Pharmaceutical Wholesale and Distribution Industry Outlook and Analysis 2010-2025

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Pharmaceutical Wholesale and Distribution Industry Outlook and
Analysis 2010-2025
Published on February 2010

Report Summary

How will changes affect this crucial part of the healthcare industry'

The pharmaceutical wholesale and distribution sector is the vital link between pharmaceutical companies and pharmacies. Growing
demand for drugs worldwide is driving that sector's growth. However, many pressures and challenges have placed a premium on
service and efficiency in pharma wholesale and distribution. What are the key issues involved' Who are the major players and how do
their businesses operate' Where are the best opportunities to be found, and how could you unlock these' Our new report -
Pharmaceutical Wholesale and Distribution Industry Outlook and Analysis 2010-2025 - reveals where the most-exciting developments
will lie from the present onwards.

Pharmaceutical wholesalers and distributers provide an often-overlooked service to the pharma industry, healthcare providers and
patients. However, that sector is currently in transition. Is the traditional wholesale model really in decline' If so, how would it be
superseded and how rapidly' Many countries are experiencing changes in the way drugs are distributed to retailers. Integration,
consolidation and disintermediation are all altering the pharma supply chain. How does the sector function and what does the future
hold for it and its stakeholders' Our new study provides the answers that you require.

In particular, Pharmaceutical Wholesale and Distribution Industry Outlook and Analysis 2010-2025 examines following major issues:
' Effects of the fee-for-service (FFS) switch
' European price controls and parallel trade
' Consolidation and integration of industry players
' The importation of prescription drugs into the USA
' Drug counterfeiting
' The Internet ' mail order drugs and on-line pharmacies
' The threat of Wal-Mart
' The three major US wholesalers ' AmerisourceBergen, McKesson and Cardinal Health ' analysis of revenues, margins and business
structures
' The three major European wholesalers ' Alliance Boots, Celesio and the Phoenix Group ' analysis of revenues, margins and
business structures
' Direct-pharmacy (DTP) trends, advantages and challenges
' Overarching analyses of the European and US sectors.

Comprehensive analysis of pharmaceutical wholesale and distribution

Pharmaceutical Wholesale and Distribution Industry Outlook and Analysis 2010-2025 critically examines that sector through a
comprehensive review of information sources. We harness both primary and secondary research. This new report provides unique
sales forecasts and analyses of commercial drivers and restraints, including a SWOT analysis. There are over 85 tables and figures
included, as well as an interview with a relevant authority. The result is a comprehensive market- and industry-centred study, with
detailed analyses and informed opinion to benefit your work.

Why you should buy Pharmaceutical Wholesale and Distribution Industry Outlook and Analysis 2010-2025

Pharmaceutical Wholesale and Distribution Industry Outlook and Analysis 2010-2025 Page 1/11


This report gives you the following benefits in particular:
' You will receive comprehensive information on the pharmaceutical wholesale sector, including how the industry works and how it is
changing
' You will review the important financial details for the US and European markets, including revenue forecasts for 2010 to 2025
' You will examine financial information for the world's leading pharmaceutical wholesalers, including forecasts for 2010 to 2025
' You will discover the effects of drug diversion, seeing how manufacturers are responding and assessing how effective those
measures will be
' You will explore how disintermediation is affecting the industry and who are benefitting in particular
' You will determine the effects of market drivers and restraints on wholesalers' profits and overall commercial prospects
' You will gain insight into the forces that influence the sector as a whole, as well as examination of those for the European and US
sectors individually
' You will receive expert opinion from our original survey of the sector.

You can obtain this report today

Nobody with an interest in pharmaceutical wholesaling, distribution or retail trade can afford to overlook this new study. We predict
that this overall sector will see growth from 2010 onwards, with efficient, resilient and responsive organisations benefiting. Demand for
pharmaceuticals is growing worldwide, but this driver alone will not be enough to ensure that wholesalers prosper. Diversification,
integration and globalisation will all play their roles. Do you want to harness those opportunities' You can stay ahead by ordering this
report today.

