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Table of Contents 2

List of Tables & Charts 3

Study Overview 4

Sample Text, Table & Chart 5

Sample Profile, Table & Forecast 6

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Pharmaceuticals in

China Industry Study with Forecasts to 2010 & 2015

Study #2024 | February 2006 | $4800 | 240 pages

The Freedonia Group 767 Beta Drive www.freedoniagroup.com Cleveland, OH • 44143-2326 • USA Toll Free US Tel: 800.927.5900 or +1 440.684.9600 Fax: +1 440.646.0484 E-mail: [email protected] Study #2024 February 2006 Pharmaceuticals in China $4800 240 Pages China Industry Study with Forecasts to 2010 & 2015

Table of Contents

Introduction Shipments...... 62 Corticosteroids...... 115 Types of Medicines...... 63 Estrogens & Combinations...... 115 Astragalus...... 64 Other Hormones...... 116 Executive Summary Atractylodes...... 66 Shipments...... 117 Bupleurum...... 67 Biologicals & Vaccines...... 119 Market EnvironmenT China Root...... 67 Demand...... 120 General ...... 4 Cinnamon...... 68 Vaccines...... 120 Economic Factors...... 5 Coptis...... 68 Blood & Blood Derivatives...... 121 Demographic Patterns...... 7 Ephedra...... 69 Shipments...... 122 Regulated Birth Planning...... 8 Ginger...... 70 Nutritional Agents...... 123 Mortality Trends...... 9 Ginseng...... 70 Demand...... 124 Migration...... 10 Hoelen...... 71 Vitamins...... 125 Medical Conditions...... 10 Licorice...... 71 Nutrients & Tonics...... 126 Acute Conditions...... 11 Peony...... 72 Parenteral Nutritionals...... 126 Chronic Conditions...... 14 Rehmannia...... 72 Other Nutritional Agents...... 127 Health Insurance Coverage...... 16 Rhubarb...... 72 Shipments...... 127 Basic Medical Insurance...... 17 Salvia...... 73 Central Nervous System Agents...... 128 Cooperative Health Insurance...... 18 Tang-kuei...... 74 Demand...... 128 Other Public Health Insurance...... 19 Other Traditional Chinese Medicines...74 Pain Control Agents...... 130 Private Health Insurance...... 19 Herbal Combinations...... 76 Psychotherapeutic Agents...... 130 National Health Expenditures...... 20 Other Agents...... 131 Medical Providers...... 23 therapeutic classes Shipments...... 131 Hospitals...... 24 Respiratory Agents...... 133 General...... 78 Demand...... 133 Clinics...... 27 Shipments...... 80 Physicians...... 28 Cough/Cold Preparations...... 134 Anti-Infective Agents...... 81 Antihistamines...... 135 Patient Activity...... 30 Demand...... 82 Hospital Care...... 32 Bronchodilators...... 136 Cephalosporins...... 83 Other Respiratory Agents...... 137 Surgical Procedures...... 34 Penicillins...... 84 Outpatient Visits...... 34 Shipments...... 137 Other Antibiotics...... 86 Other Therapeutic Groups...... 139 Antiviral Agents...... 87 Dermatological Agents...... 140 pharmaceutical OVERVIEW Antifungal Agents...... 89 Genito-Urinary Agents...... 141 General ...... 37 Other Anti-Infective Agents...... 90 All Other Therapies...... 142 Shipments...... 39 Shipments...... 92 Shipments...... 143 Regulatory Considerations...... 41 Gastrointestinal Agents...... 93 Demand...... 94 Product Classification Systems...... 41 MARKETS New Product Approval Processes...... 42 Antacids & Acid Reducers...... 95 Manufacturing Standards...... 43 Proton Pump Inhibitors...... 97 General...... 145 Intellectual Property Rights...... 44 Laxatives...... 97 Hospitals...... 147 Channels of Distribution...... 44 Antidiarrheal Agents...... 98 Consumer Market...... 149 Price Controls...... 45 Other Gastrointestinal Agents...... 99 Physicians...... 150 Import Requirements...... 46 Shipments...... 100 Clinics & Other Markets...... 151 Chinese Trade in Pharmaceuticals...... 47 Cardiovascular Agents...... 101 Western Pharmaceuticals...... 48 Demand...... 102 INDUSTRY STRUCTURE Shipments...... 49 Cardiac Drugs...... 103 Antilipemic Agents...... 104 General ...... 153 Ethical Drugs...... 50 Market Share...... 154 Generic Drugs...... 52 Antihypertensive Agents...... 105 Other Cardiovascular Agents...... 106 Competitive Strategies...... 157 Proprietary Drugs...... 54 Investment...... 163 Shipments...... 54 Shipments...... 107 Hormones & Related Agents...... 109 Mergers & Acquisitions...... 164 Over-the-Counter (OTC) Drugs...... 56 Licensing & Related Agreements...... 166 Demand Patterns...... 57 Demand...... 109 Antineoplastic Agents...... 110 Marketing & Distribution...... 171 Shipments...... 59 Manufacturing...... 171 Traditional Chinese Medicines...... 60 Antidiabetic Agents...... 112 Demand Patterns...... 61 Oral Antidiabetic Agents...... 113

