OTC Distribution in Europe - New 2010 Edition - Driving the Recovery

Table of Contents

Chapter 1 Distribution of OTC Medicines in Europe - Introduction, Market Definitions and Summary of Key Issues

• 1. Forward to the 2010 Study of the Distribution of OTC Medicines in Europe 1
• 2. The European Non-prescription OTC Self-Medication Market 2010 5
• 3. Estimates of the Market Size for OTC Medicines of the 18 European Markets for the 2009 OTC Distribution in Europe Study 7
  • Graph 1: Development of Sales of the Total Non-prescription Bound and OTC Self-medication market for 18 major European Markets € millions at Consumer Purchase Prices 2006 - 2009 (estimates) 7
  • Graph 2: Year on Year Sales Gains and Losses OTC Self-medication Sales compared to Semi-ethical Prescriptions - Europe 2006 - 2009 9
• 3.1 Impact of De-reimbursement of Non-prescription medicines and OTC Selfmedication Market Demand in Europe 9
  • Graph 3: Analysis of Value Sales of Non-prescription Medicines following Major Dereimbursement in Germany 2004 - Germany Compared to France 2003 to 2009 (2003 = 100) 10
• 4. Share of Sales by Market 2009 - Total Pharmaceuticals, OTC Medicines and Semi-Ethical products in Europe 11
  • Table 1 Non-prescription Medicines % € Share Europe by Country 12
• Total Retail Pharmaceutical, Non-prescription and OTC Self-medication Markets 2009 est. 12
  • Table 2 Country % € Share of Non-prescription Medicines' Country Markets taken by Prescription Sales 2006 compared to 2009 - Main European Markets 13
• 5. Barriers to Growth for the Non-prescription and OTC Self-medication Markets in Europe 13
• 6. Major Categories of OTC Self-medication Medicines in Europe' s Main Markets 14
  • Graph 4: Growth of the European Self-Medication Market by Therapeutic Category 2006 - 2009 15
• 7. Non-prescription Pharmaceuticals and OTC Self-medication Medicines Country Market Growth - Europe 2006 - 2009 15
  • Table 3 Europe' s Main Non-prescription and OTC Medicines Markets Total Non-prescription and OTC Self-medication Business % € Growth 2006 - 2009 16
• 8. Non-prescription Pharmaceuticals and OTC Self-medication Medicines Leading Manufacturers' Market Shares and Growth - Europe 2008 17
  • Table 4 Europe' s Leading Non-prescription Medicines Manufacturers' % Market Share 2008 17
  • Graph 4: Growth of Top Ten Leading Non-prescription Medicine Suppliers in Europe 2008 17
• 9. Regulatory Controls on Distributing and Merchandising of OTC Medicines in Europe 18
• 10. Non-prescription Medicines and OTC Self-medication in Europe - Changing Distribution Channel Environments 18
  • Graph 5: Key Markets - Europe 2009 Share of OTC Self-Medication Turnover through Nonpharmacy Channels (excluding prescriptions) 19
• 11. Analysis of Pharmacies in Europe 20
  • Table 5 Europe - Number of Pharmacies by Country and Population served per Pharmacy 2009 21
• 12. Growth of Retail Pharmacies in Europe 22
  • Table 6 Growth in Retail Pharmacy Numbers by European State 2006 - 2009 22
• 13. Regulatory Restraints on the Growth of Pharmacy Numbers in Europe 23
• 13.1 Restrictions on Pharmacy Numbers in Europe 23
  • Table 7 Regulations Controlling Pharmacy Numbers in Europe by State 24
• 14. The Role of the Retail Pharmacies in Europe 25
  • 15. Economic Pressures on Pharmacies in Europe 25
• 15.1. Pressures from the Social Healthcare System 26
  • Table 8 Self-Medication in Europe - Average Pharmacy Margins 1998 - 2009 26
• 16. Self-medication - The Importance of OTC Medicines to Pharmacies in Europe 27
  • Table 9 Pharmacies - Average Annual Consumer Purchases of Non-prescription and OTC Selfmedication Products by European State 2009 Consumer - Purchase Prices (€ 000s) 28
  • Table 10 29 Retail Pharmacies in Main European States - % Sources of Business Turnover 2009 29
• 17. Promoting Self-medication in Europe - Restrictions on Merchandising of OTC Medicines in Pharmacies in Different European States 29
  • Table 11 Constraints on Merchandising OTC Self-medication Medicines in Pharmacies by European State 30
• 18. Retail Price Maintenance of OTC Self-medication Medicines in Europe 30
  • Table 13 Self-medication - Status of Retail Price Maintenance on OTC Medicines in European States 31
• 19. Analysis of Trends in the Ownership of Pharmacies in Europe 32
  • Graph 6: 18 Key Markets - 2009 % Share of Number of European Pharmacies by Ownership Classification 33
  • Table 14 Retail Pharmacies in Private and Public Chains in Europe - 2008/9 35
• 20. Location of Pharmacies in Multiples in Europe 35
  • Graph 7: 18 Key Markets - Location of Chain Pharmacies by State in Europe 2009 36
• 20.2 European Court of Justice Ruling resulting from DocMorris Case Challenging German Ownership of Pharmacies Laws 2009 and its impact on EU Pharmacy Law 37
  • Table 15 Ownership Regulations for Pharmacies in Europe as at 2009 (18 Country Study) 38
• 21. Pharmacist owned Small Scale Retail Multiples in Europe 38
• 22. The Growth of Large Retail Pharmacy Chains in Europe 39
  • Table 16 Europe' s Leading Retail Pharmacy Chains 2008/2009 40
• 23. Growth of organised of Voluntary Groupings (Virtual chains) of Independent Pharmacies in Europe 42
• 24. Why do Clusters of Independent Pharmacies form into Voluntary Groupings, Virtual Chains and Symbol Groups in Europe? 42
  • Table 17 % of Pharmacies in Virtual Retail Pharmacy Chains - 18 European Markets 2008/2009 43
  • Graph 8: 18 Key Markets - Location of Pharmacies in Virtual Chains and Symbol Groups by State in Europe 2009 44
  • Table 18 Emerging Virtual Pharmacy Groupings in Europe 2009 45
• 24.1 The Difference between Voluntary Trading Organisations and Franchises - European ' Virtual' Pharmacy Chains 47
• 25. Innovation, Buyer Power and Branding - the Reasons for Retail Pharmacy Groups in Europe 48
• 26. Supermarket Chains - a growing Force in Pharmacy Retailing in Europe 49
  • Table 19 Growth of Pharmacies in Main Supermarket Groups in the UK 2006 - 2009 50
• 27. The potential Impact of Retail Pharmacy Multiple Groupings on the OTC Self-medication and Consumer Healthcare Companies in Europe 51
• 28. Threats and Challenges from Mail order and Internet Pharmacies in Europe 52
• 29. Consumer Sources of Information about their Health 54
  • Graph 9: Respondents' Descriptions of their Level of Interest in their Personal Health and Wellbeing - France, Germany, Italy, Spain and UK 2009 54
  • Graph 10: Respondents' Health Conditions Suffered - France, Germany, Italy, Spain and UK 2009 55
  • Table 20 % Minor Ailments and Conditions Treated with OTC Medication in France, Germany, Italy, Spain, Sweden, Switzerland and the UK Compared to the USA 55
  • Table 21 Sources of Information Consumers believe to be Important 5 European Countries - 2004 56
• 30. Summary Conclusions and Outline Future Agenda for Non-prescription Medicines and OTC Self-medication in Europe 56
• 30.1 The Future for Leading Pharmaceutical Wholesalers Retail Groupings in Europe 57
• 30.2 New Model for the Major Pharmacy Distributors in Europe 58
• 30.3 Growth of General Sale (GSL) OTC Self-medication Medicines across Europe 58
• 30.4 Ambitions of Mass Market Retail Chains to acquire Pharmacies in Europe 59

