copyright 2002, ims health. no portion of this document may be reproduced, used or distributed in...

Copyright 2002, IMS HEALTH. No portion of this document may be reproduced, used or distributed in any form without written

authorization. All trademarks assumed.

PRESENTED BY

Jack Tuttle

Copyright 2002, IMS HEALTH

Pharma Industry Growth 1997 - 2001

1997 2001

Other

J apan

Europe

N. America$396B

$296B

CAGR8 %


North America Leads the World in Dollar Percent Growth (Constant Exchange)

9

10

12

16

3

3

5

7

8

12

13

J apan

France

I taly

Aust/ NZ

Key Markets

Germany

Spain

Mexico

UK

USA

Canada

Comparison is Latest 12 months ending September 2002 vs. Latest 12 Months ending September 2001

Brazil –7Argentina -52


US Pharma Continues to Extend Its Large Lead

0

20

40

60

80

100

120

140

160

180

$US Bil

Source: IMS HEALTH: MIDAS, 2001 * Pharmacy only ** Hospital only

Sale

s

RxRx


2002 RecapGenerics in the SpotlightHormone Replacement Concerns“Personal Importation” No Medicare Drug Benefit State Medicaid budget deficits force states to tackle drug costs“Truthful” DTCPharmaceutical Industry under attackThree Tier Co pays continue to expand“Innovation Drought” ContinuesNexium/Prilosec, Clarinex/Claritin transitions• Claritin—Generic?, OTC, or OtherAmgen/Immunex merger, Pfizer/Pharmacia, Others?Counterfeit DrugsDrug Shortages


Express Scripts-Top Developments in the 2002 Pharmaceutical Landscape

•Claritin Goes OTC•Generic Market Share Reaches All-Time High•Prilosec Faces Generic Competition•Hormone Replacement Studies cause Concern and Confusion•Several High-Profile Drugs Approved-Others Delayed•Marketing Landscape Chills For Pharmaceutical Manufacturers•Speciality Injectable Drugs Gain Market Share


The 2002 Pharmaceutical Market Should Exceed $190 Billion Dollars

All Outlets- Ex Wholesale Cost

61.2 66.6 73.4 82 92.9107.3

128146.8

172.2194.4

0

50

100

150

200

250

93 94 95 96 97 98 99 '00 "01* 02E

Compounded Growth = 13.8%* 2001 had 53 weeks of sales


8%9%

10%

12%13%

15%

19%

15%

17%

13%14%14%

0%2%4%6%8%

10%12%14%16%18%20%

2002 Mid-Year US Dollar Growth shows a Return to More Historic Levels

Percent Change vs. Year Ago

CAGR is 13.8%


2002 Retail & Mail Prescriptions Are Growing at 5%

5%5%

1%3%

4%5% 6%

4%5%

7%9%

5%

0%2%4%6%8%

10%12%14%16%18%20%

Percent Change Vs. Year Ago Retail and Mail (excludes LTC)


Forecast of Future Rx Dispensed Growth U.S. Retail Market (Bill.) At 5.5% CAG Rate

1.6 1.6 1.6 1.61.9 1.9 2.0 2.0 2.1 2.2 2.3

2.52.7 2.8

3.03.2

3.4 3.53.7

0

0.5

1

1.5

2

2.5

3

3.5

4

87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02E 03E 04E '05E

Compounded Growth = 5.5% 1 Mail Rx = 1 RX(Excludes LTC)


Rising Rx Expenditures: A Function of Demand

0 5 10 15 20 25

Price Increases

Other

New Users

New Drugs

Increased Days perRX

Increases RXs peruser

Source: PCS Health Systems 2000


Total Prescriptions Dispensed Have Grown by 153 Million Rx’s Over the Last Year

(MAT Sept 2002 vs. MAT Sept 2001)

4866

5674

6887

7168

7168

8455

8666

18219

9041

12746

Antipsychotics

Ace Inhibitors

Bisphosponates

Antihistamines

Seizure Disorders

Beta Blockers

Codeine & Comb

Chol. Red

PPI

SSRI/SNRI


1.9 3.0 4.0 3.9 4.9 4.4 4.2 3.3

7.8

13.06.7 7.7

1.6 2.5

8.5

10.811.7

12.010.8

15.0

-113579

1113151719

1995 1996 1997 1998 1999 2000 2001 20021Q

20022Q

20023Q

Price Non Price Factors

Non Price Factors Drive Industry Growth

Source: IMS HEALTH: Retail & Provider Perspective, 2001 with 2001 adjusted for underlying 52 week trend


