The Outlook for Emerging Central American Pharmaceutical Markets 2009

Date: January 22, 2009
Pages: 324
Price:
US$ 1,390.00
Publisher: Espicom Business Intelligence
Report type: Strategic Report
Delivery: E-mail Delivery (PDF)
ID: O598F6F186CEN
Leaflet:

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The Outlook for Emerging Central American Pharmaceutical Markets 2009
Often overlooked, the US$18.1 billion Central American pharmaceutical markets present sizeable opportunities for branded and generic drug companies

While Mexico is the largest pharmaceutical market in Central America, companies should not ignore the potential of Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama. Combined, they represent a pharmaceutical market greater than Colombia, Chile or Peru. The region’s manufacturing capabilities are strong and proven, particularly in Mexico. Pharmaceutical research has been limited but opportunities exist.

All Central American countries offer attractive fiscal incentives. The North American Free Trade Agreement (NAFTA) and the Dominican Republic – Central American Free Trade Agreement (DR – CAFTA) also provide advantages, including stronger IPR enforcement. As foreign manufacturers move into Mexico, they are also considering other Central American markets.

Regional Overview + 7 Key Markets Covered

COSTA RICA
EL SALVADOR
HONDURAS
GUATEMALA
MEXICO
NICARAGUA
PANAMA

This new management report, The Outlook for Emerging Central American Pharmaceutical Markets, has been written by Espicom’s Latin American healthcare analyst Ricardo Vicente. Incorporating much original information, the study shines a critical light on the markets in the region, assessing their status and potential in the current economic and market conditions.

For each market, the report provides analysis of:

Healthcare expenditure, infrastructure and provision
Pharmaceutical regulation, IPR, pricing and reimbursement
Pharmaceutical wholesaling and retailing
Pharmaceutical markets, with forecast values to 2013

OVER 50 LOCAL MANUFACTURERS REVIEWED

The report provides insight into the local pharmaceutical industry, with a review of leading players:

Alcames
Ancalmo
Andifar
Arsal
Bonin
Calox
Ceguel
CORINFAR
Donovan Werke
Everest
Farsimán
Finlay
Francelia
Gamma
Genomma Lab
Grupo Pharma Internacional
IFA Celtics
INFARMA
INFASA
Karnel
LACOFA
LAFOFA
LAÍN
Lancasco
Landsteiner Scientific
Liomont
Lisan
López
Mapeca
MC
Mediproducts
Nacional
NPCR
Panzyma
Pharmaetica
Piersan
Pisa
Probiomed
Qualifipharm
RARPE
Rigar
Sandoval
Senosiain
Silanes
Sophia
Stein
Suizos
Teramed
Vijosa
Zepol

HIGHLIGHTS FROM THE REPORT

Costa Rica

Costa Rica has a relatively small but open pharmaceutical market dominated by foreign branded drugs in the private pharmacy sector and generics in the public sector. After Mexico, Costa Rica has been the most popular country for foreign producers in the region. Roche, MSD and Pfizer are the leading exporters of pharmaceuticals. Local and foreign producers have developed the export market in neighbouring Central American countries, the Caribbean and Venezuela.

El Salvador

El Salvador is the third largest Central American pharmaceutical market. In the private pharmacy sector, there is no drug price regulation system in place, but taxes and customs duties are applicable. In the public hospital sector, MSPAS and ISSS are co-operating but they have not yet centralised drug purchases. Pharmaceutical production mainly comprises generic medicines. El Salvador is close to Guatemala, and local producers have increased their manufacturing capabilities in order to capture the sizeable Central American market. Bayer is one of the leading international producers established in the country.

Guatemala

Guatemala is the second largest Central American pharmaceutical market. In the private pharmacy sector, there is no drug price regulation system in place, but taxes are applicable. Under Decree No. 16/2003, however, generic drugs and natural products are exempted from VAT and customs duties. In the public hospital sector, MSPAS, IGSS and the Ministry of Defence centralise pharmaceutical purchases via an open contract system with local producers and importers. There are 92 producers, most of whom produce generics. Bayer is the only leading international producer.

Honduras

Honduras is a small economy, with a strong dependence on remittances from Hondurans living abroad. Local producers are small or medium sized, therefore production is limited and only represents about 20% of the market. Honduras has failed to implement the five-year test data protection and patent linkage, under the Dominican Republic – Central America Free Trade Agreement. Prices of locally produced medicines are liberalised. However, prices of imported medicines are regulated, with established wholesalers’ and pharmacy margins.

