麥肯錫給醫(yī)藥行業(yè)的報(bào)告

1、McKinsey Broad Market Study Process,Project design (Q1, 2003)Project review with local and regional J-C team (Apr. 03)Survey market selection (Apr. 03)Field work in 2 cities in Shandong (May 03)1st interim report (mi

2、d-June 03)Field work in 2 cities in Sichuan (mid-June – mid-July 03)2nd interim report and Killer Idea workshop (end July 03)Final report (Aug. 03)Presentation to corporate management (Sept. 03),,,,BROAD MARKET CAN B

3、E DEFINED AS CLASS 2 HOSPITALS AND BELOW AT REGIONAL CITY LEVEL AND ALL HEALTH CARE INSITITUTIONS AT COUNTY LEVEL AND BELOW,Regional city,County,Town,Village,Class 3 hospital,,Class 2 & below hospital,,Pharmacy,,Clin

4、ic,,,Broad market,,,,,,,,,,Source: McKinsey analysis,BROAD MARKET DRUGS INCLUDE OTC AND “OUT PATIENT” Rx DRUGS,Source: McKinsey analysis,,Targeting easily diagnosed, non-life threatening diseases,Easy to use,Relatively

5、 cheap,Relatively safe with few side effect,Examples,OTC,,Mature,New,Motilium,Gyno-Daktarin,Rx,,Outpatient,In-hospital,Sporanox / Sibelium,Cipramil,,Broad market drugs,,,,,,,,,,,,,,,,,,,,,McKinsey Key FindingsOverall M

6、arket Situation,BROAD MARKET REPRESENTS 94% OF OVERALL DEMAND FOR BROAD MARKET DRUGS,Class 3 hospital,Broad market drug sales breakdown by geographyPercent,*For only 2 according cities**Data for only Sichuan provin

7、ceSource:Interview with distributors, hospitals, pharmacies & clinics; McKinsey analysis,All 4 cities,Broad market represents 94% of demand,100%=,3.6,2.3,1.3,Bn RMB,,Shandong*,Sichuan*,City,100%=,21,6,2,Mn RMB,Cou

8、nty,Town,Village,,Motilium,Gyno- Daktarin,Sibelium**,Broad market,,Sales breakdown of XJP productPercent,Other channel at city level,GDP per capita:# of county,9,19932,11,30018,5,80114,,County is critical for

9、 broad market,DUE TO LOW INSURANCE COVERAGE AND RECENT REIMBURSEMENT POLICIY CHANGES, MOST PATIENTS PAY BROAD MARKET DRUGS BY THEMSELVES,Insurance coverage in Yantai & Jining,For those with insurance, they can use th

10、eir personal accounts (~RMB 100~300 per year) to cover their broad market drug expenseIn loosely controlled region (like Yantai), patients can treat the personal accounts as savings accountPatients pay on their own aft

11、er the account balance is zeroA majority of population does not have insuranceThey pay broad market drugs by themselves,Insured,Self-pay,Total,City,County,Town,Village,,,3-5,95-97,20-30,70-80,10-15,85-90,1,99,0,100,So

12、urce: Interview; focus group; McKinsey analysis,PATIENTS GO TO PHARMACY/CLINICS FOR MINOR SYMPTOMS,Source:Interview; McKinsey analysis,,Drivers,Increased price sensitivityChanged medical insurance policyImproved high

13、way infrastructureRich information accessTVNewspaperIncreased life paceNo time to visit hospitalPharmaceutical market deregulation policyMore and more pharmacies & clinicsConveniently located,Severe symptoms,

14、Town hospital,Minor symptoms,Largest hospitals in city and county,Middle-small hospitals in city and county,Pharmacy/clinics,,,,,,,Rural patients,City patients,A LARGE PROPORTION OF DRUG SALES COMES FROM RETAIL PHARMACIE

15、S; PHARMACY CLERKS BECOME INFLUENTIAL,* 40% of the patients changed their mind in pharmacySource: Interview; Focus group; McKinsey analysis,“What makes you change your perceived drugs?”* – Pharmacy patient surveyPercen

16、t, Shandong city level,Perceived drug not available; persuaded by pharmacy clerk,Perceived drug available but persuaded by pharmacy clerk,Changed mind by myself,“When I go to the pharmacy without a drug in mind, I just a

17、sk the pharmacy clerk to recommend. Then I will check the drug’s introduction sheet, if this drug covers my disease, I will have a try”– Yibin city level focus group,Total drug sales breakdownPercent,Pharmacy,Hospital,