Average Rx Retail PriceAt Price To Consumer

All Rx’s Brands Generics

1990 22.06 27.16 10.29

1995 30.01 40.22 14.84

2000 45.79 65.29 19.33

4Q 2001 49.27 72.28 22.96

1Q 2002 50.35 72.84 23.11

2Q 2002 52.19 77.14 23.70

3Q 2002 53.29 80.21 24.63

Note: Prices are simple averages not adjusted for product mix and Rx size


Cash and Third Party Disbursements Have Switched Places

Source: IMS HEALTH: NPA+7, Method of Payment Report, YE 2001

63

33 29 25 21 19 16 14

11

1211

11 11 11 11

26

55 60 65 68 70 73 74

10

0

10

20

30

40

50

60

70

80

90

100

1990 1996 1997 1998 1999 2000 2001 MATSept2002

Cash Medicaid Third Party

% NRx Dispensed


Co-Payments Are Going Up!

$5.00

$6.93$8.77

$7.66

$15.91

$30.56

$0.00

$5.00

$10.00

$15.00

$20.00

$25.00

$30.00

$35.00

1996 2001

Generic(Preferred) Brand(Preferred) Brand(Non-Formulary)

GF vs. BNF=$3.77 $22.90

Source: Novartis Pharmacy Benefit Report 2001 Edition


As Co-payments Increase…. Noncompliance Will Probably Get Worse

0%

5%

10%

15%

20%

25%

Had Not Filled One RX Taken Smaller Dose Taken MedicationLess Frequently

ActionSource: Harris Interactive Survey


Mail Service Prescriptions Are Growing Faster Than Retail Prescriptions

0

2

4

6

8

10

12

Ttl. Retail & Mail Retail Mail

'98 '99 '00 '01 MAT Aug '02


Factors That Influence the Pharmaceutical Market $ Growth Rate! 1996-2001

Positive• DEMOGRAPHICS

• Managed Care Coverage

• DTC

• Blockbuster New Products

• Growth in Sales Force Size

• Price Increases

Negative• Pressure on Prices

• Two Tier Copays

• Generics


Factors That Will Influence the Pharmaceutical Market $ Growth Rate!

2001-2006 Positive

• DEMOGRAPHICS

• Technology

• Pipeline Still Strong

• Lifestyle Drugs

• Under-treated disease states

• Medicare Rx Benefit

Negative

• Weak/delayed new products in 2001 & 2002

• Negative Publicity

• Multi-tier Copays

• Generics

• Claritin/Prilosec go OTC or Generic

• Economic slow-down

• Slower growth in sales force size

• Personal importation

• State programs


Pharmaceutical Cost Containment Strategies may be getting traction

• Increase Co-payments/ Exclude list

•Maximize use of Generics

•Encourage use of Mail Service

•Formularies

•Therapeutic Substitution

•Reimbursement of OTC’s

• Informatics and POS


Health Plans Ask Themselves…

• To Merge or Not to Merge

• Targeted Marketing with Strict Pricing

• Concentric Networks with Variable Cost Sharing

• Participate in Medicare + Choice

• NCQA or bust

• How Much Copay Cost Shift to Consumer

• Extent of Utilization and Cost Containment


Leading MCO’s

• National Models• Aetna• CIGNA• United Healthcare• Humana• Wellpoint• Anthem

• Regional Models• Kaiser• Health Net• PacifiCare• Oxford• Harvard Pilgrim• The “Blue’s” ??


Nationwide Employee Benefit Costs

• Expected to Increase at an Average Rate of 15% this Year vs 2% overall inflation

• Aggressively Managed Benefits will Increase at 11%

• Those with Minimal Management will Increase at 18%

• Hospital Costs Increase at 25%

• Pharmacy Costs Increase at 17%

• Employees Bear• 22% of the Cost for Family Coverage• 17% of the Cost for Single Coverage


Insurance Options Offered

• Employers are Streamlining Costs by Offering Fewer Health Plans and Thereby Negotiating More Aggressively with Carriers for Larger Volumes

• Examples:• CalPERS 1.2 million members keeping 5 HMO’s only and

dropping 2 major health plans (Health Net and PacifiCare) with a rate increase of 25.1%

• Sears, Roebuck and Co dropped 120 HMO’s retaining only 65• American Express dropped 164 HMO’s keeping 48• Xerox dropped 92 of its 222 health plans


Employers Want Quality

• Leapfrog is a Coalition of Fortune 500 Companies Mobilizing the Nation’s Biggest Purchasers of Health-Care Services to Demand Quality

• Leapfrog was Started after a 1999 Institute of Medicine reported 98,000 Deaths each Year from Medical Errors

• Leaps in Patient Safety and Customer Value Will Be Recognized and Rewarded with Preferential Use

• 7 State pilot Project Measuring Hospital Quality• Computerized Physician Order Entry• Critical Care Trained ICU Daytime Staff• Evidence Based Hospital Referrals


