PharmaCon2007 Conference Dubrovnik Croatia

1. Vesna Marijanović Jukić, B.Pharm. Pharmacon 2007, Dubrovnik, May 26, 2007. SELF-MEDICATION IN CROATIA Where are we today and what is the future ?

5. RESPONSIBLE SELF- MEDICATION ● very important role in health improvement and well-being of each person ● large influence on population health in each country.

8. TOP 10 OTC COMPANIES WORLDWIDE Sanofi-Aventis 10 Boehringer Ingleheim 9 Taisho 8 Procter & Gamble 7 Novartis 6 Wyeth 5 GlaxoSmithKline 4 Pfizer 3 Bayer 2 Johnson & Johnson 1 COMPANY

9. 2005. 5. DERMATOLOGIC PRODUCT 4. GASTRO PRODUCTS 3. VITAMINS & MINERALS 2. COUGH/COLD/ALLERGY 1. ANALGETICS TOP 5 OTC PRODUCT CATEGORIES

10. Global OTC market constantly grows Global OTC market, 2001-2007, billion $ Self-medication more and more used for chronic diseases, not only for prevention and minor illnesses. Pharmacist has most important role. Lifestyle products improve quality of life by improving unwanted conditions that affect everyday life (not diseases in need for medical treatment) Reuters Business Insight, The OTC Outlook to 2007 6,5% CAGR

11. OTC drugs used for more indications USA: 80 categories of OTC drugs. 100.000 OTC drugs on the market, but only 1.000 different substances – combination is important - hard to develop new drug– line extensions, new tastes, new forms.... OTC market USA, 2003, total: $16,098 mil

12. Patients - different attitudes on certain aspects of their health For which problems would an OTC product be your first choice? Source: Datamonitor 2004 Patients: better informed, more concerned about self-medication OTC drug became first choice for cough & cold (USA consumers, % of answers, 2004.)

14. GROWING HEALTH PROBLEMS Alzheimer disease High blood presure Overweight Cognitive abbilities Energy loss Overweight Menopause Hyperactivity amblyopia ( low vision ) Diabetes High colesterol Physical condition Arthrytis High blood presure Cancer Energy loss Malnutrition Arthrytis High colesterol Breast cancer Overweight OLDER PEOPLE MEN WOMEN CHILDREN/ TEENAGER

17. Rx  OTC "switching" (extending of product life-cycle) PATENT EXPIRY moment for BRANDED DRUGS Product substitutes Price lowering Decrease of market share Sale reduction by 80% STRATEGIES for SALE MAXIMISING and lowering of COMPETITON influence New indications Launch of generics Re-launch Rx- OTC switch Reformulation Leaving market Competition entrance

20. OTC PRODUCTS OTC PRODUCTS IN CROATIA OTC DRUGS sintethic origin - 136 herbal origin - 28 COSMETICS with special purpose ( 320 ) DIETETIC PRODUCTS food supplements with special purpose (2.176) SOURCE : PHARMIS, 2005 56% 77% OTC DRUGS 44 % 23 % DIETETIC P. by value (kn) by unit OTC products sales

21. SOURCE : PHARMIS predicted growth: 5-10% / year

23. SOURCE : PHARMIS 10 LARGEST OTC COMPANIES 2006 . 2,5 % MENTHOLATUM 10 4,6 % KRKA 9 4,6 % JGL 8 6,5 % LEK 7 6,6 % BAYER 6 8,3 % DIETPHARM 5 8,4 % OKTAL PHARMA 4 10 % NATURAL WEALTH 3 11 % BELUPO 2 15 % PLIVA 1 MARKET SHARE rang

24. OTC DRUGS USAGE IN CROATIA OTC drugs mostly used: analgetics, cough & cold... Source: Market research on BELUPO MARKET VALUE, ACCENT, Zagreb, 09/ 2006. 84 55 54 19 12 5 2 1 1 1 5 10 0 20 40 60 80 100 ANALGETICS ANTIPERITCS COLD, FLU COUGH CIRCULATION CV PREVENTION ANTACIDS ALLERGY Tegobe prostate LIVER protect OTHER do not use

25. TOP 10 OTC PRODUCTS 2006. (kn) SOURCE : PHARMIS, 2006 STREPSILS ( amilmetakrezol, 2,4-di c lorobenzil al c ohol , BOOTS H.) 10 DEEP RELIEF ( ibuprofene/menthol, OKTAL P.) 9 ASPIRIN C (BAYER) 8 LEKADOL ( paracetamole , KRKA) 7 LUPOCET ( paracetamole, BELUPO) 6 OPERIL ( oxymethasoline, LEK) 5 GINKGO BELUPO 4 PLIVADON ( codeine/coffeine/paracetamol/propiphenasone, PLIVA) 3 CAFFETIN ( codeine/coffeine/paracetamol/propiphenasone, ALKALOID) 2 ANDOL 100 (PLIVA) 1

28. BELUPO OTC PRODUCTS ( 33 products – herbal drugs, synthetic and dietary supplements) PRODUCT CATEGORIES Imuno-cardiovascular Cough,cold, allergy Analgetics Gastro- metaboliic Urogenital Antidepressants Dermatics UROSAL, UROSAL LADY, UROSAL M HERPLEX, FLOCETA, BEVITAL, BEVITAL SUN SYLIMARIN, FITOLAX, BELOMET AKTIVIN-H LUPOCET, LUBORETA, NEOFEN, NEOFEN FORTE TABEX, FAVORA SYRUPS, EUSIN, BELODIN GINKGO, MAXI –OMEGA, FERSAN, VITASENG Overweight GO SLIM, FIT-LAX

31. SOURCE: 1000 people, MEDIA METAR, VEČERNJI LIST, 23.10.2004.

32. WHAT IS PHARMACISTS ROLE IN PATIENT EDUCATION ON SELF – MEDICATION ? They are RESPONSIBLE to EDUCATE PATIENT on: - recommended OTC drug - how and for how long it should be used - how should it be stored - therapy evaluation & results - possible interactions

34. SOURCE: 1. 1000 people, MEDIA METAR, VEČERNJI LIST, 23.10.2004. WHAT IS MOST IMPORTANT TO PATIENT ABOUT OTC DRUG?