18、Clinics,Overall,Motilium,Gyno Daktarin,Sibelium,,CLINICS ARE PLAYING IMPORTANT ROLE ESPECIALLY AT COUNTY AND TOWN AND BELOW,Source:Interview; McKinsey analysis,Clinics’ share in total drug salesPercent,Overall,County,T

19、own,Village,36%,26,34,100,Sichuan,Shandong,City,8,27%,8,27,100,3,G.I. Category Review,,,* More than half of patients going to large hospitals will purchase drug at retail pharmacies ** Branded generic drugs ref

20、erring to generic drugs that run advertising, creating brand awareness in consumersSource: Physician and pharmacy interviews; McKinsey analysis,,FOR GI DISFUNCTION DRUGS AS A WHOLE THERE IS SIGNIFICANT LATENT DEMAND; PE

21、OPLE GENERALLY SEEK TREATMENT IN CLINICS AND PHARMACIES,,Latent market demand 60% of total patients do not seek any treatmentAs market leader, increasing awareness for Motilium to further boost treatment rate is one of

22、 the key demand levers Small clinics and pharmacies are important channels75% of patients seeking treatment go to clinics and pharmacies,Total incidence,Do not seek treatment,Go to large hospital*,Go tosmall clinic,Se

23、lf medicate at pharmacy,Seek treatment,Not aware,,,,,,,Percent,,Motilium’s market share,,Motilium has a vast room for grow because of significant leakage along the patient flow60% of GI patients that do seek treatment

24、Current market share of 4% which could be grown furtherAmong the 40% people who seek GI treatment, about 30% would buy banded generic drugs**, while the rest would buy non-brand generic drugs,,,1.6%,,FOR GI DRUGS, POLAR

25、IZATION IS BECOMING MORE OBVIOUS,Anecdotes,Quantitative examples,Sub-TA sales by channelPercent,,,,Source: Hospital pharmacy interviews; retail pharmacy interviews; McKinsey analysis,1997,1999,2002,Retail Pharmacy,Hos

26、pital,Clinic,“Unlike things in the past, patients nowadays generally try to avoid coming to hospitals because of hospitals’ expensive charges. For GI disease, most people can judge by themselves. So they usually prefer t

27、o go to pharmacies or clinics to buy drugs.”—— Qixia GI physician interview,,“Most GI patients are repeating patients. They know which drugs to buy, and where the drugs are cheap. So usually they will choose pharmacies

28、& clinics.”—— Jining retail pharmacist interview,Yantai,1997,1999,2002,Retail Pharmacy,Hospital,Clinic,Jining,Importance of GI drug sales in hospital is diminishingRetail pharmacy would be the major battle field

29、for GI drugs,,ROUGH ESTIMATION,SALES OF GI DRUGS ARE MORE CONCENTRATED TOWARDS VILLAGE AND COUNTY, WHILE THE MARKET IS FRAGMENTED WITH MANY DIFFERENT DRUGS,Percent,Motilium,Wei’ershu (謂爾舒),Mosapride (莫沙比利),Tidines** (

30、替丁類藥),Others*,Sidashu (斯達(dá)舒),*Others including more than 200 different GI drugs such as Kuiweipian(快胃片)、 Weifuan(w胃復(fù)安)、 Jinweixiaoshipian (健胃消食片)、999(三九胃泰)、丹桂香、胃舒平、健胃酵母片、果膠鉍、邦消安、調(diào)胃片、胃氣痛片、濕胃舒、養(yǎng)胃舒, and many other cheap non

31、-branded generic drugs**Including Cimetadine, Ramitidine & FamotidineSource: Distributor interviews; physician interviews; patient interviews; McKinsey analysis,Total = RMB 243.05 million,Village,County,Town,Cit

32、y,,,IN BROAD MARKET, MOTILIUM IS LOSING OUT BIG TIME IN RETAIL PHARMACY CHANNEL …,Retail pharmacy,Hospital,Clinic,Source: Distributor interviews; hospital pharmacy interviews; retail pharmacy interviews; McKinsey analys

33、is,Sales by channelMn RMB, %,Motilium,Sidashu (斯達(dá)舒),Wei’ershu (謂爾舒),Mosapride (莫沙比利),Tidines (替丁類藥),GI drugs,12,35,53,243.05,14,34,52,9.83,6,66,29,6.62,5,76,20,7.30,40,38,21,7.93,4,22,73,44.64,YANTAI & JINING,… AND

34、IN COUNTY GEOGRAPHY,City,County,Town,Village,Source: Distributor interviews; hospital pharmacy interviews; retail pharmacy interviews; McKinsey analysis,Sales by strataMn RMB, %,Motilium,Sidashu(斯達(dá)舒),Wei’ershu(謂爾舒),Mos

