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New year news letter 2010 print ready.docx

medotceurope.com™ New Year 2010 The News Letter of James Dudley Management Mail Order Sales Up -
Wishing You a
but Celesio's Retail
Pharmacies under

Prosperous
Cloud in Ireland, Italy
and the Netherlands?
Celesio‘s mail-order turnover from on-line activities in
Germany, Netherlands, Norway and UK rose significantly
in the first nine months of 2009 by 14.9 per cent to
€186.6 million. This is equivalent to the total turnover of
more than 160 of the company's retail pharmacies.

According to the Company strengthening its mail-order operations isimportant in building Celesio's Patient and Consumer Solutions division in the future. Celesio currently operates the Dutch-based DocMorris mail-order pharmacy, which serves customers in Germany and the Netherlands, as well as the mail-order operations of its Lloydspharmacy chain in the UK and Vitusapotek chain in Norway.
In Germany, a television campaign led to a strong boost in mail order demand with orders peaking at some 10,000 per day for the mail-order pharmacy DocMorris. According to Service Barometer DocMorris is the leading mail order company in Germany in 2009 with 15% share.
On a darker note Celesio is examining the future of its pharmacy operations in Ireland, Italy and the Netherlands, according to chief executive officer Fritz Oesterle. Addressing a press conference in Germany in December, Oesterle said the Europe-wide pharmaceutical retailer and distributor was "evaluating whether to continue its pharmacy operations" in the three countries. The company had already announced on 8 October 2009, that valuations were adjusted by €274 million in the course of the annual review of goodwill for its retail activities. The adjustments referred to the retail pharmacies in the Netherlands, Ireland and Italy as well as for DocMorris' brand partner business. The mail-order pharmacy business remained unaffected. OTC Distribution in Europe the 2010
Back in October the Company described the Dutch preference policy as Driving the Recovery
generics tendering in all but name and that it was this that was responsible for the reduced income streams of pharmacies in Holland. James W. Dudley is now available for details and table of Meanwhile reduced medicine prices and a cut in pharmacists' remuneration had had the same effect in Ireland. Government measures in Italy were also blamed for the "additional and unpredictable decline in pharmacy margins".