Chapter 2 Pharmaceutical Wholesalers Strategies for Managing Change in Europe

• 1. The Role of Wholesalers within the Pharmaceutical Supply Chain in Europe 1
  • Figure 1: Pharmaceutical Supply Chain in Europe 1
• 2.1 Services offered by European Pharmaceutical Wholesalers 4
  • Figure 2: Summary of Services Provided by Pharmaceutical Wholesalers The basic offer Marketing and training support Additional support services Financial services 6
• 2. Unfolding Company Strategies across the European Pharmaceutical Wholesaling Industry 7
• 3. Transformation from Wholesalers to Integrated Channel Managers - Driving Change for Europe' s Pharmaceutical Distribution Industry 9
• 4. Innovation, Diversification, Vertical Integration and Competitor Strategies of Major European Pharmaceutical Wholesalers 9
  • Table 1 Europe' s Leading Pharmaceutical Distributors' Activities along the Supply Chain 2009 10
• 5. Impact on Pharmaceutical Distributors Strategies of Changes to Third party Pharmacy Ownership Rules in Europe 11
• 6. Expansion of major Pharmaceutical Wholesalers across borders in Europe and into the Global market Place 11
  • Graph 1: International Pharmaceutical Wholesalers' and Channel Managers' Turnover in Europe in 2008/9 (est. Euros Billions) 12
  • Graph 2: Estimated % Market Share of Leading International Pharmaceutical Distributors in Europe based on Wholesale/Logistics Turnover 2008/9 - 18 European Market Study 13
  • Table 2 Major Pharmaceutical Wholesaler' s' and Channel Managers' National and Consolidated % Market Share 2009 18 European Market Study (Based on reported sales as a % of national wholesale sales) 14
  • Table 3 Leading International Pharmaceutical Wholesalers Rank Position by Country Market 2008/9 16
• 6.1 Reasons for Mergers and Acquisitions in the European Pharmaceutical Wholesale Industry 16
• 7. Role of Major Pharmaceutical Distributors in the Development of Multiple Retail Pharmacy Chains, Mail order and Internet retailing in Europe 18
  • Graph 3: Split of European Pharmaceutical Wholesalers' Turnover between Wholesaling/Logistics and Retail Pharmacy Sales 2009 (est.) 19
  • Table 4 Leading Pharmaceutical Distributor Retail Developments in Europe 2009 Apteek - Estonia Selmos Valstine - Norway 20
• 8. European Pharmacy Chains wholly owned by Pharmaceutical Wholesaler Groups - Alliance Boots, Celesio, Phoenix and Mediq (OPG) 20
• 8.1 Alliance Boots Retail Europe 21
• 8.2 Celesio Retail Europe 21
• 8.3 Phoenix Retail Europe 21
• 8.4 Mediq Retail Europe 21
• 9. Creation and Expansion of Voluntary Groupings of Pharmacies in Europe - Symbol Groups, Franchise Concepts and Virtual Chains 22
• 9.1 Mail Order Pharmacies 22
• 10. Conclusions - New Business Models for the European Pharmaceutical Supply Chain - a Response to changing Manufacturer, Pharmacy and Patient Needs 23

Chapter 3 Profiles of Companies Driving the European Pharmaceutical Supply Chain

• 1. Summary of Celesio' s Business in Europe
  • Table 1 Celesio Consolidated Sales & Profits (€ 000) 2007 - 2008 2
• 1.1 Celesio - Sources of Business Growth 2000 - 2008 2
  • Table 2 Celesio Source of Business and EBIT 2000 - 2008 3
  • Table 3 Celesio Group Turnover by Market and Main Activity - (€ Millions) 2008 Celesio Refocused Business Strategy 1999 - 2008 4
• 1.2 Celesio - New Business Organization 2009 4
  • Figure 1: Celesio Organizational Structure as at January 2009 5
• 1.2 Celesio' s Pharmaceutical Wholesaling Market Share by Country 6
  • Table 4 Celesio' s Market Share by European Pharmaceutical Wholesale Market 2008 7
• 1.3 Celesio Pharmacy Retailing - Consumer and Patients' Solutions 7
  • Table 5 Celesio European Retail Pharmacy Estate 2008 Compared to 2003 8
• 1.4 Celesio Pharmacy Retailing - Outline Performance in Seven European States 8
  • Table 6 Celesio Seven European Markets - Average Turnover per Retail Pharmacy 2008 Compared to 2003 (€ Millions) 9
• 1.5 Celesio Mail Order Internet Pharmacy Retailing 9
• UK - Lloydspharmacy Business 10
• Celesio Pharmacies in Italy 10
• Celesio Pharmacies Czech Republic 10
• Celesio Pharmacies Norway 11
• Celesio Pharmacies Netherlands 11
• Celesio Pharmacies Belgium 11
• Celesio Retail Pharmacy Chain Developments in Sweden 11
• Celesio Pharmacies Ireland 12
• Celesio in Germany 12
• 1.6 Celesio - ' Manufacturer Solutions - Pre-wholesaling Services and Contract Sales Forces 12
• Celesio Contract Sales Operations in Europe 13
• Celesio Homecare UK 13
• 1.5. Celesio - The Future
• Alliance Boots 15
• 2. Summary of Alliance Boots Business
• Alliance Boots Retail Divisions - UK 15
  • Table 7 16 Alliance Boots Pharmacy Chains and Number of Outlets in the UK 2009
• Boots the Chemist Trading Profile UK 16
• 2.3 Boots the Chemist Internet Services in the UK 17
• Alliance Boots Non-pharmacy Retail Activities in the UK 17
• Alliance Boots International Retail Division 17
• 2.1 Alliance Boots Group Source of Revenue and Trading Profit 19
  • Table 8 Revenues and Profits Alliance Boots Pharmaceutical wholly owned and Associate Businesses 2008 19
• Alliance Boots Minority owned Companies and Strategic Partnerships 19
• Alliance Boots Associates - Andreae-Noris Zahn AG (ANZAG) and Galenica A.G. 19
• Hedef Alliance Holding A.S. 20
• Alliance Healthcare Portugal 20
• Guangzhou Pharmaceuticals Corporation - China 20
• Unidrug Distribution Group (UDG) - UK 20
• Unifarma Distribuzione S.r.I. - Italy 20
  • Table 9 Alliance Boots Main Associate Companies 2009 21
• 2.2 Alliance Boots emerging Global Pharmaceutical Wholesaler and Distributor 21
  • Table 10 Alliance Boots Pharmaceutical Wholesale Market Share by European Country 2008/9 22
• 2.3 Alliance Boots Development of an International Brand of Generic Pharmaceuticals - Almus 23
• 2.4 Alliance Boots Pharmaceutical Retailing 24
  • Table 11 Alliance Boots European Retail Pharmacy Estate 2009 compared to 2006 24
• 2.4. The Future for Alliance Boots - Emerging Global Player 25
• Phoenix 27
• 3. Summary of Phoenix Business in Europe 27
• CERP Lorraine 28
  • Table 12 Phoenix Pharmaceutical Wholesaling Market Shares - Europe, % € Share 2008/9 29
• 3.1 Phoenix Tamro - Wholesale Pharmaceutical Distribution and Retail Pharmacy Chains in the Nordic and Baltic States region 29
• 3.2 Phoenix Pre-wholesaling in Europe 30
• 3.3 Phoenix in Pharmacy Retailing in Europe 30
  • Table 13 Phoenix Associated Groupings of Independent Pharmacies 2009 31
• MIDAS 31
• MVDA/Linda 31
• Numark 31
• Escura Apotheek in the Netherlands, Midas in Germany, SPEM in Italy and VMI in Denmark 31
• Apteeks 1, Seimos Vaistine and Aptieka 1 (renamed from Tamro Aptieku) 32
• 3.2 The Future for Phoenix Group in European Pharmaceutical Distribution 32
• 4. Summary of Sanacorp - CERP Rouen Merger 34
  • Graph 1: Millennium Combined Pharmaceutical Wholesale Market Share Resulting from the Merger of CERP Rouen France and Sanacorp Germany 2009 34
• 4.2 Conclusions Millennium (CERP Rouen and Sanacorp Merger) 35
• Mediq N.V. (previously named) OPG Groep N.V Netherlands 36
• 5. Summary of Mediq Business in Europe 36
• 5.1 Mediq N.V. (OPG Groep) Sources of Business 36
  • Table 14 Mediq N.V. Business Units and Sales Share 2009 36
• Mediq Pharmacy - Retail and Wholesale Pharmacy Operations in the Netherlands, Belgium and Poland 37
• Mediq Direct 37
• Mediq Institutional 37
• 5.2 Mediq NV Business Strategy 2007 to 2009 37
• 5.3 The Future Mediq (OPG Groep) Netherlands 38
• A.S. Watson Group 39
• 6. A.S. Watson Group Expansion of Pharmacy and Drugstores into Europe 39
• 6.1 A.S Watson in the Netherlands 39
• 6.2 A.S Watson in Germany, Poland, Hungary and the Czech Republic 40
• 6.3 A.S Watson in the Baltic Region 40
• 6.4 A.S Watson in the UK 41
• 6.5 A.S Watson in the Ukraine 41
• 6.6 A.S Watson in Russia 41
• 6.7 A.S Watson Global Buying Policy 42