Medicare Prescription Drug Coverage

Republican Proposal

• $35-40 Premium/Month

• $250 Deductible

• 70% Coverage to $1,000

• 50% Coverage $1,000 - $2,250

• No Coverage $2,250 - $5,000

• 100% Coverage > $5,000

• Private Insurance Risk

• $350 Billion Over 10 years

Democratic Proposal

• $25 Premium/Month

• $0 Deductible

• 50% Coverage up to $4,000

• 100% Coverage > $4,000

• Medicare and Private PBM’s Risk

• $425 Billion Over 7 years


Medicare Prescription Drug Coverage Issues

• Private Sector Solution will Likely Increase Role of Large PBMs• Increase Purchasing / Negotiating Power• Impact on Smaller PBMs

• PBMs will Need to Market Directly to Consumers

• Expanded Coverage is Expected to Increase Pharmaceutical Usage

• Loss of One of the Last Blocks of Cash Business


Pharmacy Discount Card (Bush)

• Private Sector PBM Solution

• $25.00 Annual Fee

• Negotiate Discounts with Manufacturers

• Closed Networks

• Preferred Drug Lists

• Mail Service

• Telephone Call Centers

• Retail Pharmacy Sponsored Lawsuit

• Concern Over Limited PBM Oversight


Pharmaceutical Industry Response

• GlaxoSmithKline “Orange Card” Giving Discounts To Qualifying Seniors on all GSK Products, Admin by ESI

• Novartis “Care Card” Gives 25% or Greater Discount, Enroll Via Pharmacies and Administered by a PBM

• “Pfizer for Living” Share Card Offers a 30-day Supply of its Drugs for a $15 fee. Currently 80,000 enrollees

• Others: Eli Lily “LilyAnswers” Merck, Pharmacia

• NACDS Pharmacy Care One Card Program


Pharmaceutical Industry Response

• Together Rx Card Created by 7 Pharma Co’s for Seniors without Drug Coverage with Discounts of 20% to 40% on 150 Drugs.

• Qualifying Income is $28,000 individually or $38,000 as a couple

• The companies sponsoring the card are: Abbott, AstraZeneca, Aventis, BristolMyers Squibb, GlaxoSmithKline, Johnson & Johnson and Novartis

• Bristol Myers Squibb and GlaxoSmithKline recently decreased their discounts so as to not interfere with Medicaid Best Price


Rx Financing Challenges

• Overall Pharmacy Benefit Inflation

• Flexibility at What Cost?

• New Drugs with Higher Replacement Costs

• Disease Management• Prevention Emphasis

• Improved Compliance

• Expansion of Prescription Drug Coverage

• Direct to Consumer Advertising

• Management of Injectable Drugs


PBM MembershipImpact of Consolidation

Advance PCSMedco Health SolutionsExpress ScriptsMedImpactWellpointCaremarkRxNew EckardPharmacare/CVSFirst HealthPrescription SolutionsPrime TherapeuticsAetnaWalgreens

75,000,00065,000,00047,000,00038,500,00029,000,00023,000,00016,000,00012,000,0009,400,0005,300,0005,000,0004,800,0002,100,000


2001 HMO Average PMPM Expendituresby Line of Business

Source: Novartis Pharmacy Benefit Report™


Level of Pharmacy BenefitManagement Control

• 92% of all Rx’s are Filled Within the Formulary

• 58% of Rx’s are Filled with Branded Drugs

• 82.1% of all HMO’s Require Generic Substitution

• 68.7% Require Some Additional Charge for the Branded Drug When a Generic is Available


Three Tier Copays

• Cover Approximately 35% of IPA HMO Enrollees

• Expected to Rise to 47% of All Beneficiaries by year end 2002

• Average Copays will Approach $10/$25/$40 within next 12 months

• Source: Health Industries Three Tier Copay Report Spring 2001


Copay Variations

• Humana Four Tier Program• Generic $10• Brand $25• Brand with Lower Drug Price Alternative $45• Expensive “Top of the Line” Drugs 25% of Retail Price

• Express Scripts Five Tier Program• Employers Select Copay and Drugs by Tiers• Selected Based in Cost, Effectiveness and Rebates

• Wellpoint Reference Policy Pricing Plan• Reference Price Established by Therapeutic Company

• Prime Therapeutics• Tiers are Based on Evidence of Value to Patient & System


Pipeline Presentations

• Customers are Closely Tracking Products in Development 2 – 5 years from Launch• Potential for Formulary Impact• Copay Assignment• Coverage Policies / Limitations

• Specific Pipeline Committees Separate and Distinct from the Pharmacy and Therapeutics Committees

