Reducing the number of wholesalers helps to reduce internal costs for manufacturers, and by dealing only with a few wholesalers may create more manageable business relationships

The European pharmaceutical distribution system is set to change dramatically over the next few years. The adoption of direct-to-pharmacy (DTP) in the UK and its emergence in Poland sets a potential precedent for other European markets.

To date, pharmaceutical manufacturers have managed to drive the changes to suit their interests. However, the establishment of new relationships with select wholesalers will lead to a new type of distributor, which will expand their portfolio of business interests across Europe.

With the underlying structure of the supply chain about to change wholesalers are keen to remain competitive in the market.

The Future of Pharmaceutical Distribution in Europe - The impact of DTP on manufacturers and wholesalers from URCH Publishing, is a market report that comprehensively reviews the business of medicines distribution in Europe.

This 88 page report is an update of the 2008 report "Pharmaceutical Distribution in Europe".

The report is logically divided into four chapters.

Chapter 1 provides a comprehensive history and overview of the key issues related to the pharmaceutical supply chain in Europe, including European law, EU institutions and the retail pharmacy industry.

Chapter 2 fully reviews the role of pharmaceutical wholesale companies with profiles of Alliance Boots, Celesio AG, Mediq and The Phoenix Group. Distribution in the major markets is examined and the role of technology in wholesaling is reviewed.

Chapter 3 discusses how pharmaceutical manufacturers organise the distribution of their products. The emergence in the UK of direct-to-pharmacy distribution is analysed, as is reaction to the Office of Fair Trading's report. The impact of Pfizer's DTP scheme is assessed and moves by the other big players like AstraZeneca and Novartis are discussed.

Chapter 4 looks at the pressures that the European supply chain sector is under. Particular attention is paid to the growing problem of counterfeit medicines and the moves by the authorities and manufacturers to control this illegal trade.

The report provides a comprehensive insight into the realities of distributing medicines in Europe. Questions answered include:

What has been the impact of direct-to-pharmacy distribution in the UK?
Will government austerity measures impact the pharmaceutical distribution sector?
Are there significant legal obstacles to be overcome when moving to a DTP distribution model?
Do pharmacists have a future beyond the administration of dispensing?
Are counterfeit medicines the next big major issues that the industry has to deal with?
Is parallel trade still such a threat to manufacturer's profits?
How wholesalers will have to change to remain competitive?

Key features of the report include:

Over 10 case studies including these companies, Alliance Boots, AstraZeneca, Celesio, PharmacyChecker.com and Sanofi-Aventis
Unbiased synopsis of the Office of Fair Trading's (OFT) report into the UK's pharmaceutical supply chain
Overview of the European pharmaceutical supply chain and the stakeholders involved in medicines distribution
Insight into the aggressive Pan-European expansion strategies of some wholesalers
Overview moves by manufacturers and authorities to reduce the problem of counterfeit medicines and the challenge of creating a Europe-wide response.

The report will help readers:

Understand the impact of IT on managing distribution in Europe
Analyse changing impulses in supply chain demand
Gain insights into the consolidation process amongst wholesalers
Evaluate the impact of the European Union on business strategy

With 13 Tables and 27 Figures this report is essential reading for anyone working in the pharmaceuticals supply chain including manufacturers, wholesalers, distributors and pharmacists.

Organisations mentioned in this report include:

Alliance Boots, Alliance Healthcare, Amedis UE AG, Association of Pharmacies of Attica (APA), Associazione Distributori Farmaceutici, Astellas, AstraZeneca, Chambre Syndicale de la Répartition Pharmaceutique (CSRP), Der Bundesverband des pharmazeutischen Großhandels (PHAGRO), EFPIA,. Europa Apotheek, Europharm, Farmacol, Federación Nacional de Asociaciones de Mayoristas Distribuidores de Especialidades Farmacéuticas y Productos Parafarmacéuticas (FEDIFAR), Galexis, GlaxoSmithKline, Groupement International de la Répartition Pharmaceutique (GIRP), Independent Pharmacy Federation (IPF), International Pharmaceutical Excipients Council (IPEC), Laboratorio Flandria NV, Les Entreprises du Médicament (LEEM), Medicines and Healthcare products Regulatory Agency (MHRA), Mediq, Napp Pharmaceuticals, Novartis, OFT, Panpharma, Pfizer, Phoenix Group, Polska Grupa Farmaceutyczna, Roche, Sanofi-Aventis, Tamro, The British Association of Pharmaceutical Wholesalers (BAPW), Torfarm, Unione Farmaceutica, Voigt AG, World Health Organization (WHO)

Use This Report To:

Identify key areas that will change in the pharmaceutical market structure over the next five years.
Support internal planning and decision-making with an external perspective founded on detailed analysis and transparent market forecasts.
Understand how the market and regulatory environment could change

Remember URCH Publishing's healthcare management reports are designed to help business executives make properly informed and timely business decisions.