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Company Profiles List of Tables/Charts

AstraZeneca...... 173 EXECUTIVE SUMMARY 2 Pharmaceutical Shipments Bayer AG...... 175 1 Summary Table...... 3 by Therapeutic Group...... 80 Beijing Double-Crane Pharmaceutical..... 177 Cht Pharmaceutical Shipments Beijing Tongrentang...... 179 by Therapeutic Class, 2005...... 81 Bristol-Myers Squibb...... 181 MARKET ENVIRONMENT 3 Anti-Infective Agent Demand...... 83 China National Medicines...... 183 1 Macroeconomic Indicators...... 5 4 Anti-Infective Agent Shipments...... 93 Chongqing Taiji Industry Group...... 184 2 Resident Population by Age Group...... 8 5 Gastrointestinal Agent Demand...... 95 Chongqing Tong Jun Ge...... 185 3 Acute Conditions by Type...... 11 6 Gastrointestinal Agent Shipments.... 101 GlaxoSmithKline plc...... 186 4 Selected Chronic Conditions by Type..15 7 Cardiovascular Agent Demand...... 102 Guangzhou Pharmaceutical...... 189 5 Health Insurance Coverage...... 17 8 Cardiovascular Agent Shipments...... 108 Harbin Pharmaceutical Group...... 190 6 National Health Expenditures 9 Hormone/Related Agent Demand..... 110 Henan Topfond Pharmaceutical...... 191 by Type & Source...... 23 10 Hormone/Related Agent Shipments. 119 ...... 193 7 Medical Providers...... 24 11 Biological & Vaccine Demand...... 120 Jiangsu Hengrui Medicine...... 194 8 Patient Activity...... 32 12 Biological & Vaccine Shipments...... 123 Jinling Pharmaceutical...... 195 13 Nutritional Agent Demand...... 125 Jiuzhitang Company...... 196 PHARMACEUTICAL OVERVIEW 14 Nutritional Agent Shipments...... 128 Johnson & Johnson...... 197 1 Pharmaceutical Demand by Type...... 38 15 Central Nervous System Lilly (Eli) and Company...... 200 Cht Pharmaceutical Demand Agent Demand...... 129 Livzon Pharmaceutical Group...... 202 by Type, 2005...... 39 16 Central Nervous System Merck & Company...... 204 2 Pharmaceutical Shipments by Type....40 Agent Shipments...... 132 Nanjing Medical...... 206 Cht Pharmaceutical Shipments 17 Respiratory Agent Demand...... 134 North China Pharmaceutical Group...... 208 by Type, 2005...... 41 18 Respiratory Agent Shipments...... 138 Novartis AG...... 209 3 China Trade in Pharmaceuticals...... 48 19 Other Pharmaceutical Demand...... 140 Pfizer Incorporated...... 213 4 Western Pharmaceutical 20 Other Pharmaceutical Shipments..... 144 Roche Holding...... 216 Demand by Type...... 49 Sanjiu Medical & Pharmaceutical...... 218 5 Western Pharmaceutical Schering-Plough Corporation...... 219 Shipments by Type...... 50 MARKETS Shandong Dong-E E-Jiao...... 221 6 Western Ethical Drug Demand 1 Pharmaceutical Demand by Market... 146 Shandong Lukang Pharmaceutical...... 222 by Therapeutic Group...... 52 Cht Pharmaceutical Demand Shandong Xinhua Pharmaceutical...... 223 7 Western Ethical Drug Shipments by Market, 2005...... 147 Shanghai Fosun Pharmaceutical...... 225 by Therapeutic Group...... 56 2 Hospital -- Pharmaceutical Demand 149 Shanghai Pharmaceutical...... 226 8 Western Over-the-Counter (OTC) Drug 3 Consumer Market -- Pharmaceutical Shanghai Worldbest Pharmaceuticals...... 227 Demand by Therapeutic Group...... 57 Demand...... 150 Shijiazhuang Pharmaceutical Group...... 228 9 Western Over-the-Counter (OTC) Drug 4 Physicians’ Market -- Pharmaceutical Tianjin Tasly Pharmaceutical...... 231 Shipments by Therapeutic Group....60 Demand...... 151 Tianjin Tianyao Pharmaceutical...... 232 10 Traditional Chinese Medicine (TCM) 5 Clinic & Other Markets -- Tianjin Zhongxin Pharmaceutical...... 233 Demand by Therapeutic Group...... 62 Pharmaceutical Demand...... 152 Wyeth 234 11 Traditional Chinese Medicine (TCM) Yangtze River Pharmaceutical...... 236 Shipments by Therapeutic Group....63 INDUSTRY STRUCTURE ...... 237 1 China Pharmaceutical Sales Zhejiang Hisun Pharmaceutical...... 238 THERAPEUTIC CLASSES by Company, 2004...... 156 Zhejiang Medicine...... 239 1 Pharmaceutical Demand Cht China Pharmaceutical Market Share by Therapeutic Group...... 79 by Company, 2005...... 157 Cht Pharmaceutical Demand 2 Selected Acquisitions & Divestitures 166 by Therapeutic Class, 2005...... 79 3 Selected Cooperative Agreements.... 168