medotceurope.com Major Acquisition in Fragmented
Going Dutch - Mediq Finds Alternative
German Mail Order Pharmacy
to Preference Policy
Mediq Pharmacies, the Dutch retail chain, and
The mail-order pharmacy Europa Apotheek Venlo
healthcare insurer CZ have signed a two-year
Germany has acquired shop-apotheke.com, an online
contract that offers an alternative to the preference
OTC medicines and healthcare products retailer, for an
The key elements of the contract are that prices of pharmaceuticals Medco Health Solutions – the US pharmacy benefit manager, which will be lower, the fee for service received by Mediq will be higher and acquired Europa Apotheek in April 2008, said the acquisition Mediq will control its own pharmaceuticals product portfolio.
expanded both its product offering and the channels through which it reached consumers in Germany.
Mediq represents the largest retail pharmacy chain in the Netherlands and has 14% share of the sector.
The German pharmacy mail order business was born out of changes to the laws on distance selling of pharmaceutical products in 2004. Whereas insurers take on pharmaceuticals purchasing under the The rapid growth of on-line business start ups have left the German preference policy, Mediq will remain responsible for supplier selection pharmacy mail order sector highly fragmented with the top seven in this contract. This deal puts Mediq pharmacists back in the driving operators taking around 41% share. Europa Apotheek jointly takes seat in deciding the pharmaceuticals to be dispensed on the basis of fifth place in the German market with just 2% market share according GPs' prescriptions and stops insurers centrally determining which to Service Barometer. It can be expected that there will be further medicines qualify exclusively for reimbursement. In addition, Mediq consolidation in the sector. The market leader is DocMorris which is Pharmacies and CZ will jointly develop additional healthcare services owned by Celesio.
for their customers. The contract is set to become effective on 1 January 2010.
Europa Apotheek based in Venlo is a Dutch pharmacy certified by TÜV Nord with over 180 employees. The business was founded in 2001 Mediq will receive a lower but fixed reimbursement from the insurer and operates in the German and Dutch markets. Europa Apotheek for pharmaceuticals dispensed. The costs of pharmaceuticals will Venlo is among the largest mail-order pharmacies in Europe and as a consequently be lower. At the same time, CZ will pay Mediq the full-service pharmacy supplies drugs to patients with chronic diseases maximum dispensing fee per prescription item set by the Dutch such as diabetes, cardio-vascular diseases, arthritis, asthma, COPD Healthcare Authority ((Nederlandse Zorgautoriteit - NZa). This fee is multiple sclerosis and HIV. Europa Apotheek Venlo also maintains an currently at € 7.94, i.e. € 0.66 higher than the basic fee of € 7.28. In order-and-pickup service for prescription drugs at PharmaPoints in addition, CZ will no longer withhold a certain percentage (known as some 1,000 dm-drogeriemarkt drugstores.
the clawback) on the reimbursement for the agreed range. shop-apotheke.com was established some six years ago as a mail- Mediq will retain the purchasing function. Under the preference order pharmacy in Germany and has over 300,000 registered buyers policy, pharmacies are required to stock the various different and approximately 2.4 million visits/visitors per month to its website. preferred pharmaceuticals of the various healthcare insurers, who in The company has TUV quality certification.
addition regularly switch their preference. Mediq avoids the associated logistical and administrative costs by purchasing itself. This also enables Mediq to negotiate better terms with suppliers.
% Share Mail Order Pharmacies in Germany 2009 Mediq recently signed similar contracts with Zilveren Kruis Achmea and Agis and with these contracts is positioning itself for the free market to be introduced in the pharmacy sector. Marc van Gelder, CEO Mediq: "We have never supported the preference policy, as it leads to an erosion of healthcare. This agreement with CZ provides an alternative that ties in with Mediq's strategy. The additional healthcare services lead to improved health for end users".
Source: Service Barometer medotceurope.com James Dudley Management medotceurope.com As well as selling off the 465 pharmacies in eight large clusters, the Sweden's Pharmacy Monopoly is
Swedish government has made 150 pharmacies available to small businesses. The other 330 pharmacies will remain under the control of Apoteket. All of Sweden's 945 pharmacies had been under state control as part of the Apoteket chain.
Rx to OTC News
Parliament Approves
Pantoprazole Rx to OTC Switch
From 1 January 2010 medicinal products containing 20mg
pantoprazole for short-term treatment of heartburn and acid
reflux will have OTC status in Germany.

Germany's upper house of parliament, the Bundesrat, passed legislation on 18 December that allowed the marketing status Picture Bertil Hagberg of 20mg pantoprazole to be changed from prescription-only to non-prescription. The maximum pack size will be 14 tablets or Oriola-KD and two private equity groups have come out
capsules. However, OTC 20mg pantoprazole will be indicated tops over some of the most hotly tipped industry
for adults only.
bidders in the SKr5.9bn (€560m) auction of part of
The proposed switch from prescription only to OTC (Rx to OTC) Sweden's state-owned Apoteket pharmacy chain.
was introduced soon after Nycomed commercialised 20mg pantoprazole tablets in Germany as the non-prescription The winners, Altor and Segulah private-equity investors and Oriola-KD medicine Pantozol Control - the first OTC proton pump blocker have acquired the bulk of the state-owned Apoteket pharmacies. on the German market approved for short-term treatment Altor and Segulah, both Nordic-focused buy-out funds, were with frequently recurring heartburn successful bidders and point to a revival in the region's private equity market after a long period of inactivity since the financial crisis. Altor Germany was among the initial countries where Nycomed won the biggest nationwide cluster of 208 Apoteket stores.
introduced Pantozol Control after the 20mg pantoprazole tablets gained non-prescription status for frequent heartburn Kronans Droghandel Retail AB, a company jointly owned by Oriola-KD throughout the European Union in June. Pantozol Control is Corporation and Kooperativa Förbundet (KF), has won the tender for only the second EU wide Rx to OTC switch achieved through a a national pharmacy cluster with 171 pharmacies. Proforma net sales Centralized Procedure of the 171 pharmacies in 2008 were SEK 4.4 billion (€421 million), 14.5 per cent of Swedish pharmacy market. Proforma operating profit The Rx to OTC switch of all 20mg pantoprazole formulations including average central overhead costs of Apoteket AB in 2008 was with a maximum pack size of 280mg is seen very much as a SEK 183 million(€17.6 million), 4.2 per cent of net sales. The net debt tidying up exercise after Nycomed's switch became effective of the acquired pharmacy cluster at the end of August 2009 was SEK throughout the European Union.
136 million (€13 million). The pharmacy cluster employed 931 employees at the end of 2008.
The general switch will inevitably lead to the introduction of a number of branded and generic non-prescription competitors The total purchase price of the acquisition is expected to be to Nycomed's Pantozol Control as the pantoprazole patent ran approximately SEK 1.56 billion (€150 million) in cash. The closing of out in Germany in early 2009.
the transaction is expected to take place in the first quarter of 2010, and is subject to approval by the Swedish Competition Authority (Konkurrensverket) and the granting of pharmacy license by the Swedish Medical Products Agency (Läkemedelsverket).
Medstop owned by the private equity company Segulah won the bid for three pharmacy clusters with a total of 62 stores with combined Free Download
sales of SEK 3.1 billion (€296 million) James W Dudley's
Rx to OTC Presentation
Alliance Boots, Europe's largest pharmacy group, was among those Innovating Self-medication - European Switch
whose bids failed. Celesio had previously announced that it would not participate in a bidding war and would set up a new 100 branch pharmacy chain under the DocMorris banner progressively over the next few years.
medotceurope.com James Dudley Management medotceurope.com Important new Report
German Pharmacies Grow in Number
"OTC Distribution in Europe"
The New 2010 Edition