Table of Content

Table of Contents

1. Executive Summary
1.1 Aims of this Report
1.2 Brief Overview of the Chapters in This Report

2. Introduction to The Pharmaceutical Wholesale and Distribution Sector
2.1 An Overview
2.2 The Drug Wholesaler - More Than Just a Middleman
2.3 Roles and Functions of the W&D Companies
2.4 Types of Wholesaler
2.4.1 Full-Line Wholesalers
2.4.2 Short-Line Wholesalers
2.4.3 Secondary Wholesalers
2.4.4 Vertical Integration
2.5 The World Market Estimate and Forecast

3. Key Concepts in Pharmaceutical Wholesale and Distribution
3.1 Pharmaceutical Wholesale is Different from Other Forms of Wholesale
3.2 Business Models
3.2.1 Gross Profit
3.2.2 Forward Buying
3.2.3 Fees-for-Service
3.2.4 Discounts
3.2.5 Inventory Management Agreements



3.3 Specialty Products
3.4 Reimbursement
3.5 Clawback
3.6 Pharmacy Benefit Managers
3.7 Diversion
3.7.1 Re-importation
3.7.2 Parallel Trade
3.8 Disintermediation
3.8.1 Direct-to-Pharmacy
3.8.2 Case study: Pfizer and Alliance Healthcare (Alliance Boots)
3.8.3 Pfizer's DTP Discounts
3.8.4 Internet Pharmacies
3.8.5 Mail Order Pharmacies
3.8.6 Supermarkets
3.9 Counterfeits

4.The US Pharmaceutical Wholesale and Distribution Market
4.1 Overview
4.2 Trade Associations
4.3 Legal Matters
4.4 The Fee-for-Service Switch
4.5 Where Do the Drugs End Up'
4.6 Re-importation of Pharmaceuticals
4.7 US Market Forecast

5. The Three Leading US Wholesalers
5.1 Overview
5.2 Consolidation and Market Share
5.3 US Big Three: Market Share Forecast
5.4 US Big Three: Earning Margins
5.5 Important Note on Dates and Data
5.6 AmerisourceBergen
5.6.1 Divisions
5.6.2 Customers
5.6.3 Recent Performance
5.6.4 Forecast and Analysis
5.7 Cardinal Health
5.7.1 Divisions
5.7.2 Customers
5.8 McKesson Corporation
5.8.1 Operating Segments
5.8.2 Largest Customers

6.The European Pharmaceutical Wholesale and Distribution Market
6.1 Overview
6.2 Trade Associations



6.3 Legal Issues
6.4 Major Differences between US and European Pharmaceutical Wholesale and Distribution Sectors
6.4.1 Pharmaceutical Price Controls
6.4.2 Parallel Imports
6.4.3 State-Funded Healthcare and Reimbursement
6.4.4 Generics
6.4.5 A Single Market'
6.4.6 Consolidation of European Pharmaceutical Wholesale Industry
6.4.7 Independent Pharmacies are Rare in Parts of Europe
6.4.8 Pre-wholesaling
6.4.10 European Online Drug Sales are Low and Limited to OTC
6.4.11 Accounting Practices
6.4.12 Exchange Rate Information
6.5 European Pharmaceutical Wholesale and Distribution Market Forecast

7. The Three Leading European Wholesalers
7.1 Overview
7.2 Big Three: Market Share
7.3 Big Three: Market Share Forecast and Analysis
7.4 Alliance Boots
7.4.1 Overview
7.4.2 Divisions
7.4.3 Margins
7.4.5 Analysis and Forecast
7.5 Celesio
7.5.1 Overview
7.5.2 Divisions
7.5.3 Revenue by Country
7.6 The Phoenix Group
7.6.1 Overview
7.6.2 Group Members
7.6.3 Revenue by Country
7.6.4 Phoenix Group to be Sold'
7.6.5.1 Phoenix Group
7.6.5.2 Phoenix Pharmahandel (Germany)
7.6.5.3 Tamro (Nine Scandinavian and Baltic Countries)

8. Major Issues Affecting the Pharmaceutical Wholesale and Distribution Sector
8.1 Increased Demand for Pharmaceuticals
8.2 Specialty Drugs
8.3 Generics
8.4 Globalisation
8.5 Low Margins
8.6 Disintermediation