Mexico

The private pharmacy sector accounts for 72.9% of the pharmaceutical market at retail prices, while the public sector represents the remaining 27.1%. Due to the economic downturn, out-of-pocket pharmaceutical expenditure in the private pharmacy sector is slowing down. The pharmaceutical regulatory environment is fragmented but is showing signs of consolidation. Local manufacturing plant requirements are being phased out over two years. The reform of the Health Supplies Regulation has improved the renewal and registration processes of pharmaceuticals, and there will only be patented drugs and bioequivalent generics in the market from February 2010.

Nicaragua

Nicaragua is the smallest pharmaceutical market in Central America. The market is mainly supplied by imports, as local production represents between 15% and 20% of the market. Pharmaceutical prices are regulated by the Ministry of Development, Industry & Trade (MIFIC); no taxes are applicable to medicines. Pharmaceutical distributors and importers can increase prices in local currency values due to devaluation or inflation. In July 2008, new measures were agreed, mainly increasing the prices of branded medicines until March 2009.

Panama

Rapid economic growth, increasing pharmaceutical imports, a lack of pharmaceutical price regulation, the rising retail pharmacy sector and the consolidation of the public sector have made Panama the sixth largest Central American pharmaceutical market. Panama is expected to show exceptional growth over the next five years and will reach the same size as El Salvador by 2013. Panama is one of the pioneering countries in terms of pharmaceutical regulation in the region; one of the latest measures is the regulation of biologic products.
FOREWORD

REGIONAL OVERVIEW

EXECUTIVE SUMMARY
  Summary of Key Data Projections in Central America, 2008-2013
POLITICAL ANALYSIS
ECONOMIC ANALYSIS
  Projected GDP in Central & Latin America, 2008-2013 (US$ Billions)
  Projected GDP Real Growth in Central & Latin America, 2008-2013 (%)
  Projected GDP Per Capita in Central & Latin America, 2008-2013 (US$)
  Projected Inflation Growth in Central & Latin America, 2008-2013 (%)
HEALTHCARE ANALYSIS
  Demographics
    Population
      Projected Population in Central & Latin America, 2008-2013 (Millions)
      Projected Population Growth in Central & Latin America, 2008-2013 (%)
      Projected Population Aged 65+ in Central & Latin America, 2008-2013 (Millions)
      Projected Population Aged 65+ in Central & Latin America, 2008-2013 (%)
    Public Health
      Summary of Demographic Data in Central America
    Health Expenditure
      Projected Health Expenditure in Central & Latin America, 2008-2013 (US$ Billions)
      Projected Health Expenditure per Capita in Central & Latin America, 2008-2013 (US$)
      Projected Health Expenditure as % of GDP in Central & Latin America, 2008-2013
      Projected Private Health Expenditure in Central & Latin America, 2008-2013 (%)
PHARMACEUTICAL REGULATORY ANALYSIS
  Pharmaceutical Regulation
    Health Authorities in Central America, 2008
    Pharmacopoeias Accepted in Central America, 2007
    Legal Requirements for NCE Registrations in Central America, 2007
    Technical Requirements for NCE Registrations in Central America, 2007
    Approval Times & Fees for NCE Registrations in Central America, 2007
    Legal Requirements for Renewals in Central America, 2007
    Technical Requirements for Renewals in Central America, 2007
    Approval Times & Fees for Renewals in Central America, 2007
    SIECA‟s Resolutions Affecting Pharmaceuticals, 2002-2008
  Intellectual Property
    IPR Summary in Central America, 2008
  Pricing & Reimbursement
    Drug Pricing Summary in Central America, 2008
PHARMACEUTICAL DISTRIBUTION ANALYSIS
  Wholesaling
  Retailing
  Ranking of Central American Pharmacy Chains, 2006
PHARMACEUTICAL MARKET ANALYSIS
  Projections
    Pharmaceutical Market Projections of Central & Latin America, 2008-2013 (US$ Billions)
    Pharmaceutical Market Projections of Central & Latin America, 2008-2013 (%)
    Pharmaceutical Market Projections per Capita of Central & Latin America, 2008-2013 (US$)
    Private Pharmacy Sector of Central & Latin America, 2005-2007 (US$ Millions)
    SWOT Analysis of the Central American Pharmaceutical Market, 2008
  Imports
    Pharmaceutical Imports in Central & Latin America, 2002-2006 (US$ Millions)
  Domestic Production
  Trade Associations
    ALIFAR
      Members of ALIFAR, 2008
    FEDEFARMA
      Members of FEDEFARMA, 2008
    FIFARMA
      Members of FIFARMA, 2007
    FIFCCA
  Local Manufacturers
  Multinational Manufacturers
  Exports
    Pharmaceutical Exports in Central & Latin America, 2002-2006 (US$ Millions)
    Balance of Pharmaceutical Trade in Central & Latin America, 2002-2006 (US$ Millions)
  Research & Development