35、apride(莫沙比利),Tidines(替丁類藥),GI drugs,15,26,19,243.05,41,15,22,20,9.83,43,22,37,26,6.62,15,26,44,21,7.30,9,18,50,23,7.93,10,1,17,17,44.64,66,YANTAI & JINING,Vaginal Infection Category Review,,FOR VAGINAL INFECTIONS, PA

36、TIENTS ARE MORE AWARE OF THE DISEASE AND GO TO HOSPITAL FOR TREATMENT,Percent,,,Less latent demand Almost all patients aware of the disease due to obvious symptoms and regular check up80% of patients seek treatmentLar

37、ge hospital is important influencing channel Most patients seeking treatment will go to large hospitalsThough half or more will purchase prescribed drugs in pharmaciesMarket player should focus on share gain,Total i

38、ncidence,Do not seek treatment,Go to large hospital,Go tosmall clinic,Self medicate at pharmacy,Seek treatment,Not aware,,,,,,,,,Source:Physician, pharmacy and clinic interviews,,Hospital is still number 1 channel to

39、push Gyno Daktarin salesPharmacy is becoming increasingly important,,,,30% would use branded drugs, while 70% would use non-branded drugs,,FOR GYNO DAKTARIN, HOSPITAL IS CRITICAL FOR PRESCRIPTION BUT PURCHASING HAS BEEN

40、 GRADUALLY SHIFTING TO RETAIL PHARMACY,Anecdotes,Quantitative examples,Sub-TA sales by channelPercent,,,,Source: Hospital interviews; Retail pharmacy interviews; McKinsey analysis,1997,1999,2002,Retail Pharmacy,Hospit

41、al,Clinic,“Gyno patients will usually come to hospital for body check and go to pharmacies to refill drugs. For such kind of disease, people still trust large hospitals. However, more and more people purchase drugs in ph

42、armacies”—— Liangshan No.2 hospital, Gyno physician interview,,“I don’t have many gyno patients. This is because of 3 reasons. First, I am a man; second, I don’t have facilities to check the body in the clinic; third, p

43、atients are usually familiar with me and they will feel awkword.”—— Zhangyongxin town level clinic interview,Yantai,1997,1999,2002,Retail Pharmacy,Hospital,Clinic,Jining,ESTIMATE,IN ADDITION, GYNO DAKTARIN NEEDS TO GRO

44、W THE MARKET SHARE ESPECIALLY THOSE OF COUNTY AND TOWN,Source: Distributor interviews; hospital pharmacy interviews; retail pharmacy interviews; McKinsey analysis,Sales by strataMn RMB, %,Gyno Daktarin,Xiaomishuan(消糜栓)

45、,Mycostatin(制霉菌素),Shuangzuotaishuan(雙唑泰栓),Jie’eryin(潔爾陰),Vaginal infection drugs,YANTAI & JINING,City,County,Town,Village,26,50,20,71.38,42,47,12,2.47,24,43,32,4.54,41,46,13,4.46,3,59,38,5.46,9,43,27,5.83,4,0,0,0,0,2

46、2,Nail Fungal Infection Category Review,,FOR TINEA UNQUIUM DRUGS, DEMAND LATENCY IS EVEN HIGHER,Percent,Extremely latent demand with increasing awareness 90% of patients do not seek treatmentAwareness and treatment rat

47、e is increasing slightly due to competitor's heavy advertisingOnly around 10 % of those seeking treatment purchase drugsOnly 1% would follow prescription,,Total incidence*,Do not seek treatment,Seek treatment,Not

48、aware,,,,,,,,* The incidence rate is around 5% in ShandongSource: Physician and pharmacy interviews; McKinsey analysis,Only 1% actually buy drugs,,,,Low treatment rate is mainly due to affordability issue of the patient

49、sSporanox’s potential market as a Tinea Unquium drug is small, and is unlikely to be a broadmarket hit,,,Go to large hospital,Go toclinic,Go to pharmacy directly,HOSPITAL CHANNEL IS STILL DOMINATING TINEA UNQUIUM DRUG

50、MARKET WHILE PHARMACY CHANNEL IS PICKING UP,Anecdotes,Quantitative examples,Sub-TA sales by channelPercent,,,,Source: Hospital pharmacy interviews; Retail pharmacy interviews; McKinsey analysis,1997,1999,2002,Retail P

51、harmacy,Hospital,Clinic,“We gradually carry some Tinea Unquium drugs in these years. Because more and more patients, although still quite small in amount, come here to ask for Liangjia after seeing its advertisement. I t