Chapter 4

• New Channels for Consumer Access to Healthcare in Europe
• 1. Development of Internet Pharmacies in Europe - 2010 Report 1
• 1. 1 The Internet as a new Challenge in Pharmacy Retailing in Europe 3
• 1.2 Internet Pharmacy Development in Europe - The German Experience 4
• 1.3 Internet Applications to the Delivery of Primary Care Services in Europe 4
• 2. Business to Business Internet Applications in Pharmaceutical Distribution in Europe 6
• 2.1 Alliance Boots Internet Portal - dot Info in Europe 7
• 2.2 Celesio - Internet based Solutions for Pharmacies in Europe 7
• 3. Business to Consumer (B2C) Internet Pharmacy Retailing Applications in Europe 8
• 3.1 Internet Pharmacy Retailing Models in Europe Compared 8
• 3.2 ' Pureplay' Online Pharmacies in Europe 8
• 3.3 DocMorris Building a New Retail Pharmacy Brand in Europe 9
• 3.4 The Emergence of Healthcare Portals linked to ' Clicks and Bricks' Pharmacies in Europe 10
• 4. Opportunities for Business to Consumer e-Commerce for Pharmaceutical Companies in Europe 11
  • Table 1 Patients and Medical Professionals - Trust in Sponsored Healthcare Web sites Europe 12
  • Table 2 Online Commerce in Pharmaceuticals - Regulatory Status in Europe States Permitting Online Commerce - Revised 2009 13
• 5. Development of Internet Pharmacies in individual European States 14
• 5.1 Development of Internet Pharmacies in France 14
• 5.2 Development of Internet Pharmacies in Germany 15
• 5.3 Development of Internet Pharmacies in Italy 15
• 5.4 Development of Internet Pharmacies the Netherlands 16
• 5.5 Internet Pharmacies in Poland 17
• 5.6 Development of Internet Pharmacies in Switzerland 17
• 5.7 Consumers Access to Internet Pharmacies in the UK 18
• 5.8 Development of Internet Pharmacies in Sweden 19
• 5.9 Development of Internet Pharmacies in Denmark 19
• 5.10 Development of Internet Pharmacies in Finland and Norway 20
• 5.11 Development of Internet Pharmacies in Austria 20
• 5.12 Development of Internet Pharmacies in Belgium 21
• 5.13 Development of Internet Pharmacies in Spain 21
• 6. Development of Internet Pharmacies in Czech Republic, Hungary, Slovakia and Slovenia 22
• 6.1 Internet Pharmacies in Czech Republic 22
• 6.2 Internet Pharmacies Hungary 22
• 6.3 Internet Pharmacies Slovakia 22
• 6.4 Internet Pharmacies Slovenia 23
• 7. Evolution of the Legal Status of Mail Order and Internet Pharmacies for Medicines in Europe 23
• 8. The Future for Mail order and Internet Marketing of Non-prescription Medicines and OTC Self-medication in Europe 24

Chapter 5 OTC Distribution in Belgium

• 1. The Non-prescription and OTC Self-Medication Market in Belgium 2009 1
  • Graph 1: Belgium Total Self-medication Market 2005 - 2009 1
• 2. Share of the Belgian Self-medication Market by Category 2009 1
  • Table 1 Belgium - Self-Medication Market Category Share and Growth 2005 - 2009(est.) 2
• 3. Changing Structure of the Belgian Self-medication Market 2
  • Table 2 Leading OTC Self-medication Brands in Belgium 3
• 4. Professional or Semi-ethical Pharmaceutical Brands 3
• 5. Consumer OTC Self-medication Brands in Belgium 3
• 6. Classification of Medicines in Belgium 4
• 7. Reimbursement of Non-prescription Medicines in Belgium 4
• 8. Statutory Control of Prices on OTC Medicines in Belgium - New Cost Control Measures 2009 5
• 9. The Changing Business Environment for Non-prescription medicines in Belgium 5
• 10. Regulatory Environment for Pharmaceutical Distribution in Belgium 6
• 11. Structure of Distribution Channels for Self-Medication in Belgium 7
  • Figure 1: Outline Structure of OTC Pharmaceutical Distribution in Belgium 7
• 12. Trends in the Retail Pharmacy Sector in Belgium 7
  • Graph 2: Pharmacy Development Belgium 1997 - 2008 8
• 13. Retail Pharmacy Groupings in Belgium 8
  • Table 3 Types of Pharmacy - Belgium 2008 8
• 14. Pharmacy Co-operatives in Belgium 9
  • Table 4 Leading Cooperative Retail Pharmacy Groups - Belgium by Number of Pharmacies 2009 10
• 15. Retail Pharmacy Co-operatives' Strategies in Belgium 10
• 16. Celesio and Mediq (OPG) Retail Pharmacy Chains in Belgium 11
• 17. Independent Pharmacies in Belgium 11
• 18. Pharmacy Analysis of Turnover and Economics in Belgium 11
• 19. Trade Margins and VAT Manufacturer to Retail Pharmacy Price for Prescription and OTC Medicines in Belgium 12
• 20. Internet Pharmacies in Belgium 12
• 21. Restructuring of Pharmaceutical Wholesalers in Belgium 12
  • Table 5 Belgian Pharmaceutical Wholesalers' Market Shares 2008 13
• 22. The Future for OTC Medicine Distribution in Belgium 14

Chapter 6 OTC Distribution in France

• 1. The Self-Medication Market in France 2009 1
  • Graph 1: France Total Self-medication Market 2005 - 2009 1
• 2. Prescribing Medicines not requiring a Prescription remains big Business in France 2
  • Table 1 France - on Non-prescription Pharmaceutical and Self-Medication Markets Growth indices 2003 - 2009 est. (2003 = 100) 2
• 3. Share of the France Non-prescription Medicines and Self-medication Market by Therapeutic Category 2009 2
  • Table 2 France - Self-Medication Market Category Share and Growth 2005 - 2009 est. 3
• 4. Medicine Classifications in the French Prescription Pharmaceutical and Nonprescription OTC Medicines Markets 3
• 4.1 Classification of Medicines in France 3
• 4.2 Legal Definition of Non-prescription Medicines in France 3
• 5. Pharmacy Monopoly - Ownership Regulations in France Challenged by European Commission 4
• 6. Advertising Regulations for Non-prescription and OTC Medicines in France 4
• 7. Use of Trademarks for Medicinal Products in France 5
• 8. OTC Medicines Linkages to the Prescription Pharmaceuticals Sector in France 5
• 9. French Pharmaceutical Distribution - Price Control and Reimbursement Systems 5
• 10. Price Control - Prescription Medicines in France 6
• 11. Reimbursement Bands for Non-prescription Medicines in France 6
• 12. Scrutiny of the List of Pharmaceutical Products for Reimbursement in France 6
• 13. Generic Substitution Targets for Prescription Medicines imposed on French Pharmacies 7
• 14. Structure of Distribution for Self-Medication in France 8
• 15. Types of Non-prescription or OTC Medicine Brand in France 8
• 16. The Retail Pharmacy Channel in France 9
  • Figure 1: Outline Structure of OTC Pharmaceutical Distribution in France 9
• 17. Pharmacy Distribution by Region in France 10
  • Table 3 Number of Retail Pharmacies by Metropolitan Region in France 2009 10
• 18. Pharmacy - Virtual Chains and Buying Groups in France 11
  • Table 4 Leading Voluntary Groupings and Virtual Chains of Pharmacies in France 2009 11
• 19. Sources of Business Turnover and Economics of French Pharmacies 13
• 20. Consumer Attitudes towards Pharmacists in France 13
  • Table 5 Healthcare - Sources of Information French Consumers believe to be Important 14
  • Table 6 Self-medication - % of French Consumers Suffering Common Ailments Treating with an OTC Medicine 14
• 21. Potential for Internet Pharmacies in France 15
• 22. Prices and Margins of Non-prescription and OTC Medicines in France 16
  • Table 7 France - Price Build-up Reimbursed Pharmaceutical Products 2009 16
• 23. Non-Pharmacy Distribution in France of Consumer Healthcare Products in France 24. Pharmaceutical Wholesalers in France 17
  • Table 8 France - Pharmaceutical Wholesalers' Share of Market and Distribution 2008/2009 17
• Celesio France 18
• Alliance Healthcare (Alliance Boots) France 18
• CERP (Cooperative d' Exploitation et de Repartition) 19
• Phoenix 19
• Phoenix France 19
• 25. France - The Future for OTC Medicines 20