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Western proprietary ethical drugs will generate the strongest growth based on new product introductions that serve indications not treated effectively by currently available therapies.

Drug demand in China Western to grow 13.6% annually Ethical Drugs China Pharmaceutical Demand through 2010 43% (198 billion yuan, 2005) Demand for pharmaceuticals in China is projected to increase 13.6 percent annually to ¥375 billion in 2010. Western proprietary ethical drugs will generate the strongest growth based on new product introductions, especially for Western OTC Drugs cardiovascular, neurological, cancer and 19% antiviral indications that are not treated effectively by currently available thera- Traditional pies. Due to price advantages and an Chinese Medicines increasing number of proprietary medi- 38% cines losing patent protection, Western generic ethical medicines will continue to hold the largest share of the Chinese pharmaceutical market. The best growth opportunities for these drugs will emerge in newly off-patent cholesterol-reducing, antipsychotic and second-generation increasing internal funding for biotech- anti-infectives, AIDS/HIV antivirals, and antihistamine preparations. nology research. insulin and oral antidiabetic agents.

Western drugs to capture Western over-the-counter (OTC) medi- Traditional medicines cation will increasingly penetrate the two-thirds of market Chinese market as the government to remain large segment Western pharmaceuticals are forecast to promotes the expansion of the retail drug Traditional Chinese medicines will con- generate demand of ¥248 billion in 2010, sector to improve the accessibility of tinue to form a large segment of China’s comprising about two-thirds of the mar- basic medicines to residents of rural and pharmaceutical industry, but will see ket. Regulatory and commercial reforms overcrowded urban areas. New versions somewhat slower growth than Western will open up distribution systems to a of existing ethical antihistamines, anal- drugs. Single and combination formula- wider range of proprietary and generic gesics, antifungal agents, cholesterol tions of astragalus, atractylodes, bupleu- drugs. Several therapeutic classes of reducers and acid reducers will generate rum, China root, cinnamon, coptis, ephe- medication, including antiviral, antican- the strongest growth opportunities based dra, ginger, ginseng, hoelen, licorice, cer, psychotherapeutic and neurological on treatment needs in the population. peony, rehmannia, rhubarb, salvia and agents, are under served in China. The The expansion of the drug store sector tang-kuei hold the best growth pros- government will encourage the increas- will also create a new distribution chan- pects. All of these herbs serve multiple ing development of medicines in these nel for widely prescribed ethical drugs indications and offer viable alternatives areas by lowering trade barriers and such as cephalosporin and quinolone to Western drugs.

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Sample Text, TABLE III-6 Table & Chart WESTERN ETHICAL DRUG DEMAND BY THERAPEUTIC GROUP (million dollars)

Item 1995 2000 2005 2010 2015

Selected Chronic Conditions (million) 1330 1520 1740 2010 2340 markets ¥ western ethical pharm/condition 22 30 48 85 158

Cardiac Drugs -- Cardiac drugs exert a vasodilating effect on Western Ethical Drug Demand 29.0 45.0 84.0 171.0 370.0 blood vessels, increasing blood flow and decreasing vascular resistance. Anti-Infective 7.2 11.0 21.8 44.1 97.0 Included in this group are angiotensin-enzyme converting (ACE) inhibi- Biologicals & Vaccines 6.8 10.2 18.2 36.0 73.0 tors, calcium channel blockers, coronary vasodilating agents and antiar- Hormones & Related 5.0 8.9 15.9 31.8 64.5 rythmia agents. Demand for these drugs in China is projected to reach Cardiovascular 3.6 sam6.4 13.6ple 30.1 75.0 ¥14.5 billion in 2010, up 12.4 percent annually from 2005. Gastrointestinal 2.1 2.9 5.4 10.5 20.3 Central Nervous System 1.3 1.8t ab4.5le 10.0 22.6 ACE inhibitors slow the actions of an enzyme that causes a nar- Respiratory 1.1 1.3 1.8 3.5 8.4 rowing of bloodsam vesselsple and thereby provide an effective treatment for Nutritional 0.8 0.9 1.1 1.8 3.4 heart failure and hypertension. Widely employed types in China include Other 1.1 1.6 1.7 3.2 5.8 captopril, benazepril,tex tenalapril, fosinopril, lisinopril, moexipril, perindo- pril, quinapril, ramipril and trandolapril. All are off patent and available % ethical drugs 76.3 72.6 68.9 69.0 68.5 to generic producers. Among the various ACE inhibitors, quinapril Western Pharmaceutical Demand 38.0 62.0 122.0 248.0 540.0 provides the most effective action, producing significant flow-mediated vasodilation in patients with coronary artery disease.

