Pharmaceutical Industry: Key Issues in Growth in Pakistan & International Market

© European Journal of Scientific Research, Vol. 93, No 1, 2012 ______________________________________________________________________________________ ______________________________________________________________________________________

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© FRDN Incorporated, 2012 Editor-In-Chief & Managing Editor: Adrian Marcus Steinberg, PhD 117, Orion Mall, Palm Street, P.O. Box 828, Victoria, Mahé, Seychelles Tel: +248 400138344 Fax: +248 400138345 European Journal of Scientific Research ISSN: 1450-216X / 1450-202X Vol. 93 (1): 234-249, December 2012 DOI: http://www.europeanjournalofscientificresearch.com/issues/EJSR_93_1.html

Pharmaceutical Industry Report - 2012 Pharmaceutical Industry: Key Issues in Growth in Pakistan &

International Market

Rizwan Raheem Ahmed Hamdard University, Karachi, PAKISTAN

1. Introduction

Pakistan has a very vibrant and forward-looking Pharma Industry. At the time of independence in 1947, there was hardly any pharma industry in the country. Today Pakistan has about 400 pharmaceutical manufacturing units including those operated by 25 multinationals present in the country. The Pakistan Pharmaceutical Industry meets around 70% of the country's demand of Finished Medicine. The domestic pharma market, in term of share market is almost evenly divided between the Nationals and the Multinationals (Ahmed & Saeed, 2012).

The National pharma industry has shown a progressive growth over the years, particularly over the last one decade. The industry has invested substantially to upgrade itself in the last few years and today the majority industry is following Good Manufacturing Practices (GMP), in accordance with the domestic as well as international Guidance. Currently the industry has the capacity to manufacture a variety of product ranging from simple pills to sophisticated Biotech, Oncology and Value Added Generic compounds (Aamir & Zaman, 2011).

Although Pakistan 's pharmaceutical and healthcare sectors are expanding and evolving rapidly, about half the population has no access to modern medicines. Clearly this presents an opportunity, but much more work needs to be done by the government and industry's stakeholders. The value of pharmaceuticals sold in 2007 exceeded US$1.4bn, which equates to per capita consumption of less than US$ 10 per year and value of medicines sold is expected to exceed US$2.3 B by 2012 (Ahmed et al., 2011).


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Pakistan is a developing pharmaceutical market, with a large population and economic progress evident, but per capita drug spending was rather low at around US$9.30 in 2007 (Ahmed & Jalees, 2008). Private spending accounts for 65% of total healthcare expenditure sourced through out-of pocket payments, international aid and religious or charitable institutions. Pharmaceutical spending accounts for less than 1% of the country's GDP, comparable to levels in some neighboring countries but above that in some of the South Asian countries (Federal Bureau of Statistics, 1997). The forecast period is likely to witness the marginal strengthening of the generics sector, albeit more in terms of volumes than values. The share of generics is also likely to increase further as major drugs come off patent in the near term, to the likely benefit of the generics-dominated local industry (Dr. Akhtar, 2006).

The Pakistan pharma industry is relatively young in the international markets with an export turnover of over US$ 100 Million as of 2007. Pakistan Pharma Industry boasts of quality producers and regulatory authorities all over the world approve many units. Like domestic market the sales in international market have gone almost double during last five years. The pharma industry is focusing to an Export Vision of USD 500 Million by 2013. In the meantime, exports are also likely to be boosted by new regional and global opportunities (Ahmed & Saeed, 2012).

The Pakistan Pharmaceutical Industry is a success story, providing high quality essential drugs at affordable prices to Millions. Technologically, strong and self reliant National Pharmaceutical Industry is not only playing a key role in promoting and sustaining development in the vital field of medicine within the country, but is also well set to take on the international markets (Kemal et al., 2002).

2. Pakistan overview The pharmaceutical industry is considered the backbone of public health services in Pakistan. This is strategically important both for the well being of the population in general and for the provision of good yet affordable healthcare in particular (Ahmed et al., 2012). The low cost of production and the huge potential of this sector has attracted major multinationals to establish their operations and production facilities in Pakistan (Trade Development Authority, 2000-02). Local (Pakistani) pharmaceutical companies started in the 1960s but their growth increased in the 1980s. During the last decade, they made substantial investments in production facilities and introduced the latest technology along with many new high quality products that were previously either unavailable or available on a limited scale at very expensive prices. By providing quality medicines at economical rates in this fashion, Pakistani pharmaceutical companies have contributed substantially towards public health (Kemal et al., 1997).