COSTA RICA

EXECUTIVE SUMMARY
  Summary of Key Data Projections, 2008-2013
GEOGRAPHY
POLITICAL ANALYSIS
ECONOMIC ANALYSIS
GDP, 2008-2013
HEALTHCARE ANALYSIS
  Demographics
    Population
      Population, 2008-2013
      Population by Province, Age & Sex, 2006
      Population by Province, Age & Sex, 2006 (%)
    Public Health
      Demographic Indicators, 2000-2007
      Causes of Death, 2001-2006
      Causes of Death by Sex, 2006
      AIDS Mortality by Sex, 1985-2007
      Infectious Diseases, 2000-2006
    Healthcare System
      Organisation & Administration
      Health Insurance
        Population Directly Insured by the Sickness & Maternity Insurance, 2000-2007
        Population Directly Insured by the Sickness & Maternity Insurance, 2000-2007 (%)
    Health Expenditure
      Health Expenditure, 2008-2013
    Public Health Expenditure
      Public Health Expenditure, 2000-2007
      Public Health Expenditure by Provider, 2003-2007 (CRC Billion)
  Healthcare Infrastructure
    Hospital Resources
      CCSS Hospital Bed Indicators, 2000-2006
      CCSS Hospital Beds by Specialty, 2001-2006
      CCSS Bed Indicators by Hospital, 2006
      CCSS Hospital Beds by Specialty & Hospital, 2006
    Hospital Activity
      CCSS Hospital Activity, 2000-2006
      CCSS Discharges by Specialty, 2000-2006
      CCSS Hospital Activity by Hospital/Area, 2006
      CCSS Discharges by Specialty & Hospital/Area, 2006
      CCSS Diagnostic Procedures, 2000-2006
      CCSS Diagnostic Procedures by Care Area, 2006
    Outpatient Resources
      EBAIS by Province, 2006
      Health Centres, 2002
    Outpatient Activity
      CCSS Outpatient & Emergency Consultations, 2001-2006
      CCSS Outpatient & Emergency Consultations by Region, 2006
  Medical Personnel
      Doctors, Nurses & Dentists, 2003-2006
      CCSS Medical Personnel, 2000-2007
      CCSS Auxiliary & Technical Healthcare Personnel, 2000-2007
PHARMACEUTICAL REGULATORY ANALYSIS
  Pharmaceutical Regulation
    Registration
    Advertising
    Packaging & Labelling
  Intellectual Property
  Pricing & Reimbursement
    Reimbursement
PHARMACEUTICAL DISTRIBUTION ANALYSIS
  Wholesaling
    Distributors
  Retailing
PHARMACEUTICAL MARKET ANALYSIS
  Current Size
    Summary of the Costa Rican Pharmaceutical Market, 2008
  Market Structure
    Market Structure, 1998-2006 (US$ Million)
  CCSS Sector
    CCSS Market Value, 2007-2008
    CCSS Market Volume by Care Area, 2002-2006 (Million Units)
    CCSS Market Volume by Region, 2002-2006 (Million Units)
  Projections
    Market Projections, 2008-2013
    SWOT Analysis of the Costa Rican Pharmaceutical Market, 2008
  Imports
    Pharmaceutical Imports by Category, 2002-2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (%)
  Domestic Production
    Domestic Production, 1995-2002
  Trade Associations
    ASIFAN
  Domestic Producers
    Alcames
    Calox de Costa Rica
    LACOFA
    Lisan
    Merck Sharp & Dohme
    NPCR
    Stein
    Zepol
  Exports
    Pharmaceutical Exports, 2003-2007 (US$ Million)
    Leading Pharmaceutical Exporters, 2003-2007 (US$ Million)
    Leading Pharmaceutical Destinations, 2003-2007 (US$ Million)
    Leading Pharmaceutical Destinations, 2003-2007 (Tons)
  Research & Development