Executive Summary
Chapter 1: Introduction to European Pharmaceutical Distribution
- The pharmaceutical supply chain
- Pharmaceutical manufacturers in the EU
- The European Federation of Pharmaceutical Industry Associations (EFPIA)
- Biotech drugs
- European Biopharmaceutical Enterprises (EBE)
- Vaccines
- European Vaccine Manufacturers (EVM)
- Pharmacies in the EU
- The Pharmaceutical Group of the European Union (PGEU)
- Dispensing doctors
- Wholesalers in the EU
- Groupement International de la Répartition Pharmaceutique (GIRP)
- The hospital sector
- Pre-wholesaling
- History of the pharmaceutical supply chain
- Dynamics in the supply chain
- Relationships within the supply chain
- Vertical integration
- New changes in the supply change
- Outlook for the supply chain
- Case study: tax-efficient supply chain management
- Global perspectives for European pharmaceutical distribution
- Case study: consolidation among US pharmaceutical wholesalers
- Case study: US wholesalers poised to enter Europe
- Case study: US analysis of the DTP model
- European status of the supply chain
- European market harmonisation and pharmaceutical distribution
- The politics of EU healthcare
- The EU
- History of the EU
- The set-up of the EU
- EU law
- Primary legislation
- Secondary legislation
- Case-law
- Decision-making in the EU
- The institutions of the EU
- The European Economic Area (EEA)
- The creation of the EEA
- EU enlargement and the EEA
- The euro
- The euro and pharmaceuticals
- Case study: Greek wholesalers challenge GlaxoSmithKline at the ECJ
Chapter 2: Pharmaceutical Wholesaling in Europe
- The role of the pharmaceutical wholesaler
- Channels of distribution
- Wholesalers and the Single European Market
- Wholesaler opposition to supply quotas
- Wholesaler views of direct-to-pharmacy distribution
- Case study: GIRP dispute with Alliance Boots over DTP agreements
- Cross-border mergers and acquisitions
- EU harmonisation and the outlook for pan-European wholesaling
- The major players in pan-European wholesaling
- Celesio AG
- The Phoenix Group
- Mediq
- Alliance Boots
- European regulations for wholesalers
- Guidelines on Good Distribution Practice of Medicinal Products for Human Use (94/C 63/03)
- Lack of harmonisation and the supply chain
- Wholesaler technology solutions
- Electronic data interchange
- Collaborative planning, forecasting and replenishment
- Enterprise resource planning
- Wholesalers develop value-added services
- Case study: Alliance Boots launches online health portal
- Order fulfilment packages
- Database technology
- Electronic point-of-sale technology
- Barcoding
- European wholesaler opinions on technological solutions
- Warehouse technology
- Dispensing technology
- Future systems
- Case study: Celesio buys infrastructure services from Hewlett-Packard
- Consumers and e-commerce
- Pharmaceutical distribution in UK
- Pharmaceutical distribution in France
- Pharmaceutical distribution in Germany
- Case study: US mail-order distributor explores German market
- Pharmaceutical distribution in Italy
- Pharmaceutical distribution in Spain
- Pharmaceutical distribution in Switzerland
- Pharmaceutical distribution in Poland
- Case study: Polska Grupa Farmaceutyczna expands beyond national market
Chapter 3: The European Pharmaceutical Industry and Distribution
- The pharmaceutical market
- Pharmaceutical manufacturers in Europe
- The pharmaceutical industry and the supply chain
- Case study: the Pharmaceutical Supply Chain Initiative (PSCI)
- Cost containment
- Pricing in Europe
- Case study: the Common European Drug Database project
- Cost-effectiveness reviews
- Parallel trade in the EU
- Generics
- Case study: cost containment in the UK
- The negative impact of cost containment
- Case study: Europe's Innovative Medicines Initiative
- Counterfeiting
- Manufacturers exert control over the UK supply chain
- The Office of Fair Trading investigation
- UK Government response to Office of Fair Trading inquiry
- Implications of changes in the supply chain
- Service standards to patients
- Rationale behind changes in the supply chain
  - Pfizer's feedback on DTP
  - Criticism of Pfizer's DTP scheme by UK pharmacists
  - Case study: Pfizer UK's DTP website
  - Reaction to the Office of Fair Trading inquiry
  - Pharmaceutical Services Negotiating Committee's online survey on Pfizer's DTP scheme
  - AstraZeneca changes its UK supply chain arrangements
  - Sanofi-Aventis changes its UK supply chain arrangements