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The key to the success of Pakistani pharmaceutical companies is based on a simple formula, i.e. the production of high quality products at current Good Manufacturing Practices (cGMP)-compliant facilities and offering them at the most economical rates. Nearly all of Pakistan’s leading pharmaceutical companies has maintained high standards to ensure compliance of all operations of production and quality control under the cGMP guidelines. As a result, they are now successfully exporting their products to various international territories (TDAP, 2000). Top 25 national pharmaceutical companies are as follows: No. Company No. Company 1. Getz Pharma Pakistan (Pvt.) Ltd 14. Macter International (Pvt.) Ltd 2. Sami Pharmaceutical (Pvt.) Ltd 15. Brookes Pharmaceuticals Labs 3. Ali Gohar Pharmaceuticals 16. Himont Pharmaceuticals (Pvt.) Ltd 4. Werrick Pharmaceuticals 17. Ferozesons Laboratories Ltd 5. Hilton Pharma (Pvt.) Ltd 18. Indus Pharma (Pvt.) Ltd 6. Barrett and Hodgson Pakistan 19. Tabros Pharma 7. Wilsons Pharmaceuticals 20. Schazoo Laboratories (Pvt.) Ltd 8. Bosch Pharmaceuticals (Pvt.) Ltd 21. Highnoon Laboratories Ltd 9. Zafa Laboratories (Pvt.) Ltd 22. Atco Laboratories (Pvt.) Ltd 10. Global Pharmaceuticals 23. Remington Pharmaceutical 11. Platinum Pharmaceuticals 24. PharmEvo (Pvt.) Ltd 12. CCL Pharmaceuticals (Pvt.) Ltd 25. Amson Vaccines and Pharma 13. Nabiqasim Industries (Pvt.) Ltd * Included in IMS as a national company, although they have foreign shareholding and are a member of OCCI.

(Source: IMS, Q2, 2006) Top 10 multinational pharmaceutical companies No. Company No. Company 1. GSK 6. Novartis Pharma (Pakistan) Ltd 2. Sanofi Aventis 7. Bristol-Myers Squibb 3. Abbott Laboratories (Pakistan) 8. Pharmacia and Upjohn (Pvt.) Ltd 4. Merck Marker (Pvt.) Ltd 9. Parke-Davis 5. Roche Pharmaceuticals 10. Wyeth Pakistan Ltd Source: IMS, Q2, 2006


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3. Pakistani Pharmaceutical Sector: • $ 2.3 Billion Industry • 15.69% CAGR IN PKR, 9.98% IN US$ (IMSQ2, ‘12) • Total Domestic Investment of $ 500 Million • Foreign Direct Investment of $ 100 Million • The largest employer of University Graduates in Semi-urban and Rural Areas 4. Comparison with India Why Compare: 1. Part of tier 2 & 3 Pharmerging Countries 2. Similarities of market factors (Population, people behavior & economic conditions) 3. Medical Infrastructure 4. Prevalence, practices & treatment of diseases. 5. Growing markets with low cost of production like Pakistan 5. Industry Evolution –10 Years India vs. Pakistan 2002: • Indian Pharma’s Domestic Sales were $ 4 Billion • Pakistan Pharma’s Domestic Sales were $ 1.2 Billion

2012: • Indian Pharma Market croessed $ 16 Billion (300% Growth in a Decade or 18% per

annum) • Pakistan Pharma Market reached $ 2 Billion (66% Growth in a Decade or 4% per

annum)

6. History of Pharmaceutical Regulation in Pakistan: 1972: Drugs (Generics) Act passed prohibiting use of brand names/differentiation, instituting 100% controls on drug Pricing. 1976: Drugs Act 1976 Passed, allowing for use of Brand Names, but continuing with Draconian Price Controls on 100% of all Pharmaceutical Products. 2001: Last price increase Granted by the Ministry of Health to Manufacturers to allow for inflation, rise in cost of inputs


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2011: Devolution under the 18th Amendment led to dissolution of MoH, DRAP not Formed until Feb ’12, Shifted to new Division in April 12, Still not Fully Functional 7. Reasons for Stunted Growth of Pakistani Pharma Sector 1. Arbitrary Regulations: No price adjustments for inflation in a DECADE. 2. No Vitamin Policy, No policy for Over the Counter (OTC) Drugs. OTC drugs are a large segment for Big Pharma globally, adding to scale and profitability 3. Poor Domestic Regulation and weak government procurement policies that do not encourage investment in quality. 4. Energy Crisis Rendering Sector Uncompetitive. Electricity and Steam are the two Costliest Inputs. No R&D Grants or Tax Benefits to Pharma. No Support on Utilities 8. Global Pharmaceutical Industry and Trends 8.1 Global scenario The pharmaceutical industry in any country is considered as the mainstay of public health. Looking at the global scenario, the importance given by developing nations to the pharmaceutical sector can be clearly identified by including healthcare and pharmaceutical industry in their health and welfare strategy. The global pharmaceutical market is valued at no less than US$440 billon, with annual growth of 6% (Aday, 1996). Table 1: Major pharmaceutical companies.

