actually reversed net immigration flows to
`developed markets.
`
`Talent acquisition costs are also increasing
`steadily, bringing the fully-loaded cost of
`a pharma sales rep in China, for example,
`closer to developed country levels. In some
`Eastern European countries and Russia, it
`is a common practice to hire physicians as
`sales reps, because doctors can often earn
`multiples of their government-paid salaries.
`
`Continuing education, training and sustainable
`career paths in a MNC remain important
`attributes in the war for local talent. However,
`MNCs may be slowly losing this edge to
`local branded generic manufacturers, which
`historically have attempted to lure talent
`away from big pharma companies once people
`complete their initial training and gain
`hands-on multi-national commercialization
`experience. Now, the local players offer
`similar perks and career paths as well.
`In general, rates of attrition seem to be
`uncharacteristically high in emerging markets,
`since companies do not shy away from
`stealing trained talent from anyone, anywhere.
`
`Research and development
`The announcement in December 2011 that
`Merck planned to establish a new research
`and development (R&D) headquarters in
`China as part of a $1.5 billion investment
`over five years represents a milestone in
`MNC attempts to establish an integrated
`presence in the emerging market landscape.
`As most MNCs move into China, this strategy
`can be interpreted two ways. First, it allows
`companies to gain access to an educated local
`workforce, enabling them to dial up discovery
`functions at a lower cost. And second,
`establishing the company as a net investor
`in an emerging market can boost its influence
`with local governments, which almost always
`act as monopsony players (i.e., a single
`buyer with multiple sellers) in countries
`that lack a healthy commercial insurance
`segment. The case of China in particular,
`is a good example, where drugs developed
`locally often enjoy a semi-official fast track
`for reimbursement by local authorities that
`may save them years in the process.
`
`While pharmaceutical industry R&D has
`traditionally been a slow process, in India
`the adoption of reverse pharmacology has
`provided production efficiency gains, helped
`manufacturers to test generic drugs more
`quickly and thus helped to increase the
`speed to market. The ability to bring relevant
`products quickly to market at low price
`points has been instrumental for domestic
`players in shaping the Indian market on
`their terms.
`
`Another recent development is the practice
`of enrolling ever-larger patient populations
`from emerging markets for clinical trials.
`Doing so can help to speed up patient
`recruitment, which appears to have been
`an operational obstacle for clinical stage
`development. Due to lower treatment rates
`in emerging markets, the ability to find
`more eligible patients has often attracted
`drug developers (and the contract research
`organizations they use) to these geographies
`to perform Phase II and III clinical trials.
`This practice can also help to speed up
`the approval process with emerging market
`regulatory authorities, because many sub-
`mission packages are mandated to include
`clinical outcomes data for local populations.
`However, MNCs should consider striving
`for full transparency in such trials which
`can help to avoid the potentially negative
`perception that they are taking advantage
`of local populations, whose protections
`from negative outcomes may be lower than
`those in developed markets. This issue is
`exemplified by claims made by an African
`government concerning clinical trial
`recruitment for an antibiotic tested by
`a large global pharma company, and led
`to a major public relations issue that was
`drawn out over many years.
`
`Becoming involved locally can actually
`enhance a big pharma player’s image in
`the eyes of local healthcare providers,
`positioning it as a progressive and innovative
`company that supplies high quality products.
`However, companies should consider
`weighing the costs and benefits associated
`
`Partner with local players
`Successful MNCs often create partnerships with local companies with deeper
`expertise in the local market and perhaps more support from the local
`government. Bayer HealthCare, for example, recently launched a joint venture
`with Cadila, one of India’s largest privately held pharmaceutical companies.
`These ventures are also often designed to establish a new base for expansion
`into other emerging markets. In 2009, GSK signed an agreement with India’s
`Dr. Reddy’s to develop and market selected products across a variety of
`emerging markets.8
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`2.
`Engage in portfolio
`marketing
`
`The ability to create strong brand equity
`by engaging in portfolio marketing is a key
`factor for success with branded generics in
`emerging markets. The strength of the sales
`and marketing organization and its capabilities
`in terms of field sales, promotions, market
`research and medical services can play a
`critical role in creating such brand equity.