Chapter 7 OTC Distribution in Germany

• 1. The Self-Medication Market in Germany 2009 1
• Graph 1: Germany Total Non-prescription and OTC Self-medication Market 2005 - 2009 € 000 at Consumer Prices 1
  • Table 1 Germany - Impact of Act on the Modernization of Statutory Health Insurance (GMG) on Non-prescription Pharmaceutical and Self-Medication Markets 2
• Growth indices 2003 - 2009 est. (2003 = 100) 2
• 2. Share of the German OTC Self-medication Market by Category 2009 2
  • Table 2 Germany - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 3
• 3. The Structure of the German Non-prescription Bound Medicines and OTC Selfmedication Market 3
• 3.1 Changing Structure of the German Non-prescription and OTC Self-medication Medicines Market 3
• 4. The Regulatory Environment for OTC Self-medication Consumer Medicines in Germany 5
• 4.1 Self-Medication Definition in Germany 5
• 5. New Healthcare Reforms impacting on the Non-prescription OTC Selfmedication Medicines Sector in Germany 5
• 6. The Changing Regulatory Environment for the Distribution of Pharmaceutical Products in Germany 7
• 7. Prices and Margins of Non-prescription Pharmaceutical Products in Germany 7
  • Table 3 Average Wholesaler and Pharmacy Margins in Germany 8
• 8. Distribution Channels for OTC (non-prescription) Self-medication Medicines in Germany 8
  • Graph 2: Share of the German Non-prescription Medicines Market by Outlet Type - Pharmacy, Internet Pharmacy, Drugstore, Supermarket and Health Food Outlet (Reformhaus) 2008 9
• 8.1. The Changing Structure of the Retail Pharmacy Sector in Germany 10
  • Figure 1: Outline Structure of Non-prescription Pharmaceutical Distribution through Retail Pharmacies in Germany 10
  • Graph 3: Growth of Pharmacies in Germany 1995 to 2008 11
  • Table 4 Pharmacy Groupings - Analysis of Retail Pharmacy Numbers and Branch Ownership in Germany by Region 2008 compared to 2005 12
• 8.2 Pharmacy Turnover Analysis Germany 12
  • Table 5 Analysis of Pharmacy Turnover in Germany by Pharmacy Category 2008 compared to 2003 and 2005 13
• 8.3 Economic Impact on Pharmacy Retailing resulting from the 2004 Act to Modernise the Statutory Health Insurance System in Germany 13
  • Graph4: German Retail Pharmacies - Euro Turnover Analysis 2008 compared to 2005 14
• 9. Development of Retail Pharmacy Chains in Germany 14
  • Table 6 The Principal Virtual Pharmacy Chains (Voluntary Pharmacy Groupings) and Wholesaler owned Franchise Concepts in Germany 2008 15
• 9.1 Wholesaler Sponsored Virtual Pharmacy Chains in Germany 16
• 9.2 Independent Apotheken Kooperation Groups in Germany 16
• 9.3 Weaknesses of Virtual Pharmacy Chains in Germany 16
• 9.4 Franchise Concept Pharmacy Chains in Germany 16
• 9.5 DocMorris - A Major Breakthrough in Pharmacy Franchise Concepts in Germany 16
• 9.6 Growth of Private Label Brands in Pharmacy Groups in Germany 17
• 10. Internet and Mail Order Distribution Channels for OTC Medicines in Germany 17
  • Table 7 Examples of Internet Online Pharmacies in Germany 19
• 11. Retail Competition from Internet and Mail Order Pharmacies in Germany 19
• 11.1 OTC Self-medication - Challenges for Internet and Mail Order Pharmacy Distribution in Germany 20
• 12. Pharmaceutical Wholesalers Germany 20
  • Table 8 Analysis - Concentration of German Pharmaceutical Wholesalers 1981 - 2009 21
  • Table 9 Analysis - German Pharmaceutical Wholesalers' % Market Shares in 2008 compared to 1995 22
• 12.1 Pharmaceutical Wholesaler Strategies - Key Themes in a Changing Business Environment in Germany 22
• 13. Pharmaceutical Wholesalers Customer Strategies in Germany 24
  • Graph 5: Trends - German Pharmaceutical Wholesaler % Margins - Prescription Only Medicines 2001 - 2008 25
• 14. Free sale or General Sale List (GSL) OTC Self-medication Medicines through Non-Pharmacy Channels in Germany 25
• 14.1 Drugstores in Germany 26
• 14.2 Independent Drugstores in Germany 26
• 14.3 Multiple Drugstore Retailers in Germany 26
• 14.4 Health food Shops in Germany 26
• 15. Consumer Uses, Acquisition of Information, Sources Purchase and Attitudes to OTC Self-medication in Germany 27
  • Table 10 % Ailments and Conditions Treated with OTC Medication in Germany Compared to the USA and other Major Nationalities 28
  • Table 11 % Population Suffering Conditions Compared to % Treating with OTC Self-medication Remedies in Germany 29
  • Table 12 % Main Sources of Information for Population Treating Minor Health Conditions in Germany 30
• 15.1 OTC Self-medication Users Most Frequent Source of Purchase in Germany 30
  • Graph 6: OTC Self-medication Users Most Frequent Source of Purchase in Germany 31
• 16. Conclusions - Themes of Change Driving the Restructuring of the OTC Selfmedication and non-prescription Market in Germany 31
• 16.1 Vertical Integration within the Pharmaceutical Supply Chain - Continuing leadership by Pharmaceutical Wholesalers in Germany 33

Chapter 8 OTC Distribution in Italy

• 1. Introduction - The Non-prescription Pharmaceutical and OTC Self-medication Market in Italy 1
  • Graph 1: Italy Total Non-prescription and Self-medication Market 2005 - 2009 1
• 2. Share of the Italian OTC Self-medication Market by Category 2009 2
  • Table 1 Italy - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 2
• 3. Classification of Medicines in Italy - Prescription only, Non-prescription and OTC Medicines 2
• 3.1 Medicine Classification and the Structure of the Italian Non-prescription and OTC Self-medication Market 2
• 3.2 Definition of Non-prescription OTC Medicines in Italy 3
• 3.3 Reimbursement of Pharmaceutical Products not requiring a Prescription (nonprescription medicines) in Italy 3
• 3.4 Non-prescription Status does not automatically mean OTC (farmaco di automedicazion) Status in Italy 4
• 4. Structure of the Non-prescription OTC Medicines Market in Italy 4
  • Table 2 Structure of the Italian Non-prescription Bound and OTC Medicines Market 5
• 5. Price Controls - Non-prescription and OTC Self-medication Medicines in Italy 5
• 6. Changes to the Regulatory Environment for Pharmaceutical Distribution Italy 5
• 6.1 Self-service Merchandising of OTC Medicines in Italy 6
• 7. Partial Deregulation of Retail OTC Medicine Supply through Non-pharmacy Channels in Italy 7
• 8. Regulations Covering Wholesaling of Pharmaceuticals in Italy 8
• 9. Prices and Margins of Non-prescription Pharmaceuticals in Italy 9
• 10. The Importance of Pharmacies in the Retail Distribution of Non-prescription Pharmaceuticals in Italy 9
• 11. Growth and Distribution of Retail Pharmacies in Italy 10
  • Table 3 Growth in Number of Public and Private Pharmacies and Populations served compared by Region in Italy 2006 - 2008 11
• 11.1 Community Pharmacy Density by Region in Italy 11
  • Table 4 Pharmacy Density compared to Population Density by Region in Italy 2008 12
• 12. Retail Pharmacy Chains in Italy 12
  • Table 5 Retail Pharmacy Chains in Italy 2008 13
• 13. Analysis of Italian Pharmacy Turnover by Merchandise Category 14
  • Graph 2: Italy - Estimates of Pharmacy Turnover by Category 2008 14
• 13.4 Italian Pharmacists' Attitudes to Self-Medication 15
• 14. Non-pharmacy Distribution of Non-prescription OTC Medicines for Selfmedication in Italy 15
• 14.1 Non-pharmacy Retail Sales for Non-prescription OTC medicines in Italy 16
  • Graph 3: Italy - Sales of Non-prescription OTC Self - medication through Mass Market Retail Channels 2006 - 2009 16
• 15. The Future for Parapharmacy Outlets (sanatoria), Supermarket based Nonpharmacy Channels and Pharmacy Distribution of OTC Medicines in Italy 16
• 16. Mail order and Internet Pharmacies in Italy 17
• 17. Consumer Uses and Attitudes to OTC Self-medication in Italy 18
  • Table 6 % Ailments and Conditions Treated with OTC Medication in Italy Compared to the USA and other Major Nationalities 18
  • Table 7 % Population Suffering Conditions Compared to % Treating with OTC Self-medication Remedies in Italy 19
  • Table 8 % Main Sources of Information for Population Treating Minor Health Conditions in Italy 20
• 18. Pharmaceutical Wholesalers Italy 20
  • Table 9 Leading Pharmaceutical Wholesalers Market Share in Italy 2008 21
• 18.1 Phoenix - Comifar Group Italy 21
• 18.2 Alliance Healthcare Italia (Alliance Boots) 22
• 18.3 Farmintesa 22
• 18.4 Unico 23
• 18.4 Celesio Italy 23
• 19. The Future for OTC Distribution in Italy 24
• 19.1 The Future for Pharmacy Ownership in Italy 24
• 19.2 The Future for Parapharmacy (sanatoria) and Non-pharmacy Distribution of OTC Medicines in Italy 24
• 19.3 Future Growth of Parapharmacy Retail Channels in Italy 25
• 19.4 The Future for Pharmaceutical Wholesalers in the Distribution of OTC Medicines in Italy 26
• 19.5 Pharmacists' Attitudes to OTC Self-medication in Italy 26