  - Napp Pharmaceuticals changes its UK supply chain arrangements
  - Novartis changes its UK supply chain arrangements
  - Eli Lilly changes its UK supply chain arrangements
  - Astellas adopts DTP for transplant medicines in the UK
  - Reduced wholesaling
  - UCB changes its UK supply chain arrangements
  - Roche changes its UK supply chain arrangements
  - Launch of DTP schemes in Poland
Chapter 4: Protecting the European Pharmaceutical Supply Chain
- Stability of the European pharmaceutical supply chain
- Safeguarding the European supply chain
- Product shortages in the supply chain
- Case study: production plant issues cause European vaccine shortages
- Parallel trade
- Parallel trade and disruption to the supply chain
- Case study: GlaxoSmithKline's Spanish dual-pricing strategy
- Case study: parallel trade leads to drug shortages in Greece
- Traceability throughout the supply chain
- Counterfeit products
- Mediq tackles counterfeit insulin needles in the Netherlands
- Case study: Spain positions itself as supply chain pioneer
- Counterfeiting trends
- Counterfeiting and the European supply chain
- Case study: joint meeting between EU customs administrations and pharmaceutical companies
- European anti-counterfeiting measures
- EFPIA combats counterfeiting
- The MHRA's anti-counterfeiting strategy in the UK
- Case study: Sanofi-Aventis's anti-counterfeiting initiative
- Case study: shock tactics in UK public anti-counterfeit campaign
- The International Medical Products Anti-Counterfeiting Taskforce (IMPACT)
- The Pharmaceutical Security Institute (PSI)
- Case study: AstraZeneca opts for mass serialisation to prevent counterfeiting
- Using nanotechnology to combat counterfeiting
- Future perspectives on European anti-counterfeiting measures
- Internet trading
- Case study: PharmacyChecker.com
- References
List of Figures
- Figure 1.1 Outline of the supply chain
- Figure 1.2 Number of public pharmacies in Western Europe
- Figure 1.3 Number of public pharmacies in Eastern Europe
- Figure 1.4 Dispensing doctors in Europe
- Figure 1.5 Major Western European pharmaceutical wholesale markets
- Figure 1.6 Emerging Central and Eastern European pharmaceutical wholesale markets
- Figure 1.7 Number of hospital pharmacies in Western Europe
- Figure 1.8 Number of hospital pharmacies in Eastern Europe
- Figure 1.9 Corporate tax rate on profit (2009)
- Figure 2.1 Number of full-line wholesalers in Western Europe
- Figure 2.2 Number of wholesaler warehouses in Western Europe
- Figure 2.3 Number of full-line wholesalers in Eastern Europe
- Figure 2.4 Celesio wholesale revenue development
- Figure 2.5 Celesio wholesale revenue by market
- Figure 2.6 Celesio pharmacy revenue by market
- Figure 2.7 Phoenix turnover
- Figure 2.8 Mediq net sales
- Figure 2.9 Mediq revenue by market
- Figure 2.10 Alliance Boots 2009 revenue by division
- Figure 2.11 Alliance Boots 2009 wholesale revenue by market
- Figure 3.1 Pharmaceutical R&D expenditure in Europe, by year
- Figure 3.2 Pharmaceutical R&D expenditure across Europe, by country
- Figure 3.3 Employment in the European pharmaceutical industry
- Figure 3.4 The Common European Drug Database
- Figure 3.5 Share of parallel imports in European pharmacy markets
- Figure 3.6 Comparison of pharmaceutical R&D expenditure in Europe and the US
- Figure 3.7 UK pharmacy respondent views on potential costs of setting up a separate Pfizer account for DTP
- Figure 4.1 Geographical split of reported counterfeiting incidents
- Figure 4.2 EFPIA standardised identification solution for pharmaceutical products
- Figure 4.3 Total number of reported counterfeiting incidents
- Figure 4.4 Counterfeiting arrests by region
List of Tables
- Table 1.1 Types of manufacturer medicines
- Table 1.2 The institutions of the EU
- Table 1.3 Adoption of the euro
- Table 2.1 Mediq's activities in Europe
- Table 2.2 Summary of GDP guidelines
- Table 2.3 The BAPW's Gold Standard of GDP by pharmaceutical wholesalers as endorsed by the MHRA
- Table 3.1 The European pharmaceutical pricing environment
- Table 3.2 The European environment for generics
- Table 3.3 Overall risks of DTP identified by OFT
- Table 3.4 Implications of reduced service standards resulting from DTP
- Table 4.1 European anti-counterfeiting measures
- Table 4.2 Variations in national codification systems
- Table 4.3 Key areas of focus for the International Medical Products Anti-Counterfeiting Taskforce (IMPACT)

Pharmaceutical Market Research

Future of European Pharmaceutical Distribution, The