8.6.2 Supermarkets
8.6.3 Internet and Mail Order Pharmacies
8.7 Consolidation Throughout the Industry
8.8 Counterfeits
8.9 Reimbursement Issues
8.10 Diversion

9. Expert Opinion
9.1 Monika Derecque-Pois
9.1.1 Importance of the Full-Line Wholesaler
9.1.2 Challenges Facing the Industry
9.1.3 Security of the Supply Chain and EU Legislation
9.1.4 Detecting Counterfeits

10. Conclusions
10.1 Wholesalers are the Vital Link between Manufacturers and Retailers
10.2 Pharmaceutical Wholesaling is a Sector with High Revenues but Low Margins
10.3 The Pharmaceutical Wholesale and Distribution Industry is in a State of Transition
10.4 The Direct-to-Pharmacy Model Threatens Revenues but Guarantees Profits
10.5 The Industry's Main Driver is Increased Demand for Pharmaceuticals
10.6 Generics have Good Margins Now, But for How Long'
10.7 The US and European Pharmaceutical Wholesale Sectors are both Dominated by a Small Numbers of Large Wholesalers
10.8 Vertical Integration of Wholesalers and Retailers is Common in Europe
10.9 Consolidation Threatening Wholesalers Margins'
10.10 Diversion: Who Benefits'
10.11 There are No Easy Solutions to Stop Counterfeit Medicines
10.12 The Future of Pharma Wholesale and Distribution

List of Tables

Table 2.1 Pharmaceutical Wholesale Industry: Worldwide and Area Revenue Forecasts, 2008-2025
Table 4.1 The US Wholesale Industry: Breakdown by Sector, 2008
Table 4.2 Number of States with Pedigree Legislation
Table 4.3 HDMA Members: Customers by Revenue Share, 2008
Table 4.4 HDMA Members: Revenue by Product Type, 2008
Table 4.5 US Pharmaceutical Wholesale Market: Forecast, 2010-2025
Table 4.6 Drivers and Restraints for the US Pharmaceutical Wholesale Industry, 2010
Table 5.1 US Big Three: Revenues and Market Shares, 2008
Table 5.2 US Big Three: Revenue and Market Share Forecast, 2010-2025
Table 5.3 How Prescription Dollars are Spent, 2009
Table 5.4 US Big Three: Revenue, Gross Profit and Net Income, 2008
Table 5.5 US Big Three: Fiscal Years
Table 5.6 AmerisourceBergen: Major Customers, Fiscal Year 2009
Table 5.7 AmerisourceBergen: Revenues, Gross Profit and Net Income, 2005-2007
Table 5.8 AmerisourceBergen: Revenue, Profit and Income Forecast, 2010-2025
Table 5.9 Cardinal Health: Division Revenue and Income, Fiscal Year 2009
Table 5.10 Cardinal Health: Customers by Contribution to Overall Revenues, Fiscal Year 2009
Table 5.11 Cardinal Health: Revenue, Profit and Income, 2005-2009
Table 5.12 Cardinal Health: Liabilities, Three Months to September 2009