Company HQ location

Revenue of pharmaceutical segment, mln USD

Total sales, mln USD

Share of pharmaceutical segment, %

Pfizer NY, U.S. 46,133 52,516 87.85% GlaxoSmithKline UK 31,434 37,324 84.22% Johnson & Johnson NJ, U.S. 22,190 47,348 46.87% Merck NJ, U.S. 21,494 22,939 93.70% AstraZeneca UK 21,426 21,426 100.00%

Novartis Switzerland 18,497 28,247 65.48%

Sanofi-Aventis France 17,861 18,711 95.46%


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Roche Switzerland 17,460 25,168 69.37%

Bristol-Myers Squibb NY, U.S. 15,482 19,380 79.89% Wyeth NJ, U.S. 13,964 17,358 80.45% Abbott IL, U.S. 13,600 19,680 69.11% Eli Lilly IN, U.S. 13,059 13,858 94.23% Takeda Japan 8,648 10,046 86.09% Schering-Plough NJ, U.S. 6,417 8,272 77.57% Bayer Germany 5,458 37,013 14.75% Source: 2004 Annual Reports of the companies

As Table above shows, the majority of the largest pharmaceutical companies are not diversified. They are either concentrated exclusively on pharmaceutical products (Eli Lilly and AstraZeneca are good examples with virtually 100% of their revenues coming from sales of pharmaceutical products). Table 2: Average 2004 exchange rates. Currency Exchange rate EUR / USD 1.2438 GBP / USD 1.8333 USD / JPY 108.1508 USD / CHF 1.2426 Source: calculated using Federal Reserve daily data

8.2 Industry Trends Several factors are worth mentioning. First, for almost all companies presented in the table, the pharmaceutical segment is the largest; and only for one of them, world giant Johnson & Johnson, sales of pharmaceutical segment are below 50% (Catlin et al, 2007). Table 3: Business segments of major U.S. pharmaceutical companies

Pfizer J&J Merck BMS Wyeth Lilly* Abbott Schering-Plough

Pharmaceutical 87.8% 46.9% 93.7% 80.0% 80.4% 94.2% 69.0% 77.6% Consumer Health & Nutritional products 6.7% 17.6% 10.0% 14.7% 13.1% Animal Health 3.7% 4.8% 5.8% 9.3% Medical Devices 35.5% 31.0%


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and Diagnostics Other Healthcare 10.0% Other 1.8% 6.3% Source: Annual Reports of the companies *In Financial statements Animal Health products are not stated as separate segment

Table 4: Top 5 pharmaceutical products for each company based on the sales in 2004

Sales, mln USD

% of total sales

Sales, mln USD

% of total sales

Pfizer Wyeth Lipitor $10,862 20.7% Effexor $3,347 19.3% Norvasc $4,463 8.5% Protonix $1,591 9.2% Zoloft $3,361 6.4% Prevnar $1,054 6.1%

Celebrex $3,302 6.3% Premarin family $880 5.1%

Neurontin $2,723 5.2% Zosyn / Tazocin $760 4.4%

J&J

Eli Lilly Procrit / Eprex $3,589 7.6% Zyprexa $4,420 31.9% Risperdal $3,050 6.4% Gemzar $1,214 8.8% Remicade $2,145 4.5% Humalog $1,102 8.0% Duragesic $2,083 4.4% Evista $1,013 7.3% Topamax $1,410 3.0% Humilin $998 7.2%

Merck

Schering-Plough Zocor $5,200 22.7% Remicade $746 9.0%

Fosamax $3,200 14.0% Clarinex / Aerius $692 8.4%

Cozaar $2,800 12.2% Nasonex $594 7.2% Singulair $2,600 11.3% Peg-intron $563 6.8% AZLP $1,500 6.5% Temodar $459 5.5%