Calcium channel blockers provide vasodilation by inhibiting the entry of calcium into the muscle cells of the heart or arteries. They serve as a treatment for angina, cardiac rhythm disorders and hyperten- sion. Top-selling calcium channel blockers in China consist of amlodip- ine, diltiazem and verapamil.

Coronary vasodilating agents, primarily isosorbide and nitroglyc- erin, are widely prescribed in China to treat angina. These drugs widen coronary arteries and veins and increase the flow of blood to the heart. In addition to calcium channel blockers, other Western drugs used to treat heart rhythm disorders are amiodarone, bretylium, encainide, lido- caine, propafenone and quinidine. CHART VI-1 Traditional Chinese medicines that serve indications as cardiac drugs include astragalus, bupleurum, cinnamon, hoelen, rhubarb and CHINA PHARMACEUTICAL MARKET SHARE BY COMPANY, 2005 salvia. Astragalus is employed as a yasodilating agent for angina and (198 billion yuan)

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Sample Profile, TABLE IV-1 Table & Forecast PHARMACEUTICAL DEMAND BY THERAPEUTIC GROUP (billion yuan)

Item 1995 2000 2005 2010 2015

Selected Chronic Conditions (million) 1330 1520 1740 2010 2340 ¥ pharm/condition 58 74 114 187 325

Pharm Demand by Therapeutic Group 77.0 112.0 198.0 375.0 760.0 Anti-Infective 16.4 24.5 46.0 88.0 180.0 Gastrointestinal 9.5 15.7sam 27.8ple 52.0 100.0 Cardiovascular 9.2 13.8 24.7 49.0 110.0 Hormones & Related 8.8 13.1t ab23.6le 45.0 88.0 Biologicals & Vaccines 6.8 10.2 18.2 36.0 73.0 Nutritional 6.3 8.8 14.4 27.0 56.0 Central Nervous System 3.4 5.2 13.2 26.0 53.0 Livzon Pharmaceutical Group Incorporated Livzon Building Respiratory 5.9 7.6 12.8 23.0 46.0 Guihua Road North, Gongbei Other 10.7 13.1 17.3 29.0 54.0 Zhuhai, Guangdong 519020 CHINA 86-75-6813-5888 http://www.livzon.com.cn Sales: ¥1.6 billion (2004) [US$188 million] Chinese Sales: ¥1.5 billion (2004) [US$178 million] Employment: 4,510 (2004) Key Products: Chinese and samchemicalple medicine preparations International Contact: Mr. Xiao Siyang, President “In spite of reforms in drug distribu- profile tion systems, hospitals will continue Livzon Pharmaceutical Group is a joint stock company that produces pharmaceuticals and raw pharmaceutical materials. The to dominate sales of pharmaceuticals Company also imports various medical products. to Chinese consumers, and will also re- Livzon Pharmaceutical Group’s pharmaceuticals encompass Chi- main a leading user of drugs for surgery nese and chemical medicine preparations, which generated 2004 sales of ¥262 million [US$32 million] and ¥851 million [US$103 million], and other patient procedures. Demand respectively. These drugs are available in several formats, including, for medication among these facilities is tablets, pills and injections. Livzon Pharmaceutical Group’s principal pharmaceuticals include LIVZON DELE (colloidal bismuth citrate), forecast to grow 11.5 percent annually shenqi fuzheng, sulbactam sodium/cefoperazone sodium, bifidobiogen to ¥210 billion in 2010, or 56 percent and valaciclovir hydrochloride medicines. Among Livzon Pharmaceu- tical Group’s Chinese medicine preparations are anti-viral, cardiovas- of the total market.” cular and neurological drugs, cough medicines, and general medicinal types. Livzon Pharmaceutical Group’s chemical medicine preparations include numerous digestive, cardiovascular and cerebrovascular, anti- --Section V, pg. 147 biotic, hormonal, and vascular and hematopoietic varieties. In 2004, sales for the Company’s chemical medicine preparations were ¥223 million [US$27 million] for digestive pharmaceuticals; ¥65 million [US$8 million] for cardiovascular and cerebrovascular drugs; ¥289 mil- lion [US$35 million] for antibiotics; ¥37 million [US$4 million] for

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