EL SALVADOR

EXECUTIVE SUMMARY
  Summary of Key Data Projections, 2008-2013
GEOGRAPHY
POLITICAL ANALYSIS
ECONOMIC ANALYSIS
  GDP, 2008-2013
HEALTHCARE ANALYSIS
  Demographics
    Population
      Population, 2008-2013
      Population by Department, 2007 Census
    Public Health
      Demographic Indicators, 2005-2007
      Ten Leading Causes of Death by Gender, 2006
      AIDS Deaths, 2000-2007
      Infectious Diseases, 2005-2007
      Vaccination Coverage, 2005-2007 (%)
      HIV/AIDS Cases, 1984-2007
      Antiretroviral Therapy Patients, 2001-2006
    Healthcare System
      Organisation & Administration
    Health Expenditure
      Health Expenditure, 2008-2013
      Health Expenditure by Sector, 2006
      Public Health Expenditure by Provider, 2006
      MSPAS Health Expenditure, 2003-2007 (US$ Million)
      MSPAS Health Expenditure by Type, 2005-2007 (US$ Million)
  Healthcare Infrastructure
    Hospital Resources
      MSPAS Infrastructure, 2003-2007
      MSPAS Hospital Infrastructure by SIBASI, 2007
      MSPAS Diagnostic Infrastructure, 2003-2007
      MSPAS Hospital Diagnostic Infrastructure by SIBASI, 2007
    Hospital Activity
      MSPAS Hospital Activity, 2003-2007
      MSPAS Diagnostic Activity, 2003-2007
      MSPAS Diagnostic Activity by Provider, 2007
    Outpatient Resources
      MSPAS Outpatient Infrastructure, 2003-2007
      MSPAS Outpatient Infrastructure by SIBASI, 2007
      MSPAS Other Outpatient Infrastructure by SIBASI, 2007
      MSPAS Outpatient Diagnostic Infrastructure by SIBASI, 2007
    Outpatient Activity
      MSPAS Medical Consultations by Type, 2003-2007
      MSPAS Medical Consultations by Provider, 2007
      MSPAS Dentist Consultations by Provider, 2003-2007
    Medical Personnel
      MSPAS Personnel, 2006
PHARMACEUTICAL REGULATORY ANALYSIS
  Pharmaceutical Regulation
    Registration
    Packaging & Labelling
    Manufacturing Licence
  Intellectual Property
  Pricing & Reimbursement
PHARMACEUTICAL DISTRIBUTION ANALYSIS
  Retailing
    Pharmacy Chains
    Económicas
    Meykos
    San Nicolás
PHARMACEUTICAL MARKET ANALYSIS
  Current Size
    Summary of the Salvadorian Pharmaceutical Market, 2008
  Market Structure
    MSPAS Medical Prescriptions, 2003-2007
    MSPAS Pharmaceutical Suppliers, 2007 & 2008
  Projections
    Market Projections, 2008-2013
    SWOT Analysis of the Salvadorian Pharmaceutical Market, 2008
  Imports
    Pharmaceutical Imports by Category, 2002-2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (%)
  Domestic Production
    Pharmaceutical Production by Number of Employees, 2004
    Pharmaceutical Production by Turnover, 2004
  Trade Associations
    INQUIFAR
    ASI
      Pharmaceutical Members of ASI, 2008
  Domestic Producers
    Ancalmo
    Arsal
    Bayer
    Gamma
    López
    Suizos
    Teramed
    Vijosa
  Exports
    Pharmaceutical Exports by Category, 2002-2004 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2004 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2004 (%)