BMS

Plavix $3,327 17.2% Pravachol $2,635 13.6% Taxol $991 5.1% Avapro / Avalide $930 4.8% Paraplatin $673 3.5%


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Chart 1: Liquidity analysis

Chart 2: Geographical distribution of sales, 2004

Source: Annual Reports of the companies

Liquidity ratios

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

1.80

2.00

Pfizer J&J Merck BMS Wyeth Eli Lilly Abbott Schering-Plough

Current Ratio CF from operations to Total Liabilities Debt-Equity Ratio

Geographical distribution of sales in 2004

58%68%

59% 55% 57% 55% 57%

39%

42%32%

41% 45% 43% 45% 43%

61%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pfizer J&J Merck* BMS Wyeth* Lilly Abbott* Schering-Plough*

USA International


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*No geographical distribution of pharmaceutical segment is available. Proportions calculated on geographical distribution of total sales.

Table 5: Sales dynamics of non-US pharmaceutical companies, 2002-2004

2002 2003 2004 GlaxoSmithKline 3.5% 1.1% -5.0% AstraZeneca 10.0% 5.6% 13.7% Novartis 11.3% 19.1% 13.6% Roche 1.0% 6.0% 0.2% Sanofi-Aventis 14.8% 8.1% 86.9% Takeda 4.3% 4.1% 3.9% Bayer -2.2% -3.6% 4.2% Source: calculations, data used from Annual Reports of the companies

Table 6: Total assets dynamics of non-US pharmaceutical companies, 2002-2004

2002 2003 2004 GlaxoSmithKline -0.1% -5.0% 6.5% AstraZeneca 16.7% 9.3% 8.7% Novartis 13.3% 9.5% 10.4% Roche -15.0% -7.0% -2.4% Sanofi-Aventis -5.1% 3.1% 687.3% Takeda 12.4% 4.8% 13.4% Bayer 12.6% -10.2% 1.0% Source: calculations, data used from Annual Reports of the companies

Bayer’s current acquisitions (seed treatment business and over-the-counter medicines) even further decreased its share of pharmaceutical segment. Major acquisitions of non-US pharmaceutical companies are summarized in Table 7. Table 7: Recent acquisitions by major non-US pharmaceutical companies

Company Company acquired*

Core business of target Purchase price

GlaxoSmithKline

Merger of Glaxo Wellcome and SmithKline Beecham

Megrer of two major pharmaceutical companies (registered in 2000)

-

Block Drug Oral care and over-the-counter medicines

843 mln GBP

AstraZeneca Merger of Astra and Zeneca

Megrer of two major -


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pharmaceutical companies (registered in 1999)

Novartis

Sabex

Generic manufacturer with a leading position in generic injectables

565 mln USD

Mead Johnson's adult nutrition business

Global adult medical nutrition 385 mln USD

Idenix Pharmaceuticals Inc

Biotechnology

255 mln USD + up to 357 mln USD in possible additional payments

Roche

Igen International Human in-vitro diagnostics 1,823 mln CHF

Disetronic

Insulin pumps and injection systems for the treatment of diabetes.

1,132 mln CHF

Sanofi-Aventis Merger of Sanofi-Synthelabo and Aventis

Merger of two major pharmaceutical companies (registered in 2004)

-

Bayer

Roche's over-the-counter business

Over-the-counter medicines 206 mln EUR

Gustafson Seed treatment 100 mln EUR

Source: Annual Reports of the companies *Acquisition of patents is not included in this table

Overall, as shown in Table 8, non-US pharmaceutical companies have approximately similar R&D costs as % of total sales to those of U.S. companies. Table 8: R&D costs as % of 2004 total sales 2001 2002 2003 2004 GlaxoSmithKline 12.5% 12.9% 12.9% 13.9% AstraZeneca 17.1% 17.2% 18.3% 17.7% Novartis 13.5% 13.6% 15.1% 14.9% Roche 13.3% 14.5% 15.3% 16.3% Sanofi-Aventis 15.9% 16.4% 16.4% 49.6% Takeda 9.3% 10.0% 11.9% 11.9% Bayer 8.5% 8.7% 8.4% 7.1%


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Source: Annual Reports of the companies To calculate this ratio R&D costs and revenues for all business segments of the company were used