Since January 2004 German pharmacists have been able to
own up to four pharmacies in their neighborhood.

Driving the Recovery
"This study has identified themes of change that
While skeptics accused the German Government of watering down are reshaping the structure of the healthcare supply
plans for unlimited controls on pharmacy chains at the time, the chain, focusing buyer power and presenting
policy of allowing a pharmacist to own up to three branch pharmacies suppliers with new strategic challenges.
along with the main retail store seems to have contributed to halting the worrying decline in numbers. The aim of this seventh study into OTC Distribution
The number of pharmacy branches under management in Germany in Europe is to explore these themes and to provide
increased from 6% in 2006 to 13% in 2008, while the actual number of a reasoned framework for anticipating unfolding
proprietors declined by 2,554 according to ABDA. Since the threats and opportunities". James W. Dudley
introduction of the new rules the decline in the number of pharmacies in Germany has been reversed. Having dipped to 21,300 in 2003, German pharmacy numbers have climbed back to over This is the seventh edition of James Dudley's highly regarded 18 country 23,600 today – a figure close to the previous peak in 2000. consultancy report - OTC Distribution in Europe. This much expanded 2010
edition is the largest and most up to date strategic analysis of the supply
Following the introduction of limited branch ownership and the network serving the non-prescription and OTC Self-medication sectors in overall reduction in owner managers the average pharmacy turnover Europe With over 460 pages and 200 graphs, tables & figures
has increased by 15% and the number of pharmacies with turnoverin For details and table of contents visit excess of €1.75 million has grown from 23% to 29%. The increase in small pharmacy groupings has also coincided with the rapid growth of virtual chains created by voluntary groupings of pharmacies and wholesaler driven concept franchises. According to OTC Distribution in Europe the 2010 edition some 65% of Germany pharmacies are affiliates of virtual chains representing 40% of all pharmacies in virtual chains in the 18 European countries covered by the study. Average pharmacy annual turnover is €1.75 million (up from €1.52 million in 2005) but 57.5% of pharmacies fall below this figure. While just under a quarter of pharmacies are struggling to survive, pharmacies in the top 20% have sales of over €2.0 million a year.
Number of Pharmacies in Germany 1995 to 2008 Contact Telephone :++44(0) 1562 747705
e-mail: [email protected]

Graph: James Dudley Management – OTC Distribution in Web site: www.jamesdudley.info
Europe the 2010 Edition – Driving the Recovery(data ABDA/Anzag/James Dudley) medotceurope.com James Dudley Management

Source: http://www.james-dudley.co.uk/downloads/newsletters/newyear-2010.pdf

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