GUATEMALA

EXECUTIVE SUMMARY
  Summary of Key Data Projections, 2008-2013
GEOGRAPHY
POLITICAL ANALYSIS
ECONOMIC ANALYSIS
  GDP, 2000-2009
HEALTHCARE ANALYSIS
  Demographics
    Population
      Population by Age Group, 2005, 2010 & 2015
      Population, 2000-2009
      Population by Sex, Area & Department, 2002 Census
    Public Health
      Demographic Indicators, 2000-2005
      Causes of Death, 2001-2006
      Causes of Death by Sex, 2006
      Infectious Diseases, 2004-2006
    Healthcare System
      Organisation & Administration
        IGSS Coverage, 2000-2006
    Health Expenditure
      Health Expenditure, 2006-2013
      Health Expenditure by Sector, 2005
    MSPAS Health Expenditure
      MSPAS Health Expenditure by Type, 2006
      MSPAS Health Expenditure on Primary Care by Health Area, 2005
      MSPAS Health Expenditure on Hospital Care by Health Area & Hospital, 2005
  Healthcare Infrastructure
    Hospital Resources
      MSPAS Hospitals by Type, 2005 & 2006
      MSPAS Hospitals by Type & Health Area, 2005
      MSPAS Beds by Health Area & Hospital, 2005
      IGSS Beds by Department & Hospital/Consulting Office, 2006
    Hospital Activity
      MSPAS Hospital Activity, 2005 & 2006
      IGSS Hospital Activity, 2006
      MSPAS Diagnostic Procedures, 2005 & 2006
      MSPAS Hospital Activity by Health Area & Hospital, 2005
      MSPAS Diagnostic Procedures by Health Area & Hospital, 2005
    Outpatient Resources
      MSPAS Outpatient Resources, 2005 & 2006
      MSPAS Health Centres & Posts by Health Area, 2005
      IGSS Outpatient Resources, 2006
    Outpatient Activity
      MSPAS Outpatient Activity by Health Area, 2005
      IGSS Outpatient Activity, 2006
    Medical Personnel
      IGSS Medical Personnel, 2006
PHARMACEUTICAL REGULATORY ANALYSIS
  Pharmaceutical Regulation
    Pharmaceutical Registration
    Packaging & Labelling
    Advertising
  Intellectual Property
  Pricing & Reimbursement
PHARMACEUTICAL DISTRIBUTION ANALYSIS
  Retailing
    Pharmacy Chains
PHARMACEUTICAL MARKET ANALYSIS
  Current Size
    Summary of the Guatemalan Pharmaceutical Market, 2008
  Projections
    Market Projections, 2008-2013
    SWOT Analysis of the Guatemalan Pharmaceutical Market, 2008
  Imports
    Pharmaceutical Imports by Category, 2002-2005 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2005 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2005 (%)
  Domestic Production
    Pharmaceutical Producers, 2007
  Trade Associations
    ASINFARGUA
    Members of ASINFARGUA, 2008
    CÁMARA DE INDUSTRIA DE GUATEMALA
  Domestic Producers
    Bayer
    Bonin
    Donovan Werke
    INFASA
    LAFOFA
    Lancasco
    Mediproducts
    Piersan
    Qualipharm
  Exports
    Pharmaceutical Exports by Category, 2002-2005 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2005 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2005 (%)

HONDURAS

EXECUTIVE SUMMARY
  Summary of Key Data Projections, 2008-2013
GEOGRAPHY
POLITICAL ANALYSIS
ECONOMIC ANALYSIS
  GDP, 2000-2009
HEALTHCARE ANALYSIS
  Demographics
    Population
      Population, 2000-2009
      Population by Department & Sex, August 2008
      Population by City, 2003-2007 (000s)
    Public Health
      Demographic Indicators, 1990, 2000 & 2006
      Cumulative HIV/AIDS Cases by Year, December 2007
      Cumulative HIV/AIDS Cases by Transmission Type, January 2007
      HIV Projections in the Adult Population, 2008-2012
      HIV Estimates, 2002-2006
    Healthcare System
      Organisation & Administration
        IHSS Coverage, 2003-2007
        IHSS Coverage by City, 2003-2007
    Health Expenditure
      Estimated Health Expenditure, 2005-2009
    Hospital Infrastructure
      Hospital Resources
        Hospitals by Sector, 2003-2007
        SS Hospitals by Location & Department, 2007
        Hospital Beds, 2001-2007
      Outpatient Resources
        SS Health Centres, 2001-2007
        SS Peripheral Clinics (CLIPER) by Location & Department, 2007
      Medical Personnel
        Medical Personnel, 2006-2009
        SS & IHSS Personnel, 2004
PHARMACEUTICAL REGULATORY ANALYSIS
  Pharmaceutical Regulation
    Pharmaceutical Registration
  Intellectual Property
  Pricing & Reimbursement
    Reimbursement
PHARMACEUTICAL DISTRIBUTION ANALYSIS
  Retailing
    Fines to Pharmacy Chains & Associations, July 2008
PHARMACEUTICAL MARKET ANALYSIS
  Current Size
    Summary of the Honduran Pharmaceutical Market, 2008
  Market Structure
    Private Pharmacy Sector
    Public Sector
  Projections
    Market Projections, 2008-2013
    SWOT Analysis of the Honduran Pharmaceutical Market, 2008
  Imports
    Pharmaceutical Imports by Category, 2002-2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (%)
  Domestic Production
    Trade Association
      ANAPROHFAR
  Domestic Producers
    Andifar
    CORINFAR
    Everest
    Farsimán
    Finlay
    Francelia
    Grupo Pharma Internacional
    INFARMA
    Karnel
    LAÍN
    Mapeca
    MC
    Nacional
    Pharmaetica
    Sandoval
  Exports
    Pharmaceutical Exports by Category, 2002-2006 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2005 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2005 (%)