Table 9: Top 5 pharmaceutical products based on the sales in 2004

GlaxoSmithKline

Sales, mln GBP

% of total sales

Sales, mln USD Roche

Sales, mln CHF

% of total sales

Sales, mln USD

Seretide / Advair

£2,461

12.1%

$4,512

MabThera / Rituxan

CHF 3,378

10.8%

$2,719

Avandial / Avandamet

£1,116 5.5%

$2,046

NeoRecormon, Epogin

CHF 2,082 6.7%

$1,676

Paxil £1,063 5.2%

$1,949

Pegasys + Copegus

CHF 1,562 5.0%

$1,257

Zofran £763 3.7% $1,399 Herceptin

CHF 1,435 4.6%

$1,155

Wellbutrin £751 3.7% $1,377 CellCept

CHF 1,403 4.5%

$1,129

AstraZeneca

Sales, mln USD

% of total sales

Sanofi-Aventis

Sales, mln EUR

% of total sales

Sales, mln USD

Nexium $3,883

18.1% Lovenox

€ 1,904

12.7%

$2,368

Seroquel $2,027 9.5% Plavix

€ 1,694

11.3%

$2,107

Losec / Prilosec

$1,947 9.1% Allegra

€ 1,502

10.0%

$1,868

Seloken $1,387 6.5% Taxotere

€ 1,436 9.5%

$1,786

Pulmicort $1,050 4.9% Stilnox

€ 1,423 9.5%

$1,770

Novartis

Sales, mln USD

% of total sales Bayer

Sales, mln EUR

% of total sales

Sales, mln USD

Diovan / Co-Diovan

$3,093

10.9%

Ciprobay / Cipro € 837 2.8%

$1,041

Gleevec/Glivec

$1,634 5.8% Adalat € 670 2.3% $833

Lamisil $1,16 4.1% Ascensia € 627 2.1% $780


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2

Zometa $1,078 3.8% Aspirin € 615 2.1% $765

Neoral / Sandimmun

$1,011 3.6% Kogenate € 563 1.9% $700

Source: Financial reports of the companies Sales are provided in the currency of financial reports; conversion of sales into USD was made for comparison purposes

Table 10: Profitability analysis

2002 2003 2004 GlaxoSmithKline ROA 17.6% 20.6% 19.7% Profit margin 18.5% 20.9% 21.1% Total Assets Turnover Ratio 0.95 0.99 0.93 AstraZeneca ROA 14.2% 13.4% 15.5% Profit margin 15.9% 16.1% 17.8% Total Assets Turnover Ratio 0.89 0.83 0.87 Novartis ROA 11.1% 10.6% 11.1% Profit margin 22.6% 20.2% 20.4% Total Assets Turnover Ratio 0.49 0.53 0.54 Roche ROA -5.8% 5.0% 11.3% Profit margin -13.7% 9.8% 21.2% Total Assets Turnover Ratio 0.42 0.51 0.53 Sanofi-Aventis ROA 18.1% 21.6% -8.3% Profit margin 23.6% 25.8% -24.0% Total Assets Turnover Ratio 0.77 0.84 0.35 Takeda ROA 12.5% 13.5% 13.0% Profit margin 23.1% 26.0% 26.3% Total Assets Turnover Ratio 0.54 0.52 0.49 Bayer ROA 2.7% -3.4% 1.6% Profit margin 3.6% -4.8% 2.0% Total Assets Turnover Ratio 0.75 0.72 0.79 Source: calculations, data used from Annual Reports of the companies


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It is also interesting to compare European and Asian business models: Takeda, the only Asian country in this group, showed the lowest debt-equity ratio (0.25) that is much lower than average 0.48 for the whole group (Lexchin, 1995). Chart 3: Liquidity analysis

Chart 4: Geographical distribution of sales, 2004

Source: Annual reports of the companies

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

4.50

GlaxoSmithKline

AstraZeneca

Novartis

Roche

Sanofi-Aventis

Takeda

Bayer

Current Ratio CF from operations to Total Liabilities Debt-Equity Ratio

49% 45% 40% 35% 31% 27%36%

30% 36%34% 38% 49%

14%

36%

21% 19%26% 26%

20%

59%

28%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

GlaxoSmithKline

AstraZeneca

Novartis

Roche*

Sanofi-Aventis

Takeda*

Bayer

USA Europe Other


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* No geographical distribution of pharmaceutical segment is available. Proportions calculated on the basis of geographical distribution of total sales (Agarwal, 2001). REFERENCES

A. Catlin et al., “National Health Spending in 2005: The Slowdown Continues,” Health Affairs 26, no. 1 (2007): 142–153.

Aday, L. A. (1996). Designing and conducting health surveys (2nd ed.). San Francisco: Jossey-Bass.