Chapter 9 OTC Distribution in the Netherlands

• 1. The Non-prescription Medicines and OTC Self-Medication Market in the Netherlands 2009 1
  • Graph 1: The Netherlands Total Self-medication Market 2005 - 2009 1
• 2. Share of the Dutch OTC Self-medication Market by Category 2009 2
  • Table 1 The Netherlands - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 2
• 3. Classification of Non-prescription Pharmaceutical Products in the Netherlands - New Three-class System includes General Sale List (GSL) and Pharmacy only Medicines. 2
• 3.1 Criteria for Non-prescription Medicines classified as AV - General Sale (GSL) in the Netherlands 3
• 4. Reimbursement of Non-prescription Medicines in the Netherlands 4
• 5. Regulations to Abolish Price Fixing of OTC Medicines in the Netherlands 4
• 6. Structure of Distribution for Non-prescription Medicines and OTC Self-Medication in the Netherlands 4
• 6.1 Pharmacy and Non-pharmacy Retail Channels for Non-prescription Medicines and OTC Self-medication in the Netherlands 5
  • Graph 2: The Netherlands - Analysis % Retail Channel Category Share of OTC Selfmedication by Pharmacy, Druggist and Supermarket 2008 6
  • Table 2 Average Turnover of OTC Medicines by Retail Channel in the Netherlands 2008 compared to 2006 7
  • Sources: Neprofarm/IMS Consumer Health 2006/8/calc. James Dudley Management 7
• 7. Drugstores Retailing Non-prescription Medicines and OTC Self-medication in the Netherlands 7
• 7.1 Declining Drugstore Sector (Druggists) in the Netherlands 8
  • Graph 3: Analysis - Growth of Pharmacies and Decline in Drugstores (Druggists) Numbers in the Netherlands 2001 - 2008 8
• 8. Self-medication - Private Label Brands of OTC (non-prescription) Medicines Sales through Drugstores in the Netherlands 9
• 9. Self-selection and Point of Purchase Merchandising for OTC Self-medication Medicines in Dutch Drugstores 9
• 10. Non-prescription Medicines and OTC Self-medication Sales through Grocery Outlets in the Netherlands 11
• 11. Retail Pharmacies - The Netherlands 11
  • Table 3 Main Pharmacy Chains in the Netherlands 2009 12
• 12. Consumer health on the net - OTC Self-medication - Mail Order Internet Pharmacies in the Netherlands 12
• 13. DocMorris international On-line Pharmacy Provider 13
• 14. Non-prescription Medicines and OTC Self-medication Channel Influences on Consumer Sources of Purchase and Choice of Brand for Self-medication in the Netherlands 13
• 15. Pharmaceutical Wholesalers in the Netherlands 14
  • Table 4 Market Shares of Pharmaceutical Wholesalers the Netherlands 2009 14
• 16.1 Dutch Pharmaceutical Wholesalers - Pharmacy Groupings Analysis 15
  • Table 5 Pharmaceutical Wholesaler Pharmacy Chains Development in the Netherlands 2003 - 2008 16
  • Table 6 Pharmaceutical Wholesalers Virtual Pharmacy Chains and Franchised Outlets in the Netherlands 2009 16
• 16. Wholesaler Private Label OTC (non-prescription) Medicine Brands in the Netherlands 17
• 17. Conclusions - The Future for OTC Self-medication Distribution in the Netherlands 17

Chapter 10 OTC Distribution in Spain

• 1. Introduction - The Spanish OTC Medicines Market 1
  • Graph 1: Spain Total Self-medication Market 2005 - 2009 1
• 2. Impact of Health Reforms on Reimbursement of Non-prescription Pharmaceuticals in Spain 2005 to 2009 1
  • Table 1 Spain - Analysis of Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 2
• 3. Share of the Spanish OTC Self-medication Market by Category 2009 2
  • Table 2 Spain - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 2
• Structure of the Spanish Non-prescription and OTC Medicines Market 3
• 4. The Regulatory Environment for Non-prescription and OTC Medicines in Spain 3
• Classification of Medicines in Spain 3
• Registration of Non-prescription and OTC Medicines in Spain 4
• 5. Issues affecting the Prescription Sector for Products classified as Nonprescription Medicines in Spain 6
• 5.1 Reimbursement of Medicinal Products not requiring a Prescription in Spain 6
• 5.2 Pricing and Price Controls of Non-prescription and OTC Medicines in Spain 6
• 6. Advertising of OTC Medicines in Spain 7
• 6.3 Regulation of Trade Names for Non-prescription and OTC Medicines in Spain 7
• 7. The Regulatory Environment for Pharmaceutical Distribution in Spain 8
• 8. Structure of Distribution for Non-prescription Medicines and OTC Self-Medication in Spain 8
• 9. Growth of Pharmacies in Spain 8
  • Table 3 Growth of Pharmacies in Spain 1986 to 2008 9
• 10. Regulatory Controls on the Number of Pharmacies in Spain 9
• 10.1 Analysis of Pharmacy Numbers Compared to Population Density by Region in Spain 9
  • Table 4 Number of Pharmacies by Autonomous Community - Spain 10
  • Table 5 Analysis - Number of Pharmacies by Province Compared to Population Spain 2009 11
• 12. Analysis of Spanish Pharmacy Turnover 12
  • Table 5 % Share of Pharmacy Sales by Categories by Value - Spain 12
• 12.1 Pricing and Margins 12
• 13. Consumer Uses and Attitudes to OTC Self-medication in Spain 12
  • Table 6 % Ailments and Conditions Treated with OTC Medication in Spain Compared to the USA and other Major Nationalities 13
  • Table 7 % Spanish Population Suffering Conditions Compared to % Treating with OTC Selfmedication Remedies 14
  • Table 8 % Main Sources of Information for Population Treating Minor Health Conditions in Spain 15
• 14. Pharmaceutical Wholesalers in Spain 15
  • Table 9 Spain - Pharmaceutical Wholesaler Coverage - Number of Depots by Region and Number of Pharmacies Served 16
• 14.1 Leading Pharmaceutical Wholesalers in Spain - Market Shares and Strategies 17
  • Table 10 Spain - Pharmaceutical Wholesalers' Market Shares 2008 17
• 14.2 Cofares - Spain 17
  • Table 11 Cofares Group of Regional Companies - Spain 18
• 14.3 Alliance Boots Group - SA Farmaceutica Aragonesia (SAFA) 18
• 15. The Future for Pharmaceutical Wholesalers in Spain 19
• 16. The Future of OTC Distribution in Spain 19

Chapter 11 OTC Distribution in the UK

• 1. Introduction - The UK OTC Medicines Market 1
• 2. The Self-Medication Market in the UK 2009 1
  • Graph 1: The UK Total Self-medication Market 2005 - 2009 2
  • Table 1 The UK - Non-prescription Pharmaceutical and Self-Medication Markets Growth indices 2005 - 2009 est. (2005 = 100) 2
• 3. Share of the British OTC Self-medication Market by Category 2009 3
  • Table 2 The UK - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 3
• 4. Structure of the Market Demand for Non-prescription and OTC Medicines in the UK 3
• 5. The Regulatory Environment for Non-prescription and OTC Medicines in the UK 4
• 5.1 Classifications of Medicines in the UK 4
• 5.2 Legal Definitions of Non-prescription Medicines and OTC Self- Medication in the UK 4
• 6. Consumer Uses and Attitudes to OTC Self-medication in the UK 5
  • Table 3 % Ailments and Conditions Treated with OTC Medication in UK Compared to the USA and other Major Nationalities 6
  • Table 4 % Population Suffering Conditions Compared to % Treating with OTC Self-medication Remedies in the UK 6
• 7. Structure of Distribution Channel Systems for Non-prescription Pharmaceuticals and OTC Medicines in the UK 7
• 8. Consumer Source of Purchase and Share of UK OTC Medicines Market by Outlet Type 8
  • Table 5 Consumer Sources of Purchase for OTC Self-Medication by Channel in the UK 2006 8
• 9. The Retail Pharmacy Sector in the UK 9
• 9.1 New Role for Pharmacies in the UK - New Pharmacy Contract 9
• 9.2 Pharmacy Numbers compared to Population Density by Region in the UK 10
  • Table 6 Share of Pharmacies in the UK by Region 2009 11
• 10. Ownership of Pharmacies in the UK 12
  • Graph 2: Retail Pharmacy Groupings in the UK - Chain Stores and Independent Pharmacies 2009 12
• 11. Independent Pharmacies in the UK 13
• 11.2 ' Virtual' Chains of Pharmacies (Symbol Groups) in the UK 13
• Numark Phoenix (merged with Nucare) 13
• 11.3 Other Voluntary Pharmacy Groupings in the UK 14
• 12. Leading Pharmacy Chains in the UK 15
  • Table 7 Leading Pharmacy Chains and Number of Outlets in the UK 2009 15
• 12.1 Alliance Boots Pharmacy Chains in the UK 16
  • Table 8 Alliance Boots Pharmacy Chains and Number of Outlets in the UK 2009 17
  • Graph 3: Share of Boots Retail Turnover by Category 2008 19
• Boots online in the UK 19
• 12.2 Celesio Lloydspharmacy in the UK Lloydspharmacy online in the UK 20
• 12.3 Co-operative Group Pharmacy in the UK 20
• 12.4 L. Rowland (Phoenix) - Retail Pharmacy Chain in the UK 21
• 13. Independent and Regional Pharmacy Chains The Day Lewis Group 21
• 14. Regional Independent Retail Pharmacy Multiples in the UK 21
  • Table 9 Leading Regional Independent Pharmacy Multiples in the UK 2009 (Retail Pharmacy Chains with 30 to 100 branches) 22
• 15. Importance of Supermarket Chains and Discount Drugstores for OTC Selfmedication Distribution in the UK 22
  • Table 10 Number of Pharmacies Located in Leading Supermarket and Discount Drug Chains in the UK 2009 23
  • Graph 4: Leading Supermarket Groups % Share of the Grocery Market in the UK 2009 23
• 16. Internet as a Consumer Channel for Pharmaceuticals in the UK 24
• 17. Pharmaceutical Wholesaling in the UK 25
  • Table 11 Leading Pharmaceutical Wholesalers in the UK - 2008 25
• 18. Pharmaceutical Wholesaler Strategies in the UK - AAH Pharmaceuticals Celesio), UniChem (Alliance UniChem) and Phoenix 25
• 18.1 AAH Pharmaceuticals (Celesio) 25
• Wilkinson Healthcare 26
• Enterprise 26
• Trident 26
  • Table 12 Celesio Wholesale Turnover € Millions 2008 in the UK Turnover 26
• 18.2 Alliance Healthcare (UniChem Alliance Boots) 26
• Alliance Healthcare 27
• Cordia Healthcare 27
  • Table 13 Alliance Healthcare (UniChem) Turnover € Millions 2008 in the UK 27
• 18.3 Phoenix Healthcare Distribution UK 28
• 19. Conclusion Wholesaler Strategies in the UK 28
• 20. The Future for the Distribution of Non-prescription and OTC Medicines in the UK to 2013 29
• 20.1 Innovation to Compete for Consumer Access to Self-care will be driven by Retail Chains - both Pharmacy and Mass Market 30
• 20.2 New Models for Retailing Self-care Products and Services in the UK 30
• 21. OTC Manufacturers' Strategies in the UK 32
• 21.1 Category Management for OTC Medicine Manufacturers in the UK 32
• 21.2 Category Management Criteria for OTC Medicines Manufacturers in the UK 33