MEXICO

EXECUTIVE SUMMARY
  Summary of Key Data Projections, 2008-2013
GEOGRAPHY
POLITICAL ANALYSIS
ECONOMIC ANALYSIS
  GDP, 2008-2013
HEALTHCARE ANALYSIS
  Demographics
    Population
      Projected Population, 2008-2013
      Projected Population by State, 2009
  Public Health
    Demographic Indicators, 2000-2007
    Leading Causes of Death, 2001-2008
    Leading Reportable Diseases, 2007
  Healthcare System
    Organisation & Administration
    Social Security
  Health Expenditure
    Projected Health Expenditure, 2008-2013
    Healthcare Expenditure by Sector, 2000-2007
    Public Health Expenditure by Source of Funding, 2000-2007
  Healthcare Infrastructure
    Hospital Resources
      Public Hospitals by Provider, 2000-2008
      Private Hospitals by Bed Size, 2000-2008
      Active Hospital Beds by Sector, 2000-2008
      Public Active Hospital Beds by Provider, 2000-2008
      Private Active Hospital Beds by State, 2002-2007
      Médica Sur's Revenues, 2004-2007 (Million Pesos)
  Hospital Activity
    Hospital Discharges by Sector, 2001-2008 (000s)
    Public Hospital Discharges by Provider, 2000-2008 (000s)
    Private Hospital Activity, 2000-2008 (000s)
    Hospital Surgical Procedures by Sector, 2001-2008 (000s)
    Public Hospital Surgical Procedures by Provider, 2000-2008
  Outpatient Resources
    Public Outpatient Units by Provider, 2000-2008
    Consulting Rooms by Sector, 2000-2008
    Public Consulting Rooms by Provider, 2000-2008
    Private Consulting Rooms by State, 2002-2007
  Outpatient Activity
    Outpatient Consultations by Sector, 2000-2008 (000s)
    Public Outpatient Consultations by Provider, 2000-2008 (000s)
    Private Outpatient Consultations by Type, 2000-2008 (000s)
  Healthcare Personnel
    Doctors by Sector, 2000-2008
    Public Doctors by Provider, 2000-2008
    Private Doctors by State, 2005-2007
PHARMACEUTICAL REGULATORY ANALYSIS
  Pharmaceutical Regulation
    Regulatory Developments for Biologics
    Medical Samples Regulatory Developments
    Manufacturing Regulatory Developments
    Pharmaceutical Registration
      Legal Pharmaceutical Registration Requirements
      Technical, Preclinical & Clinical Registration Requirements
      NOM-177-SSA1-1998's Generic Tests
      Time for Registration Approval & Fees
  Registration Renewals
    Registration Renewal Requirements
  Import Regulations
    Import Fees Applicable from 1st January 2007
  Advertising
  Intellectual Property
  Pricing & Reimbursement
    Pricing in the Private Pharmacy Sector
    Pricing in the Public Sector
    Reimbursement
PHARMACEUTICAL DISTRIBUTION ANALYSIS
  Wholesaling
    Distribution Associations
    Distributors
  GCS's Sales, 2003-QII 2008
  Retailing
    Pharmacy Associations
      Members of ANADIM, 2007
    Pharmacy Chains
      Farmacias Benavides' Figures, 2002-QIII 2008
      Corporativo Fragua's Figures, 2002-QIII 2008
PHARMACEUTICAL MARKET ANALYSIS
  Current Size
    Summary of the Mexican Pharmaceutical Market, 2008
  Market Structure
    Private Pharmacy & Public Sectors by Value, 2008 (US$ Million)
  Generics Sector
  OTC Sector
  Public Sector
    Public Pharmaceutical Expenditure by Provider, 2007 (Million Pesos)
    Public Pharmaceutical Expenditure by Provider, 2004-2007 (Million Pesos)
    Change in Public Pharmaceutical Expenditure by Provider, 2005-2007 (%)
    Public Pharmaceutical Expenditure by Provider, 2004-2007 (US$ Million)
  Projections
    Market Projections, 2008-2013
    SWOT Analysis of the Pharmaceutical Market, 2008
  Imports
    Pharmaceutical Imports by Category, 2002-2006 (US$000s)
    Pharmaceutical Import Trends by Category, 2005-2006 (US$000s)
    Leading Suppliers of Raw Materials, 2006 (US$000s)
    Leading Suppliers of Antisera & Vaccines, 2006 (US$000s)
    Leading Suppliers of Medicaments, 2006 (US$000s)
  Domestic Production
    Pharmaceutical Production Indicators, 1999-2006
    Pharmaceutical Production Breakdown, 2000-2005 (Billion Pesos)
  Trade Associations
    AFAMELA
      Members of AFAMELA, 2007
    AMEGI
      Members of AMEGI, 2008
    AMELAF
    AMIIF
      Members of AMIIF, 2008
    ANAFAM
      Members of ANAFAM, 2007
    ANAPIF
    CANIFARMA
      Members of CANIFARMA, 2007
  Trade Fairs
    EXPOFARMA INTERPHEX 2009
    ExpoSALUD y Bienestar
  Local Manufacturers
    Genomma Lab
      Genomma Lab's Sales by Destination, 2005-2007 (Million Pesos)
      Genomma Lab's National Sales by Sector, 2005-2007 (Million Pesos)
      Genomma Lab's Bestsellers by Sales, 2007
    IFA Celtics
      Landsteiner Scientific
      Liomont
      Pisa Farmacéutica
      Probiomed
      Senosiain
      Silanes
      Sophia
    Multinational Manufacturers
      Armstrong
      AstraZeneca
        AstraZeneca's Sales, 2005-2006
      Bayer
      Boehringer Ingelheim Promeco
      Bristol-Myers Squibb
      Eli Lilly
      GlaxoSmithKline
      Merck
      Merck Sharp & Dohme
      Novartis
        Novartis Sales by Division, 2007
      Perrigo
      Pfizer
      Roche
      sanofi-aventis
      Schering-Plough
      Solvay Pharmaceuticals
      Teva
      Wyeth
  Exports
    Pharmaceutical Exports by Category, 2002-2006 (US$000s)
    Pharmaceutical Export Trends by Category, 2005-2006 (US$000s)
    Leading Destinations of Pharmaceuticals, 2006 (US$000s)
  Research & Development
    Clinical Studies, 2003-2006