52、hink most patients still go to hospital for treatment.”—— Jining Kangfu pharmacy,,“I seldom see Tinea Unquium patients. And also, because the drugs are very expensive, I didn’t carry them. If there is really someone com

53、e to my clinic, I will suggest them to pharmacy.”—— Yantai clinic interview,Yantai,1997,1999,2002,Retail Pharmacy,Hospital,Clinic,Jining,*Others including around five drugs, such as Huihuangmeisu（灰黃霉素）, Lisulao（里素勞）,L

54、ianghuija（亮灰甲）etc.Source: Distributor interviews; physician interviews; patient interviews; McKinsey analysis,THERE ARE ONLY A FEW COMPETITORS AT CITY AND COUNTY LEVEL FOR SPORANOX; LIANGJIA IS DOING BETTER THAN SPORA

55、NOX AT RETAIL PHARMACIES DUE TO HEAVY ADVERTISING,Percent,Others*,Total = RMB 9.22 million,County,Town,City,Sporanox,Lanmeishu (蘭美抒),Liangjia (亮甲),Village,0,,,Source: Distributor interviews; physician interviews; pati

56、ent interviews; McKinsey analysis,THERE ARE ONLY A FEW COMPETITORS AT CITY AND COUNTY LEVEL FOR SPORANOX; LIANGJIA IS DOING BETTER THAN SPORANOX AT RETAIL PHARMACIES DUE TO HEAVY ADVERTISING,City,Total,Retail pharmacy,H

57、ospital,Clinic,County,Share of leading drugs within Tinea Unquium – Yantai & JiningMn RMB, %,Total,Retail pharmacy,Hospital,Clinic,4.0,2.2,1.8,0.1,5.0,0.8,4.1,0.2,100%=,Sporanox,Lanmeishu* (蘭美抒),Liangjia (亮甲),Other

58、s,Liangjia has relatively high market share in retail pharmaciesAt city level, Lanmeishu has 31% of hospital channel, better than SporanoxHospital at county level and above should be the main focus,,PRICE IS A HUGE I

59、SSUE FOR SPORANOX,,Sporanox is too expensive for most farmers whose annual income is only around RMB 2,000Even at county level, cost of using sporanox for effective treatment is higher than total drug expense per year

60、 for an average person,County level price threashold,City level price threashold,County level annual drug expense per person,Average insurance allowance per year,Cost of sporanox as a derma drug,Source:Interviews; McKi

61、nsey analysis,Cost of sporanox as a STD drug,RMB,FOR SPORANOX, XJP SHOULD CONTINUE TO FOCUS ON HOSPITALS …,Retail pharmacy,Hospital,Clinic,Source: Distributor interviews; hospital pharmacy interviews; retail pharmacy in

62、terviews; McKinsey analysis,Sales by channelMn RMB, %,Sporanox,Lanmeishu* (蘭美抒),Liangjia (亮甲),Tinea Unquium,65,33,9.22,69,30,1,2.21,84,15,0,1.50,12,87,1.26,2,2,YANTAI & JINING,… AND AT CITY AND RICH COUNTIES,County,

63、Town,Village,Source: Distributor interviews; hospital pharmacy interviews; retail pharmacy interviews; McKinsey analysis,Sales by strataMn RMB, %,Sporanox,Lanmeishu*(蘭美抒),Liangjia(亮甲),City,Tinea Unquium drugs,44,54,9.2

64、2,48,50,2,2.21,53,47,1,1.50,67,29,1.26,2,4,0,1,1,0,YANTAI & JINING,Vertigo Drug Category Review,,,,,THERE IS UNTAPPED DEMAND IN TWO OF THE THREE PRODUCT-RELATED TAs,GI disfunction patient flow in broad market percen

65、t,Source: Hospital & pharmacy interview; McKinsey analysis,VI patient flow in broad marketpercent,Vertigo patient flow in broad marketPercent,Total incidence,100,~30,30~40,20~40,Not aware,Do not seek treatment,See

66、k treatment,Total incidence,100,~1,20~40,60~80,Not aware,Do not seek treatment,Seek treatment,,,,,,,,,,Total incidence,Not aware,Do not seek treatment,Seek treatment,100,1,99,0,,,,Vertigo incidence rate is only 1%-3%Sib

67、elium can target more indications with much larger patient population,Huge latent demandAwareness can be increased by patient educationAffordability can be improve due to economic development,BY GEOGRAPHY, COUNTY LEVEL

68、 AND ABOVE CONSUME A DOMINANT SHARE OF SIBELIUM,City,County,Town,Village,Source: Interviews; McKinsey analysis,Percent,Total = RMB 2.0 million for sales of Sibelium in Deyang and Yibin,,Sales of Sibelium is more dominant