Chapter 12 OTC Distribution in Austria & Switzerland

• 1. The Self-Medication Market in Austria 2009 1
  • Graph 1: Austria - Total Licensed Non-prescription Medicines and OTC Self-medication Market 2005 - 2009 1
• 2. Share of the Austrian OTC Self-medication Market by Category 2009 2
  • Table 1 Austria - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 2
• 3. The Regulatory Environment for OTC (non-prescription) Medicines in Austria 2
• 3.1 Classification of Medicines in Austria 2
• 3.2 Registration of Non-prescription OTC Medicines in Austria 4
• 3.3 Regulations covering the Distribution of Non-prescription OTC Medicines in Austria 4
• 3.4 Regulations covering the Control of Retail Pharmacies in Austria 4
• 3.5 Regulations covering Pricing of Non-prescription Medicines and OTC Selfmedication in Austria 5
• 4. Reimbursement of Medicines in Austria including Non-prescription Pharmaceutical Products 5
• 5. Regulations covering the Advertising of OTC (non-prescription) Medicines in Austria 6
• 6. The Distribution Environment for Non-prescription Medicines OTC Selfmedication in Austria 7
• 6.1 The Retail Pharmacy Environment for Non-prescription Medicines OTC Selfmedication in Austria 7
  • Table 2 Austria - Number of Retail Pharmacies, Pharmacy Branches and Dispensing Doctors by Federal State 2008 7
• 6.2 Analysis of Retail Pharmacy Turnover in Austria 8
• 7. Prices and Margins for Non-prescription Medicines and OTC Self-medication in Austria 8
• 8. Mail Order and Internet Pharmacies in Austria 8
• 9. Pharmaceutical Wholesalers in Austria 9
• 9.1 Ownership of Pharmaceutical Wholesalers in Austria 9
• 10. The Future for OTC Distribution in Austria 9
• 11. The Self-Medication Market in Switzerland 2009 11
  • Graph 2: Switzerland Total Self-medication Market 2005 - 2009 11
  • Table 3 Switzerland - Non-prescription Pharmaceutical and Self-Medication Markets Growth indices 2005 - 2009 est. (2005 = 100) 12
• 12. Share of the Swiss OTC Self-medication Market by Category 2009 12
  • Table 4 Switzerland - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 12
• 13. The Regulatory Environment for OTC Medicines in Switzerland 13
• 13.1 Classification of Medicines in Switzerland 13
• 13.2 Pharmaceutical Product Classifications in Switzerland 13
• 13.3 Registration of OTC Medicines in Switzerland 14
• 13.4 Regulations covering the Distribution Non-prescription Medicines OTC Selfmedication in Switzerland 15
• 13.5 Regulations covering Retail Pharmacy or Drugstore Ownership in Switzerland 15
• 13.6 Pricing of Non-prescription Medicines OTC Self-medication in Switzerland 15
• 13.7 Regulations covering the Advertising of OTC (non-prescription) Medicines in Switzerland 16
• 13.8 Regulations covering the Use of Trademarks of OTC (non-prescription) Medicines in Switzerland 16
• 14. Healthcare Reforms in Switzerland and their Impact on the Swiss OTC Pharmaceuticals Industry 17
• 15. The Distribution Environment for Non-prescription Medicines and OTC Selfmedication in Switzerland 18
• 16. Non-prescription Medicines OTC Self-medication in Retail Pharmacies in Switzerland 18
• 16.1 Galenica Pharmacy Chain Switzerland 19
• 16.2 Other Pharmacy Groups 19
• 17. Sources of Pharmacy Turnover Switzerland 19
• 18. Mail Order and Internet Pharmacies in Switzerland - Self-medication on the Net - Swiss Pharmacies engaged in e-commerce 20
• 18.1 MediService - Swiss Distance Pharmacy Concept 20
• 18.2 Zur Rose Versandapotheke - Internet Pharmacy in Switzerland 21
• 19. Distribution of OTC (non-prescription) Medicines through Drugstores in Switzerland 21
  • Table 5 Leading Drugstore Groupings in Switzerland - 2009 22
• 20. Prices and Margins of OTC Medicines in Switzerland 22
• 21. Swiss Pharmaceutical Wholesalers 23
  • Table 6 Leading Swiss Pharmaceutical Wholesalers 23
• 22. The Future for OTC Distribution in Switzerland 23

Chapter 13 OTC Distribution in the Nordic Region Sweden, Denmark, Finland and Norway