NICARAGUA

EXECUTIVE SUMMARY
  Summary of Key Data Projections, 2008-2013
GEOGRAPHY
POLITICAL ANALYSIS
ECONOMIC ANALYSIS
  GDP, 2000-2009
HEALTHCARE ANALYSIS
  Demographics
    Population
      Population, 2000-2009
      Population by Department/Autonomous Region & Sex, 2005 Census
      Population by Age Group & Sex, 2005 Census
    Public Health
      Estimated Five-Year Demographic Indicators, 1990-2005
      Estimated & Reported Births & Deaths, 2000-2002
      Reported Deaths by Cause, 2005
      Reported Deaths by Cause, 1985-2005 (%)
      Morbidity Indicators, 2005
      Malaria & Tuberculosis Rates, 1990-2005
      Vaccination Coverage, 2002-2005 (%)
      Cumulative HIV/AIDS Cases by SILAIS, 1987-June 2007
    Healthcare System
      Organisation & Administration
        INSS Affiliated Population by Type of Affiliation, 1994-2006
        INSS Insured Population Affiliated to Contracted Clinics, 1996-2006
    Health Expenditure
      Estimated Health Expenditure, 2005-2009
      Health Expenditure by Sector, 2004
    Hospital Infrastructure
      Hospital Resources
        MINSA Hospitals & Hospital Beds, 2000-2005
        MINSA Hospital Beds by Department/Autonomous Region, 2005
        INSS Contracted Clinics by Number of Affiliated Population, 2006
    Hospital Activity
      MINSA Activity, January-June 2005-2008
      MINSA Activity by Department/Autonomous Region, 2005
      MINSA Activity, 2000-2002
      INSS Activity, 2000-2006
    Outpatient Resources
      MINSA Ambulatory Network, 2000-2002
      MINSA Ambulatory Consultations by Department/Autonomous Region, 2005
    Medical Personnel
      MINSA Medical Personnel, 2000-2005
      MINSA Medical Personnel by Department/Autonomous Region, 2000-2005
PHARMACEUTICAL REGULATORY ANALYSIS
  Pharmaceutical Regulation
    Pharmaceutical Registration
  Intellectual Property
  Pricing & Reimbursement
    Reimbursement
PHARMACEUTICAL DISTRIBUTION ANALYSIS
PHARMACEUTICAL MARKET ANALYSIS
  Current Size
    Summary of the Nicaraguan Pharmaceutical Market, 2008
  Market Structure
    Private Pharmacy Sector
    Public Sector
  Projections
    Market Projections, 2008-2013
    SWOT Analysis of the Nicaraguan Pharmaceutical Market, 2008
  Imports
    Pharmaceutical Imports by Category, 2002-2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (%)
  Domestic Production
  Domestic Producers
    Ceguel
    Panzyma
    RARPE
  Exports
    Pharmaceutical Exports by Category, 2002-2006 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2006 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2006 (%)