`
`Physician engagement and the creation of
`brand equity can be even more important
`for the success of the branded generic when
`the original drug has been off-patent for
`some time and other generics have already
`been launched in the market.
`
`Companies with a branded generics portfolio
`tend to have divisions focused on certain
`therapies. This can foster the opportunity
`for them to increase their depth in a specific
`therapy by conducting focused market
`research and to develop a good understanding
`of a market’s medical needs, which in turn
`can help them to gain recognition among
`physicians. For example, Sandoz remains
`the leader in tuberculosis therapy in India
`because it has the most relevant portfolio,
`which it markets as a comprehensive package.
`
`Leveraging a portfolio of products can allow
`companies to benefit from synergies as they
`execute their strategy and develop a market
`presence. Engaging in portfolio marketing
`can generate efficiencies by enabling field
`sales teams to promote multiple products
`with physicians, further improving their
`ability to succeed in this competitive market
`with a branded generic. The MNCs’ know-
`how regarding the specific therapies and
`the market can further improve their speed
`to market, thus building their local brand
`equity. Novartis’ business in India is a perfect
`example of this approach, as most of the
`investment has been focused on creating
`awareness of diseases among local populations
`in rural settings under an umbrella brand,
`Arogya Parivar, which means good family
`health in Hindi.
`
`Promotional activities can help MNCs
`maintain the relevance of branded generic
`offerings in a market, and doing upfront
`portfolio lifecycle planning and taking steps
`to understand target segment needs can
`place the MNC in a strong commercial
`position with its branded generic offerings.
`
`Sponsor certification and training programs
`Pharmaceutical companies can build their emerging market presence by
`sponsoring local certification and training programs in collaboration with local
`and international institutions. Educating customers about a company’s products
`and the diseases they address can raise awareness and generate new revenue
`opportunities in markets that may have less understanding of Western medicine.
`One avenue involves the creation of training regimens to “certify” physicians in
`the use of a company’s product. Novo Nordisk, for example created the Changing
`Diabetes in Children Program (CDiC) which addresses barriers for children
`living with diabetes in developing countries. The program provides free insulin
`and supplies, in addition to a comprehensive training manual for healthcare
`professional and diabetes educators.9
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`3.
`Recalibrate
`regulatory affairs
`
`In many markets, established relationships
`are an important element of regulatory
`affairs performance and it is not unusual
`for former government officials and/or
`regulators to join the ranks of local or
`multi-national companies—a practice
`common in India. MNCs are often required
`to navigate these cultural norms and
`manage the risks to which they may be
`exposed concerning their governing compliance
`policies, while at the same time being clear
`when it comes to intent and desired outcomes.
`
`Overall, MNCs that play in the branded
`generic space often benefit from a versatile
`regulatory affairs function that can enable
`smooth and agile go-to-market performance.
`
`The regulatory affairs department of a
`MNC typically plays a different role when
`dealing with branded generics in emerging
`markets than it does generally in developed
`countries. In fully industrialized economies
`the regulatory affairs function primarily
`focuses on providing guidance about a new
`product’s labeling and seeks to optimize the
`ability to promote products on a post-approval
`basis while ensuring full compliance. In
`emerging markets, on the other hand, the
`ability to accelerate the company’s go-to-
`market capability by moving the branded
`generic application dossier through multiple
`bureaucratic hurdles is a key capability that
`regulatory affairs personnel must master.
`Turkey, for example, can be a difficult market
`for pharma players due to its challenging
`regulatory environment, which causes a
`significant backlog in the registration process—
`typically from 18 to 36 months.10 Likewise,
`the strong influence of the Chinese
`government and the uncertainty around
`future healthcare regulatory reforms make
`China a complex market for MNCs.
`
`Give back
`Non-profit engagements can offer a way for pharmaceutical players to build
`brand strength in emerging markets that is consistent with their corporate
`philosophy of improving healthcare. Contributing to the local economy or
`infrastructure can help build goodwill and winning over a customer base that
`recognizes a company’s brand. It also can become a vehicle to elevate the
`corporate image to attract and retain local talent who feel particularly proud
`about working for the company.