Ahmed RR, and Saeed A. Ethical and non-ethical Pharmaceutical marketing practices: Case study of Karachi city. Interdisciplinary Journal of Contemporary Research Business 2012; 3 (11): 456-475.

Ahmed M, Akhter N, Awan M & Murtaza G. Ethical Evaluation of Pharmaceutical marketing in Pakistan. Academic Journal 2011; 17 (2): 215.

Aamir M, and Zaman K. Review of Pakistan Pharmaceutical Industry: SWOT Analysis. Int. Jour. of Business & Inf. Tech 2011; 1(1): 114-117.

Ahmed, R. R., & Jalees, T. (2008). Pharmaceutical Industry in Pakistan: Unethical Pharmaceutical Marketing Practices. Market Forces-Journal of Management Thoughts, 4(2): 30-39.

American College of Physicians. (1990). Physicians and the pharmaceutical industry. Annals of Internal Medicine, 112, 392-394.

American Medical Association. (1991). Council on Ethical and Judicial Affairs. Gifts to physicians from the industry. JAMA, 265, 501.

Ahmed RR, Parmar V, and Ahmed J. Factors that affect attitude towards Generic Drugs Perception: Comparison of Physicians & General Practitioners of Karachi City. International Journal of Marketing and Technology 2012; 2 (11): 151-178.

Agarwal S, Desai S, Holcomband M, Oberoi A. Unlocking the value of Big Pharma. The McKinsey Quarterly 2001; (2): 65-73.

American Medical Association. (1995-2002). Council on Ethical and Judicial Affairs. Ethical guidelines for gifts to physicians from the industry. Retrieved February 13, 2002 from: http://www.ama-assn.org/ama/pub/printcat/5689.html

Bodenheimer, T. (2000). Uneasy alliance: clinical investigators and the pharmaceutical industry. N England J. Med, 342: 1539-1544.

Dr. J. Akhtar, Presentation at the Seminar on Pharmaceutical Industry on 20th September 2006.


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Fisher, S., Bryant, SG., Kent, TA. (1993). Post marketing surveillance by patient self-monitoring: trazodone versus fluoxetine. J Clin Psychopharmacology, 13:235-242.

Government of Pakistan, 1997, 50 Years of Pakistan in Statistics (1947-97) Volume I Summary, Federal Bureau of Statistics.

Government of Pakistan, 2005, The Medium Term Development Framework: 2005-10, Planning Commission, Islamabad.

Government of Pakistan, Census of Manufacturing Industries, Various Issues, Federal Bureau of Statistics, Islamabad.

In the fiscal year 2000-2001 the pharmaceutical exports of Pakistan amounted to US$ 38 million. The current level is indicative of progress made so far. (Source: Trade Development Authority Available at www.tdap.gov.pk.

In the year 1985 the share of generics in global market was 22% and by the year 2000, it increased to 45%. (Source: TDAP)

Ingelfinger, F. J. (1972). Advertising: informational but not educational. New England Journal of Medicine, 286: 1318-1319.

Kemal, A. R., Muslehuddin and Usman Qadir, 2002, Global Research Project: Pakistan Country Report Presented at GRP Workshop in Dhaka.

Kemal, A. R., Z. Mahmood, A, M. Ahmad, 1994, Structure of Protection, Efficiency, and Profitability, Vol. 1.

Lexchin J. (1995). Deception by design: pharmaceutical promotion in the third world. Consumers International, Malaysia.

Mathieu MP, editor. Parexel’s pharmaceutical R & D statistical sourcebook 1998. Waltham, Massachusetts: Parexel International Corporation, 1999.

Pakistani pharmaceutical industry. (2006). Information of Medical Statistics, 2nd Issue, 2: 22-33.

Pakistani pharmaceutical industry. (2012). Information of Medical Statistics, 3rd Issue, 3: 20-31.

Source: Trade Statistics, Trade Development Authority of Pakistan Singh A, Sharma PK, and Malviya R. Eco Friendly Pharmaceutical

Packaging Material. World Applied Sciences Journal 2011; 14 (11): 1703-1716. Wolpert, J. The BUY vs. BUILD Challenge to Drug Makers' Performance,

Mergers and Acquisitions. Philadelphia 2004; 39 (8): pp. 22. Ziegler, M. G., Lew, P., & Singer, B. C. (1995). The accuracy of drug

information from pharmaceutical sales representatives. JAMA, 27, 1296-1298.

Health & Medicine

Pharmaceutical Industry: Key Issues in Growth in Pakistan & International Market