• 1. The Self-Medication Market in Sweden 2009 1
  • Graph 1: Sweden - Total Self-medication Market 2005 - 2009 1
• 2. Share of the Swedish OTC Self-medication Market by Category 2009 2
  • Table 1 Sweden - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 2
• 3. The Regulatory Environment for OTC Medicines in Sweden 2
• 3.1 Classification of Medicines in Sweden 2
• 3.2 Marketing Authorisation of Non-prescription Medicines and OTC Selfmedication in Sweden 3
• 3.3 Regulations covering the Distribution of OTC Medicines in Sweden 3
• 3.4 Pricing of Prescription and Non-prescription OTC Medicines in Sweden 4
• 4. Reimbursement of Non-prescription Medicines in Sweden 4
  • Table 2 Reimbursement Rates for Swedish Patients 5
• 4.1 The Pharmaceutical Benefits Board (LFN) Medicines Review Sweden 6
• 4.2 Advertising Regulations for Non-prescription and OTC Self-medication Medicines in Sweden 6
• 4.3 Use of Trademarks for OTC Self-medication Medicines in Sweden 7
• 5. Distribution Channels for Non-prescription OTC Self-medication Medicines in Sweden 7
• 5.1 Privatisation and Restructuring of Retail Pharmacy Channels in Sweden
• 5.2 Main Players building and acquiring Pharmacy Chains in Sweden 8
• 5.3 Self-service of OTC Medicines in Swedish Pharmacies 9
• 5.4 The Introduction of General Sale List of Non-prescription Medicines and OTC Self-medication for non Pharmacy Channels in Sweden 9
• 6. Changing Structure of Pharmaceutical Wholesalers in Sweden 9
• 7. Mail Order Internet and Distance Selling of Non-prescription Medicines and OTC Self-medication in Sweden 10
• 8. Introduction - The Danish Non-prescription Medicines and OTC Selfmedication Market 11
  • Graph 2: Denmark - Development of the Total Non-prescription OTC Self-Medication Market at Consumer Prices euro-millions 2005 - 2009 11
• 9. Sales Split of Key Categories of OTC Medicines in Denmark 12
  • Table 3 Denmark Total OTC Self Medication Sales - Split by Major Category (Value) 2009 12
• 10. The Regulatory Environment for OTC Self Medication Medicines in Denmark 12
• 10.1 Classification of Medicines in Denmark 12
• 10.2 Registration of OTC Self-medication Medicines in Denmark 13
• 11. Regulations for the Distribution of Non-prescription Medicines and OTC Selfmedication Consumer Medicines in Denmark 14
• 11.1 Regulations for the Distribution of Pharmacy Only Non-prescription Medicines and OTC Self-medication Consumer Medicines in Denmark 15
• 11.2 Regulations covering Internet and Distance Selling of OTC Medicines in Denmark15
• 12. Pricing Regulations for OTC Medicines in Denmark 15
• 13. Advertising Regulations for OTC Self-medication Consumer Medicines in Denmark 16
• 13.1 Rules Applying to TV Advertising of OTC Medicines in Denmark 16
• 13.2 Rules Applying to Radio Advertising of OTC Medicines in Denmark 17
• 13.3 Rules Applying to Print Advertising of OTC Medicines in Denmark 17
• 14. Trade Margins / VAT for Pharmaceuticals in Denmark 17
• 15. Rules Covering Use of Trademarks for Pharmaceuticals in Denmark
• 16. The Distribution Environment for Non-prescription Medicines and OTC Selfmedication Consumer Medicines in Denmark 18
  • Table 4 Types of Outlet Distributing Non-prescription Medicines and OTC Self-medication in Denmark 18
• 16.1 Non-prescription Medicines and OTC Self-medication Consumer Sales through Retail Pharmacies in Denmark 18
• 16.2 Non-prescription Medicines and OTC Self-medication Sold through Non-Pharmacy Outlets in Denmark 19
• 16.3 Non-prescription Medicines and OTC Self-medication Consumer Medicines - Distance Selling through Mail order and Internet Pharmacies in Denmark 19
• 17. Restructuring of Pharmaceutical Wholesalers' Network in Denmark
• 18. The Self-Medication Market in Finland 2009 21
  • Graph 3: Finland - Total Self-medication Market 2005 - 2009 21
• 19. Share of the Finish Non-prescription Medicines and OTC Self-medication Market by Category 2009 21
  • Table 5 Finland - Non-prescription Medicines and OTC Self-medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 22
• 20. The Regulatory Environment for OTC Medicines in Finland 22
• 20.1 Registration and Classification of Medicines in Finland 22
• 20.2 Registration of OTC Medicines in Finland 23
• 20.3 Patient Information Requirements in Finland for OTC Medicines 24
• 21. Regulations for the Distribution of OTC Medicines in Finland 24
• 22. Pricing Regulations for OTC Medicines in Finland 25
• 23. Advertising Regulations for OTC Self-medication Medicines in Finland 25
• 24. Trade Margins / VAT for OTC Medicines in Finland 26
• 25. Use of Trademarks for OTC Self-medication Consumer Medicines in Finland 27
• 26. Customer Information Channels for OTC Self-medication Consumer Medicines in Finland 27
• 27. The Distribution Environment for Non-prescription Medicines and OTC Selfmedication Consumer Medicines in Finland 28
• 27.1 Pharmacies in Finland 28
• 27.2 Self-medication - Distance Selling through Mail Order and Internet Pharmacies in Finland 28
• 28. Sources of Pharmacy Sales Turnover in Finland 29
• 29. Restructuring of the Pharmaceutical Wholesaler Network in Finland 29
• 30. Introduction - The Norwegian Non-prescription Medicines and OTC Selfmedication Consumer Market 30
  • Graph 4: Norway - Development of the Pharmaceutical Non-prescription OTC Self-medication Market in Retail Pharmacy and Non-pharmacy Channels 2005 - 2009 - (Consumer Prices euro millions) 30
• 31. Sales Split of the Main OTC Self-medication Consumer Medicine Categories in Norway 30
  • Table 6 Norway Total OTC Self-Medication Sales - % Split by Major Therapeutic Category (Value) 2008 31
• 32. The Regulatory Environment for OTC Medicines in Norway 31
• 32.1 Classification of Medicines in Norway 31
• 32. 2 Marketing Authorization of OTC Medicines in Norway 32
• 32.3 Regulations for the Distribution of OTC Medicines in Norway 32
• 32.4 Deregulation to allow Retail Pharmacy Chains in Norway 33
• 32.5 Pricing Regulations for Non-prescription Medicines and OTC Self-medication in Norway33
• 32.6 Advertising Regulations for OTC Medicines in Norway 34
• 33. Trade Margins and VAT for OTC Medicines in Norway 35
• 34. Rules Covering Use of Trademarks for Pharmaceuticals in Norway 35
• 35. Channels of Distribution for Non-prescription Medicines and OTC Selfmedication in Norway 35
• 35.1 Pharmacy and Non-pharmacy Outlets for Non-prescription Medicines and OTC Self-medication in Norway 36
  • Table 7 Retail Outlets Selling Non-prescription OTC Medicines for Self-medication in Norway 36
• 35.2 Development Retail Pharmacy Chains in Norway 36
  • Table 8 Market Shares Leading Retail Pharmacy Chains in Norway 2008 36
• 36. Grocery Distribution and other Non-pharmacy Retail Channels Distributing Non-prescription Medicines and OTC Self-medication in Norway 37
  • Table 9 History of Non-pharmacy Retail Distribution of General Sale List (GSL) OTC Medicines in Norway 37
• 38. GSL OTC Self-medication - Non-pharmacy Retail Distribution in Norway 37
  • Table 10 Consumption of Leading OTC Medicines Purchased from Non-Pharmacy Channels in Norway 2008 38
• 38.1 Self-medication - Distance Selling through Mail order and Internet Pharmacies in Norway 38
• 39. Pharmaceutical Wholesalers in Norway 39

Chapter 14 OTC Distribution in Central & Eastern Europe Poland, Hungary, Czech Republic, Slovakia and Slovenia