`
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`4.
`Bolster the
`sales force with
`multi-channel
`engagement
`
`In-person, face-to-face interactions remain
`a core strategy for marketing products to
`providers in emerging markets. Many MNCs
`are investing in sales reps, who play a vital
`role in product education and relationship
`building. However, as emerging markets
`grow and an increasing number of individuals
`have access to healthcare in these markets,
`MNCs should consider taking an integrated,
`multi-channel approach.
`
`A well-executed multichannel approach
`can achieve goals and accelerate results by
`extending the sales force through digital
`and on-line interactions. For example, China
`has 120 cities with populations that exceed
`one million, and 832 million people in more
`rural areas now have access to healthcare.11
`Even faster growth rates appear to be
`occurring in mid-size cities. While many
`MNCs have been aggressively pursuing market
`access in China, few have successfully
`penetrated the Chinese market and achieved
`sales or geographic scale.12 To keep pace
`with the rate of change, to maximize their
`growth potential and effectively compete
`with local firms, MNCs should consider
`leveraging non-traditional channels that
`go beyond the individual sales rep.
`
`A multi-channel marketing strategy leveraging
`newly adopted channels (such as digital
`access) has the potential to reach a broader
`audience to deliver core branded generics
`messaging. One key goal of this strategy
`is instilling trust and recognition among
`health care providers and consumers for
`the pharmaceutical parent company. Sales
`reps may then have an opportunity to
`focus on reinforcing this messaging in
`strategically important markets where
`providers may be more likely to be receptive
`to e-Detailing and e-Learning applications.
`In the case of China, for example, it has
`been said that reps should focus on the
`cities with the largest, most technologically
`advanced populations.13, 14
`
`In general, providers in emerging markets
`will likely continue to rely on individual
`interactions with sales reps as a means to
`gain trust and educate practitioners about a
`product. However, specifically for branded
`generics, an integrated multi-channel
`strategy can enhance the brand and provide
`lower-cost solutions that align with these
`lower priced markets.
`
`Innovate to access health care providers
`Some pharma players are experimenting with innovative ways to reach health
`care providers. For example, pharmaceutical sales reps in China often have
`difficulties meeting with doctors in person due to high patient loads, time
`pressures and a variety of other factors. In addition, in Turkey and Russia, there
`is an emerging trend by governments to limit sales rep access to physicians. As a
`consequence, some companies are exploring new ways to reach doctors through
`digital channels such as the Internet and email.
`
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`5.
`Enhance contracting
`capabilities
`
`In many emerging markets, the contracting
`or tendering process is an area of focus for
`MNCs. As a result, cultivating effective
`contracting capabilities is a strategy that
`can help MNCs win the branded generics
`game. Currently, the emerging market
`tendering process is typically low-tech
`and reactive rather than proactive. In
`many markets, the individuals in charge
`of contracting and tendering processes
`simply use Microsoft Excel® spreadsheets
`to track historical bid prices, and decision-
`makers lack ready access to data or the
`tools they need to drive actionable insights.
`
`In order to compete with local players in India
`such as Ranbaxy and Dr. Reddy’s, MNCs
`could benefit from viewing contracting and
`tendering as a commodities game involving
`a robust and dynamic pricing capability, rather
`than one focused on brands. Additionally,
`the tendering process for off-patent
`products includes the additional complexity
`of dealing with generic competitors whose
`price points are generally unknown. Preparing
`multiple bidding scenarios can help MNCs
`
`deal with the potential inconsistencies that
`can arise when customers have low levels
`of influence over the prices they pay. One
`often-valuable discounting strategy involves
`offering incentives for purchases across
`an MNC’s portfolio of products, which can
`help companies sell both patented and off-
`patent drugs and MNC’s can incorporate as
`appropriate in the local market. MNCs can
`gain market share and potentially create
`positive prescribing spillover for off-patent
`drugs, which is often difficult to execute in
`a low transparency market.