PANAMA

EXECUTIVE SUMMARY
  Summary of Key Data Projections, 2008-2013
GEOGRAPHY
POLITICAL ANALYSIS
ECONOMIC ANALYSIS
  GDP, 2000-2009
HEALTHCARE ANALYSIS
  Demographics
    Population
      Population, 2000-2009
      Population by Province, Age & Sex, 2007
      Population by Province & Age, 2007 (%)
    Public Health
      Demographic Indicators, 2003-2006
      Leading Causes of Death, 2003-2006
      Cumulative AIDS Deaths by Province, 2006
      Malignant Neoplasms by Type, 2005
      Infectious Diseases, 2002-2006
      Vaccination Coverage, 2002-2005 (%)
      AIDS Cases, 1984-2006
      Cumulative AIDS Cases by Province, 2006
    Healthcare System
      Organisation & Administration
        CSS Coverage, 2002-2006
        CSS Coverage by Province, 2006
    Health Expenditure
      MINSA Health Budget, 2002-2007 (US$ Million)
      MINSA Health Budget & Expenditure by Type, 2007 (US$ Million)
    Healthcare Infrastructure
      Hospital Resources
        MINSA & CSS Hospital Infrastructure, 2007
        MINSA & CSS Hospitals by Type, 2007
        Bed Indicators by Sector, 2001-2006
        Beds by Province, 2002-2006
        MINSA & CSS Beds, 2003-2005
        MINSA & CSS Hospital Beds by Province, 2002-2005
        MINSA & CSS Hospital Beds by Province, District & Hospital, 2005-2006
      Hospital Activity
        MINSA & CSS Discharges, 2003-2005
        MINSA & CSS Discharges by Hospital Type, 2005
        MINSA Hospital External Consultations, 2003-2006
        MINSA Hospital Emergency Consultations, 2003-2006
        MINSA Hospital Diagnostic Activity, 2003-2006
      Outpatient Resources
        MINSA & CSS Outpatient Infrastructure, 2007
        MINSA Outpatient Infrastructure by Province, 2007
        CSS Outpatient Infrastructure by Province, 2007
      Outpatient Activity
        MINSA Consultations by Type, 2003-2006
        MINSA Consultations by Province, 2006
        MINSA Diagnostic Activity, 2004-2006
      Medical Personnel
        Medical Personnel, 2001-2006
        Medical Personnel by Province, 2006
        Medical Personnel in Institutions with Beds by Sector, 2001-2006
PHARMACEUTICAL REGULATORY ANALYSIS
  Pharmaceutical Regulation
    Pharmaceutical Registration
  Intellectual Property
  Pricing & Reimbursement
    Retail Pharmacy Sector
    Public Sector
PHARMACEUTICAL DISTRIBUTION ANALYSIS
  Wholesaling
  Distribution Trade Association
    Pharmaceutical Members of CCIAP, 2008
  Distributors
    Pharmacy Sector vs Impa-Doel's Pharmaceutical Sales Growth, 2003-2006 (%)
    Impa-Doel's Clients by Distribution Channel, 2006
PHARMACEUTICAL MARKET ANALYSIS
  Current Size
    Summary of the Panamanian Pharmaceutical Market, 2008
  Projections
  Macroenvironment Analysis
  Healthcare Analysis
  Pharmaceutical Market Analysis
    Market Projections, 2008-2013
    SWOT Analysis of the Panamanian Pharmaceutical Market, 2008
  Imports
    Pharmaceutical Imports by Category, 2002-2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (US$ Million)
    Leading Pharmaceutical Suppliers by Category, 2006 (%)
    Domestic Production
  Trade Association
    AREDIS
  Domestic Producers
    Rigar
  Exports
    Pharmaceutical Exports by Category, 2002-2006 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2006 (US$ Million)
    Leading Pharmaceutical Destinations by Category, 2006 (%)

APPENDIX 1: SOURCES

REGIONAL OVERVIEW
  Espicom
  Media
  Organisations
  Trade Associations
COSTA RICA
  Government Organisations
  Trade Associations
EL SALVADOR
  Government Organisations
  Trade Associations
GUATEMALA
  Government Organisations
  Trade Associations
HONDURAS
  Government Organisations
  Trade Associations
MEXICO
  Government Organisations
  Trade Associations
NICARAGUA
  Government Organisations
  Trade Associations
PANAMA
  Government Organisations
  Trade Associations
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