Table 5.13 Cardinal Health: Revenue, Profit and Income Forecast, 2010-2025
Table 5.14 Cardinal Health: Revenue and Profit by Type of Customer, 2005-2009
Table 5.15 McKesson: Division Revenue and Gross Profit, Fiscal Year 2009
Table 5.16 McKesson: Customers by Contribution to Overall Revenues, Fiscal Year 2009
Table 5.17 McKesson: Revenue, Profit and Income, 2005-2009
Table 5.18 McKesson: Revenue, Profit and Income Forecast, 2010-2025
Table 6.1 The European Pharmaceutical Wholesale Market by Type of Wholesaler, 2008
Table 6.2 How Price Controls Vary Across Europe, 2009
Table 6.3 How Pharmaceutical Retail Prices are Divided, by European Country, 2003/2004
Table 6.4 Generic Market Share by Country, 2008
Table 6.5 Number of Retail Pharmacies Owned by Three European Pharmaceutical Wholesalers, 2008
Table 6.6 European Pharmaceutical Distribution Market: Forecast, 2010-2025
Table 6.7 European Pharmaceutical Wholesale Market: Drivers and Restraints, 2010
Table 7.1 The Big Three European Wholesalers: Revenues and Market Shares, 2008
Table 7.2 European Big Three: Market Share Forecast, 2010-2025
Table 7.3 Alliance Boots: Revenue and Trading Profit by Division, 2008
Table 7.4 Alliance Boots: Division Profit Margins, 2008
Table 7.5 Alliance Boots: Pro Forma Results, 2007-2009
Table 7.6 Alliance Boots: Consolidated Results, 2007-2009
Table 7.7 Alliance Boots: Effect of Financial Costs on Profits, 2008-2009
Table 7.8 Alliance Boots: Revenue and Net Profit Forecast, 2010-2025
Table 7.9 Where Celesio Operates, 2009
Table 7.10 Celesio: Revenue, Gross Profit and Net Profit by Division, 2008
Table 7.11 Celesio: Division Profit Margins, 2008
Table 7.12 Celesio: Revenue by Country, 2008
Table 7.13 Celesio: Revenue, Gross Profit and Net Profit, 2005-2009
Table 7.14 Celesio: Revenue, Gross Profit and Net Profit Forecast, 2010-2025
Table 7.15 Phoenix Group: Members and Locations, 2010
Table 7.16 Phoenix Group: Revenue by Country, 2008
Table 7.17 Phoenix Group: Revenues, 2005-2009
Table 7.18: Phoenix Pharmahandel: Revenue and Income, 2005-2009
Table 7.19 Tamro: Revenue, Operating Income and Net Profit, 2005-2009
Table 7.20 Phoenix Group: Revenue Forecast, 2010-2025
Table 8.1 SWOT Analysis of the Pharmaceutical Wholesale and Distribution Sector, 2010
Table 8.2 Prevalence of the DTP Model in the UK, 2010
Table 8.3 Counterfeit Incidents, 2008
Table 8.4 Number of Counterfeit Incidents Recorded by PSI, 2002-2008

List of Figures

Figure 2.1 Pharmaceutical Wholesale Industry: Revenue Forecast by Area, 2010-2025
Figure 4.1 The Top Five US Wholesale Sectors by Revenue, 2008
Figure 4.2 HDMA Members: Customers by Revenue Share, 2008
Figure 4.3 HDMA Members: Revenue by Product Type, 2008
Figure 4.4 US Pharmaceutical Wholesale Market: Forecast, 2010-2025
Figure 5.1 US Pharmaceutical W&D Market by Share, 2008
Figure 5.2 US Big Three: Revenue and Market Share Forecast, 2010-2025
Figure 5.3 How Prescription Dollars are Spent: Share of $1 Spent on Prescription Drugs
Figure 5.4 US Big Three: Revenue, Gross Profit and Net Income, 2008
Figure 5.5 AmerisourceBergen: Divisions, 2009