`
`Tenders, typically the main source of high-
`volume sales opportunities-often gain even
`more importance in the overall commercial
`plan. As a consequence, identifying tenders
`by investing in third-party aggregating
`services or by establishing data-sharing
`relationships with distributors may be
`essential to finding profitable opportunities
`in this product segment. MNCs are largely
`dropping out of this game (e.g., in Brazil)
`and where they continue to play (e.g.,
`China), the pressure is intensifying.
`
`Understand generic drug pricing
`Pharmaceutical companies should also cultivate a better understanding of the
`generic drug markets in target countries. Many have strict government-enforced
`pricing measures including reference pricing that would use an average of prices
`in a basket of low-price countries as a benchmark to determine the price in the
`home country. The Chinese government, for example, has created an Essential
`Drug List (EDL), which has reduced pricing on many off-patent Western drugs,
`and many hospitals and pharmacies are restricted to providing only generic
`products from the EDL. Such price limits, as well as large low-income consumer
`populations, tend to favor generic drugs.
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`Conclusion
`
`Branded generics in emerging markets present a viable avenue
`for potential growth for big pharma players, but companies need
`to understand the often-unique challenges they face in pursuing
`this opportunity. With the increasing pressure on government
`budgets and cost containment, the window of opportunity that
`the branded generics present may not stay open for long. Therefore,
`MNCs should consider exploring and pursuing a select combination
`of the strategies discussed in this publication with a sense
`of urgency.
`
`The five elements of a winning branded generics game-plan
`described here can help leaders identify potential gaps in their
`go-to-market plans, and help prepare them for the sometimes
`unconventional aspects of doing business in many of these markets.
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`

`

`9 “Novo Nordisk to Reach 2500 Children in
`India with Free Insulin and Diabetes Care,”
`Novo Nordisk Press Release, September 7,
`2011.
`10 “Country Report; Turkey”, Steve
`Kretschmer, Pharmaceutical Market Europe,
`May 2011.
`11 “Digital Channels Reaching Doctors in
`China,” Anne O’Riordan, Kher Tean Chen,
`Accenture, December 21, 2011.
`12 What it Takes: Launching Successful
`Products in China’s Pharmaceutical Market,
`Anne O’Riordan, Kher Tean Chen, Andrew
`Yu, Accenture, July 19, 2011.
`13 Digital Channels Reaching Doctors in
`China, Anne O’Riordan, Kher Tean Chen,
`Accenture, December 21, 2011.
`14 What it Takes: Launching Successful
`Products in China’s Pharmaceutical Market,
`Anne O’Riordan, Kher Tean Chen, Andrew
`Yu, Accenture, July 19, 2011.
`
`End notes
`1 Credit Suisse Global Investment Returns
`Yearbook 2010, Elroy Dimson, Paul Marsh,
`Mike Staunton, Jonathan Wilmot.
`2 IMS Health, “The Global Use of Medicines:
`Outlook Through 2016,” July 2012, Page 3.
`3 “India: Good Endings, Good Beginnings,”
`Pharmaceutical Executive, September 2011.
`4 Drugs that offer benefits that are
`differentiated from those offered by other
`products in the market.
`5 “Use of antibiotics without medical
`prescription,” Dalton Espíndola Volpato,
`Bárbara Vicente de Souza, Luana Gabriela
`Dalla Rosa, Luíz Henrique Melo, Carlos
`Antonio Stabel Daudt, Luciane Deboni,
`Brazilian Journal of Infectious Diseases,
`Vol. 9 no.4 Salvador, August 2005.
`6 “2011 National Trade Estimate Report
`on Foreign Trade Barriers—Brazil,” Office of
`the United States Trade Representative.
`7 India’s Potential as Part of a Global
`Pharmaceutical Value Chain, Alexander
`Meyer auf der Heyde, Sriram Shrinivasan,
`Sebastian Schweitzer, Accenture.
`8 Fast Forward to Growth, Rob Hayward,
`Armen Ovanessoff, Athena Peppes, Kuangyi
`Wei, Paul Nunes, Mark Purdy, Matthew
`Robinson, Mark Spelman, Vanessa Rossi,
`Accen