• 1. The Non-prescription Medicines and OTC Self-medication Market in Poland 2009 1
  • Graph 1: Poland Total Non-prescription Medicines and OTC Self-medication Market at Consumer Prices € millions 2005 - 2009 2
• 2. Share of the Polish Non-prescription Medicines and OTC Self-medication Market by Category 2009 2
  • Table 1 Poland - Non-prescription Medicines and OTC Self-medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 2
• 3. Non-pharmacy and Mass Market Channels for Non-prescription OTC Medicines and Supplements in Poland 3
• 4. The Regulatory Environment for Non-prescription and OTC Self-medication Medicines in Poland 3
• 4.1 Classification of Medicines in Poland 3
• 4.2 Marketing Authorization for Non-prescription and OTC Medicines in Poland 4
• 5. Regulations Governing Marketing and Distribution Channels for OTC Medicines in Poland 4
• 5.1 Pharmacy and Non-pharmacy Retail Channels for Non-prescription and OTC Medicines in Poland 4
• 5.2 Controls on Pricing and Margins of OTC Medicines in Poland 5
• 5.3 Advertising and Promotion of OTC Medicines in Poland 5
• 6. Changing Distribution Environment for Non-prescription OTC Self-medication Medicines in Poland 6
• 7. The Retail Pharmacy Environment for OTC Self-medication in Poland 6
• 7.1 Independent Retail Pharmacy Multiples in Poland 7
  • Table 2 The largest Independent Retail Pharmacy Chains in Poland 2009 8
• 7.2 Retail Pharmacy Developments by Supermarket Chains in Poland 8
• 8. Mail Order and Internet Pharmacies targeting Patients and OTC Selfmedication Consumers in Poland 9
• 8.1 "Clicks and Bricks" Second Generation online Pharmacy Concept in Poland 9
• 8.2 German online Pharmacies Targeting Poland Healthcare Consumers 10
• 9. Consumer Sources of Purchase Non-prescription OTC Medicines for Selfmedication in Poland 10
  • Graph 2: Consumer Sources of Purchase - Medicines in Poland 10
• 10. Main Pharmaceutical Wholesalers Supplying Pharmacies in Poland 11
  • Table 3 Analysis Leading Polish Pharmaceutical Wholesalers Representing 85% Wholesaler Pharmacy Market Share 2008/9 12
• 10.1 Torfarm the Leading Pharmaceutical Wholesaler in Poland 12
• 10.2 Polska Grupa Farmaceutyczna (PGF) Second Largest Pharmaceutical Wholesaler in Poland 13
• 10.3 Farmacol a Leading Pharmaceutical Wholesaler in Poland 13
• 10.4 ACP Pharma Dutch Pharmaceutical Wholesaler in Poland 14
• 10.5 CF Cefarm - State Owned Pharmaceutical Wholesaler in Poland CEFARM Pharmaceutical SA 15
• 10.6 Phoenix Pharma Polska 16
• 11. Role of Pharmaceutical Wholesalers in Poland 16
• 12. The Self-Medication Market in Hungary 2009 17
  • Graph 3: Hungary Total Self-medication Market 2005 - 2009 17
• 13. Share of the Hungarian OTC Self-medication Market by Category 2009 17
  • Table 4 Hungary - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 18
• 14. The Regulatory Environment for OTC Self-medication Medicines in Hungary 18
• 14.1 Directives 18
• 14.2 Medicines' Classification in Hungary 19
• 14.3 Marketing Authorization of Non-prescription Medicines and OTC Selfmedication in Hungary 19
• 14.4 Regulations for Distribution of Non-prescription Medicines and OTC Selfmedication in Hungary 20
• 14.5 Pricing of Non-prescription Medicines and OTC Self-medication in Hungary 20
• 14.6 Resale Price Maintenance Pharmaceutical Products in Hungary 20
• 14.7 Regulations on Advertising OTC Medicines in Hungary 21
• 14.8 Trade Margins / VAT on Pharmacy Medicines in Hungary 22
  • Table 5 Average Wholesaler and Pharmacy Margins in Hungary 2009 22
• 14.9 Use of Trademarks for OTC Medicines in Hungary 22
• 15. The Distribution Environment for Non-prescription Medicines and OTC Selfmedication in Hungary - Pharmaceutical Wholesalers in Hungary 22
  • Table 6 Market Shares of the Main Pharmaceutical Wholesalers in Hungary 2008 23
• 15.1 Hungaropharma the Leading Pharmaceutical Wholesaler in Hungary 23
• 15.2 Gyongy Patek - Strategic Retail Pharmacy Partnership in Hungary 23
• 15.3 Phoenix Wholesaling in Hungary 24
• 15.4 Medimpex - Gideon Richter and Egis Jointly owned Pharmaceutical Wholesaler in Hungary 24
• 16. Retail Pharmacies - Developments in Hungary 1990 - 2009 24
• 16.1 Growth of Retail Pharmacy Chains in Hungary 1990 - 2009 24
• 17. General Sales List (GSL) for OTC Self-medication Medicines in Hungary 25
• 18. The Self-Medication Market in the Czech Republic 2009 26
  • Graph 4: Czech Republic - Total Self-medication Market 2005 - 2009 26
• 19. Share of the Czech OTC Self-medication Market by Category 2009 26
  • Table 7 Czech - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 27
• 20. The Regulatory Environment for Non-prescription Medicines and OTC Selfmedication in the Czech Republic 27
• 20.1 Medicine Classifications in the Czech Republic 27
• 20.2 Registration of Non-prescription Medicines and OTC Self- medication in the Czech Republic 28
• 21. Regulations Governing Marketing and Distribution Channels for OTC Medicines in the Czech Republic 30
• 21.1 Permitted Retail Channels for OTC (non-prescription) Self-medication Medicines in the Czech Republic 30
• 21.2 Pharmacy Ownership and Self-service Regulations for Non-prescription Medicines and OTC Self-medication in the Czech Republic 30
• 21.3 Pricing of Non-prescription Medicines and OTC Self-medication in the Czech Republic 30
• 21.4 Regulations on Advertising Non-prescription Medicines and OTC Selfmedication in the Czech Republic 32
• 21.5 Controls on Advertising of Non-prescription Medicines and OTC Self-medication in the Czech Republic 33
• 21.6 Patient Information Requirements for Non-prescription Medicines and OTC Self-medication in the Czech Republic 33
• 21.7 Use of Trademarks for Non-prescription Medicines and OTC Self-medication in the Czech Republic 33
• 22. The Distribution Environment for Non-prescription Medicines and OTC Selfmedication in the Czech Republic 34
• 22.1 Pharmaceutical Wholesalers in the Czech Republic 34
  • Table 8 € % Share Pharmaceutical Full Line Wholesalers in the Czech Republic 2008 34
• Phoenix Lekarensky Wholesale in Czech Republic 34
• Pharmos - Česka lekarnicka 35
• Alliance Healthcare Czech (Alliance Boots) 35
• GEHE Pharma Praha (Celesio) Czech 35
• 23. Growth of Pharmacies in the Czech Republic 36
  • Table 9 Czech Republic Growth in Numbers of Retail Pharmacies 1990 - 2005 36
• 23.1 Leading Pharmacy Chains in the Czech Republic 36
• Dr Max 36
• Lloyds s.r.o. 37
• Phoenix 37
• 23.2 Non-pharmacy Distribution in Czech Republic 37
• 23.3 Internet Pharmacies and Distance Selling of Pharmaceuticals in the Czech Republic 37
• 24. The Self-Medication Market in Slovakia 2009 38
  • Graph 5: Slovak Republic - Total Self-medication Market 2005 - 2009 38
• 25. Share of the Slovakian OTC Self-medication Market by Category 2009 38
  • Table 10 Slovakia - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 39
• 26. The Regulatory Environment for OTC Medicines in the Slovak Republic 39
• 26.1 Medicinal Classifications in the Slovak Republic 39
• 26.2 Marketing Authorization of OTC Medicines in the Slovak Republic 40
• 26.3 Regulations on the Distribution of OTC Medicines in the Slovak Republic 40
• 26.4 Pricing Regulations for OTC Medicines in the Slovak Republic 40
• 26.5 Reference Pricing System - Reimbursed Medicines in the Slovak Republic 41
• 26.6 Rules on Advertising OTC Medicines in the Slovak Republic 41
• 26.7 Advertising Controls on OTC Medicines in the Slovak Republic 42
• 26.8 Patient Information Requirements for OTC Medicines in Slovakia 42
• 27. Trade Margins for Prescription Medicines / VAT for OTC Medicines in Slovakia 42
  • Table 11 Slovak Republic - Prescription Pharmaceuticals' Trade Margins and VAT 42
• 28. Use of Trade Marks for OTC Medicines in Slovakia 43
• 29. The Distribution Environment for Non-prescription and OTC Self-medication Medicines - Slovak Republic 43
• 29.1 Pharmaceutical Wholesalers in Slovakia 43
• Phoenix Medical Supply 43
• Unifarma Prievidza 43
• 30. Retail Pharmacies and Pharmacy Chains in Slovakia 44
• 31. The Self-Medication Market in Slovenia 2009 45
  • Graph 6: Slovenia - Total Self-medication Market 2005 - 2009 45
• 32. Share of the Slovenia OTC Self-medication Market by Category 2009 45
  • Table 12 Slovenia - Self-Medication Market Share and Growth by Therapeutic Category 2005 - 2009 est. 46
• 33. The Regulatory Environment for Non-prescription Medicines and OTC Selfmedication in Slovenia 46
• 33.1 Directives 46
• 33.2 Medicinal Classifications in Slovenia 46
• 33.3 Authorization of Non-prescription Medicines and OTC Self-medication in Slovenia 47
• 33.4 Regulations on the Distribution of OTC Medicines in Slovenia 48
• 33.5 Pricing Controls on Non-prescription Medicines and OTC Self-medication in Slovenia 48
• 33.6 Rules on Advertising Non-prescription Medicines and OTC Self-medication in Slovenia 48
• 33.7 Patient Information Requirements for OTC Medicines in Slovenia 48
• 34. Trade Margins / VAT for OTC Medicines in Slovenia 49
  • Table 13 Slovenia - Pharmaceutical Trade Margins and VAT 49
• 35. The Distribution Environment for Non-prescription Medicines and OTC Selfmedication in Slovenia 49
• 35.1 Pharmacies in Slovenia 49
• 35.2 Internet Pharmacies and Distance Selling of Pharmaceutical Products in Slovenia 49
• 36. Pharmaceutical Wholesalers in Slovenia 50

Chapter 15 Conclusions of the Report Driving the Recovery - OTC Distribution in Europe

• 1. Growth trends and outline Prognosis for Europe' s Non-prescription OTC Selfmedication and Self-care Markets to 2013 1
  • Graph 1: Forecast of Sales of the Total Non-prescription Bound and OTC Self-medication market for 18 major Markets - € millions at Consumer Purchase Prices 2009- 2013 2
• 1.1 Growth Clusters by Country - European Non-prescription and OTC Selfmedication Market 2
  • Graph 2: Europe - 18 Country Markets % Growth Estimates compared for Nonprescription Medicines to 2013 3
• Europe -18 Country Study 4
• Prognosis and Key Issues for the Strategic Agenda by Country to 2013 4
  • Table 1(continued) 5
• Europe -18 Country Study 5
• Prognosis and Key Issues for the Strategic Agenda by Country to 2013 5
  • Table 1(continued) 6
• Europe -18 Country Study 6
• Prognosis and Key Issues for the Strategic Agenda by Country to 2013 6
• 2. Summary of the Main Factors Driving Change in Europe' s Non-prescription, Self-medication and Self-care Markets to 2013 6
• 2.1 The failure of the DocMorris case to change Europe' s Pharmacy Ownership rules 6
• 2.2 New Pharmacy Retail Model in European States not Permitting Retail Pharmacy Multiples 7
• 2.3 The Rapid Growth of Large ' Virtual' Pharmacy Chains - in Germany, Switzerland, the Netherlands, Hungary and Poland 8
• 2.4 Abolition of the Retail Pharmacy State Monopoly in Sweden 9
• 3. Refocusing of Strategies and Restructuring of Major Pharmaceutical Distributors Across Europe 10
• 3.1 New Model for the Major Pharmacy Distributors in Europe 10
• 3.2 Growth of General Sale Listing (GSL) of selective OTC medicines for Selfmedication across Europe - Influence of Major Mass Market Chains 10
• 3.3 Mass Market Retail Chains acquisition of Pharmacies Para-pharmacies and OTC Licenses in Europe 11
• 4. Competing in the Mass-Market - Implications for Brand Market Shares of OTC Self-medication Medicines in Europe 13
• 5. Unfolding development of Mail Order Internet Pharmacy in the European Union 14
• 6. De-Reimbursement of Non-Prescription Medicines in Europe 15
• 7. Developments in Poland, Hungary, Czech Republic, Slovakia, Slovenia 15
• 8. The Changing Consumer Healthcare Market - Estimating the Speed of Change by Exploring Regulatory Freedoms in Europe' s Main Markets for OTC Selfmedication Medicines 16
• 8.1 Main European States Ranked by Marketing Freedoms for OTC Medicines 17
  • Table 2 Europe' s Main OTC Medicines Markets Ranked by Marketing Freedoms 2009 compared to 2007 17
• 8.2 Main European States Ranked by Pharmacy Regulatory Freedoms 18
  • Table 3 Europe' s Main OTC Medicines Markets Ranked by Pharmacy Freedoms 2009 compared to 2007 18
• 8.3 Main European States OTC Medicines Markets Ranked by Total Regulatory Freedoms 18
  • Table 4 Europe' s Main OTC Markets Ranked by Total Freedoms 2009 compared to 2007 19
• 9. The Key Challenges to Non-prescription and OTC Self-medication Medicines Manufacturers in Europe to 2013 19
  • Figure 1: Increasing Competitive Intensity in a Changing Multi channel Supply Chain - Impacts on Consumer Healthcare Brands in Europe 20
• 10. Conclusions - Driving Recovery in the European Consumer Healthcare Market 20
  • Lessons learned over the 18 years and seven editions of this Study 20