Figure 5.6 AmerisourceBergen: Customers by Share of Revenues, Fiscal Year 2009
Figure 5.7 AmerisourceBergen: Revenue and Margins Forecast, 2010-2025
Figure 5.8 Cardinal Health: Division Contribution to Revenue, Fiscal Year 2009
Figure 5.9 Cardinal Health: Customers by Revenue Contribution, Fiscal Year 2009
Figure 5.10 Cardinal Health: Bulk and Non-Bulk Sales Contribution to Revenue, 2005-2009
Figure 5.11 Cardinal Health: Revenue and Margins Forecast, 2010-2025
Figure 5.12 McKesson: Division Contribution to Revenue and Profit, Fiscal Year 2009
Figure 5.13 McKesson: Customers by Contribution to Overall Revenues, Fiscal Year 2009
Figure 5.14 McKesson: Revenue and Margins Forecast, 2010-2025
Figure 6.1 Generic Penetration Rates by Percentage of Total Market Revenue: Selected European Countries and USA, 2008
Figure 6.2 The European Pharmaceutical Wholesale Market: Forecast, 2010-2025
Figure 7.1 Big Three European Wholesalers' Market Shares, 2008
Figure 7.2 European Big Three: Revenue Forecast, 2010-2025
Figure 7.3 Contributions of Alliance Boots' Divisions to Revenue and Trading Profit, 2008
Figure 7.4 Alliance Boots: Revenue and Profit Margin Forecast, 2010-2025
Figure 7.5 Contributions of Celesio's Divisions to Revenue, 2008
Figure 7.6 Celesio: Revenue by Country, 2008
Figure 7.7 Celesio: Revenue and Margins Forecast, 2010-2025
Figure 7.8 Phoenix Group: Revenue by Country, 2008
Figure 7.9 Comparisons of Revenues of Tamro, Phoenix Pharmahandel and Phoenix Group, 2005-2009
Figure 7.10 Phoenix Group: Revenue Forecast, 2010-2025
Figure 8.1 Counterfeit Incidents by Area, 2008
Figure 8.2 Number of Counterfeit Incidents Recorded by PSI, 2002-2008

Companies Listed

A1 Pharmaceuticals plc
AAH Pharmaceuticals Ltd
AB Acquisitions Ltd
Actavis Group hf
Alliance Boots plc.
Alliance Healthcare
Alliance Santé
Alliance UniChem
Almus
American Health Packaging
AmerisourceBergen Corporation
AmerisourceBergen Packaging Group
AmerisourceBergen Specialty Group
Anderson Packaging
Andreae-Noris Zahn AG
ARmark Authentication Technologies LLC
Astellas
AstraZeneca
Bayer Schering
Boots the Opticians
Brecon Pharmaceuticals
Bristol Myers Squibb
British Association of Pharmaceutical Wholesalers (BAPW)
Cardinal Health Inc.



CareFusion Corporation
Caremark Rx
Celesio AG
Central Homecare
Centre for Disease Control (CDC)
Centre for Medicines in the Public Interest (CMPI)
Colorcon, Inc
CVS Caremark
CVS Corporation
Department of Veterans Affairs (VA)
DocMorris
Dollond and Aitchison
Eli Lilly
European Association of Euro-Pharmaceutical Companies (EAEPC)
European Association of Pharmaceutical Full-Line Wholesalers (GIRP)
European Association of Pharmaceutical Full-Line Wholesalers (GIRP)
European Federation of Pharmaceutical Industries and Associations (EFPIA)
European Medicines Agency (EMEA)
Evolution Homecare
Federal Trade Commission (FTC)
Food and Drug Administration (FDA)
Galenica A.G.
GlaxoSmithKline
Guangzhou Pharmaceuticals Corporation
Healthcare Distribution Management Association (HDMA)
Hedef Alliance Holding A.S.
HeidelbergCement AG
International Federation of Pharmaceutical Wholesalers (IFPW)
Kohlberg Kravis Roberts & Co.
Lloydspharmacy
London Stock Exchange
McKesson Corporation
Medco Health Solutions Inc.
Medicaid
Medicare
Medicines and Healthcare Products Regulatory Agency (MHRA)
MegaPharm
Merckle Group GmbH
Movianto
Nadro S.A de C.V.
NanoGuardian
Napp
National Association of Wholesalers (NAW)
National Coalition for Pharmaceutical Distributors
National Health Service (NHS)
Novo Nordisk
Office of Fair Trading (OFT, UK)
Parata Systems
Pfizer Inc.
Pharmaceutical Security Institute (PSI)



Pharmaceutical Services Negotiating Committee (PSNC)
Quality King Distributors Inc.
Ratiopharm GmbH
Rite Aid Corporation
Roche
Safeway Inc.
Supreme Distributors Company
Tamro Group
Target Corporation
Teva Pharmaceutical Industries Ltd
The Bank of England
The Medicine Shoppe
The Phoenix Group
UniChem
US Securities and Exchange Commission (SEC)
Victory Wholesale Grocers Co.
Walgreens Co.
Wal-Mart Stores Inc.
World Health Organisation (WHO)
Wyeth Pharmaceuticals



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