Croatian Pharmaceutical Market Value Edges Up to USD882.79 Mil. in 2010

The Croatian national agency for medicines and medical devices (HALMED) has published information on the Croatian pharmaceutical market in 2010, which takes into account 82.45% of all pharmacies involved in the distribution of pharmaceutical products in the country, including both prescription and non-prescription medicines, as well as data from hospitals. On the basis of HALMED's information, the value of the Croatian pharmaceutical market in 2010 was 4.836 billion kuna (USD882.791 million), which represents an increase of 4.79% year-on-year (y/y) in wholesaler prices. In terms of the market's volume, growth was more dynamic, at 9.96% y/y, calculated in defined daily doses per 1,000 inhabitants per day. HALMED highlights the fact that growth in pharmaceutical sales by value in 2010 was considerably slower than in 2009, when it stood at 15.3% y/y in volume terms and 10.6% y/y in value terms. The page on HALMED's website featuring links to tables containing information concerning the Croatian pharmaceutical market in 2010 can be accessed, in Croatian, here.

Off-Patent Products Dominate Outpatient Sector

According to HALMED's information, the top-selling outpatient medicine during 2010 was atorvastatin, the cardiovascular blockbuster originally marketed by US firm Pfizer under the Lipitor brand, but widely available generically today. In fact, all of the medicines from the top five outpatient drugs in Croatia during 2010 are now patent-expired, although in 2010, Danish firm Novo Nordisk's fast-acting insulin NovoLog/NovoRapid (insulin aspart)—in 5th position—was still under patent in Europe (although potentially not in Croatia).

Roche Dominates Hospital Sector

Contrastingly, all of the drugs bar one in the top five hospital drugs by value in 2010 were patent-protected oncology drugs, and these were all produced by Swiss pharma major Roche. It is interesting to note what a substantial lead Roche's Glivec/Gleevec (imatinib) had on the other hospital drugs in terms of sales, which were nearly twice as high as the number two selling product.

Thus, extrapolating these figures, it can be seen that there was only one patent-protected medicine—Glivec—in the five top-selling medicines in Croatia during 2010, and this is in fact the only drug out of all the drugs in the top 10 from 2010 for which patent protection is in place.

No Change in Top Therapeutic Areas

In terms of therapeutic areas, organised by Anatomic Therapeutic Chemical groups, there were no changes of any note concerning significant shifts in the areas receiving the most reimbursement. The top four therapeutic areas in terms of the value of drugs sold in 2010 were unchanged from 2009. Cardiovascular remained the area with far and away the largest sales, with HRK975.061 million (compared with HRK940.208 million in 2009), while the second largest area was the central nervous system, seeing spending in this area totalling HRK783.524 million (compared with HRK740.292 million). Following these areas, in third was the alimentary tract and metabolism, with HRK640.411 million (compared with HRK607.053 million in 2009), and antineoplastic and immunomodulating agents in fourth, with HRK619.505 million (HRK604.620 million).

Outlook and Implications

The considerable slowdown in the rate of growth in the Croatian pharma market, as reported by HALMED, is directly related to the much-touted reduction in reimbursement provided for medicines in 2010 by the Croatian Institute for Health Insurance (HZZO), with the HZZO estimating that reimbursement spending fell by 10.2% in 2010 (see Croatia: 11 March 2011: Results of Two Years of Health Reform Presented in Croatia As Public Spending on Prescription Drugs Falls 10.2% Y/Y in 2010). Thus, it can be ascertained that although the state's contribution to pharmaceutical purchases has fallen, there has been an increase in out-of-pocket payments by Croatians, either in the form of supplementary health insurance payments or through purchasing non-prescription medicines.

Considering the fact that volume growth was faster than value growth in 2010, this is a sign that there has been an increase in the use and sale of cheaper—mainly generic—products during the year. Croatia's cost-containment drive in 2010, which involved the complete overhaul of the pharmaceutical pricing and reimbursement system in the country, has been successful in achieving a far more rational use of resources, albeit sometimes excessively punitive towards innovative producers (see Croatia: 8 August 2011: Croatia's Impending EU Entry: Latest Reforms Continue Trend of Healthcare Cost Containment As Regulatory System Aligned with EU Peers). Thus, the situation in Croatia can be contrasted with that of Romania, where each one of the top 10 best-selling products is a branded medicine, and most are patent protected, whereas in Croatia, most are off-patent and genericised. From the point of view of innovative pharmaceutical producers, the Croatian situation is more sustainable, as by making savings on generics and ensuring a financial balance in the system, the authorities enable themselves to continue investing sustainably in innovative medicines.