• Drug Trend Reports Produced by• Medco Health Solutions• Express Scripts• PCS


Managed Injectables and Specialty Pharmacy Providers

• MCO’s Carving Out the Management of High Cost Injectable Drugs

• MCO Heighten Level of Interest to Control Cost of Injectables• Exclusivity?• Administrative Challenges

• Specialty Pharmacies May Be Stand Alone Companies or Subsidiaries of PBMs or Wholesalers

• Specialty Pharmacies Provide Integrated Distribution, Training, Reimbursement Hotlines, Patient Assistance Programs, Educational Services and Reporting


Electronic Prescribing:Ideal Functionality

• Single Device Per Practice

• Connect to all PBM Systems

• Include all Formularies

• Conduct Real Time Drug Utilization Review

• Provide Reference Sources

• Interface with Electronic Transmission Vendors

• Integrated into the Physician Practice System

• Wireless Connection to Office System


RxHub

• Connectivity Hub for Electronic Prescribing Information between Physicians, Pharmacies, PBM’s, Health Plans

• Formed Through the Joint Partnership of AdvancePCS, Express Scripts and Medco Health Solutions

• 60 Million Capital Invested Recovered Over 5 Years Through Transaction Fees

• Open to all Players, Not Just Funding PBM’s• Transaction Fees Same for All Players• No Charge to MD’s

• Pre-Adjudication will Check for Drug Interactions, Formulary Status, Prior Authorization Requirements and Step Care Guidelines


Source: IMS HEALTH: DDD & Statistical Services. Trade Prices.Mail Service is projected Prescription Pharmaceuticals and Insulin, 2002

The US Market Will Exceeded $190 Billion in 2002 (Mail is Projected)

12 months ending September 2002

Hospitals 21.5 11.3 8.9Clinics 15.0 7.9 17.4LTC/HH 8.5 4.5 16.8HMOs (Staff Model) 1.5 0.8 3.0Others 0.8 0.4 12.5

%$ Bil % Change

Retail Channels 143.3 75.2%13.1%Chains 55.8 29.3 11.3

Independents 30.9 16.3 10.3 Mail Order 26.1 13.7 21.4 Food Stores 17.2 9.0 15.3 Mass Merchandisers 13.0 6.8 9.7

Institutional Channels 47.2 24.8 12.7

Total 190.2 100.0 13.0


Chains & Independents Still Largest, But Not Fastest Growing

Source: IMS HEALTH: DDD, 2001 12 months ending December 2001 Mail Service Projected

Food Store9.0%

Mail Service13.7%

Hospital11.3%

Independent16.3%

Chain29.3%

Staff HMO 0.8%Misc 0.4%LTC/HH 4.5%Clinic 7.9%Mass Mdse 6.8%

{Largest Fastest

Growing

$ Share of US Rx Market (ex-manufacturer)


Average Health Care Cost IncreasesActive Employees

0%2%4%6%8%

10%12%14%16%

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003Est.

Source: Harris Interactive Survey


Average Health Care Cost Increasesare going up dramatically

0%

5%

10%

15%

20%

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003Est.

Source: Towers Perrin 2002 health care cost survey

Yellow is Retirees Green is Active Employees


US Rx Growth Draws AttentionDespite its Relatively Small Share . . .

Physician Svcs25%

Pharmaceutical10%

Hospital Care30%Nursing/ HH

10%

Other Medical

11%

Pgm Admin

7%

Public Hlth Activity

4%Research &

Constr3%

Source: CMS (HCFA), 2001 projected data

9.6% Total HC Growth

16.4% Rx Growth

Where it Went...


Hospital Outpatient is Outpacing Pharmaceutical Growth

02468

1012141618

All Services RX Drugs HospitalOutpatient

GDP

200020012002

Strunk Et Al Health Affairs Sept. 25, 2002


29% of People think the the Pharmaceutical Industry is doing a bad job of servicing their consumers

Type Good Bad Type Good Bad

1 Banks 74 20 8 Telephone 58 36

2 Hospitals 73 17 9 Life Ins 55 21

3 Car Mfgr 64 23 10 Health Ins. 51 38

4 Airlines 63 16 11 Oil 38 44

5 Comp Soft 60 12 12 HMO’s 33 45

6 Comp Hard 59 10 13 Tobacco 25 61

7 Pharmaceutical 59 29


The Pharmaceutical Industry Approval Rate is Declining

0

10

20

30

40

50

60

70

80

1997 1999 2001

Doing a Good Job


Most New Drugs Aren’t “New”?

11

35

55

0 5 10 15 20 25 30 35 40 45 50 55 60

New Drugs with sameactive ingredient as

an identical drugalready on the market

Drugs with new activeingredients

New Versions ofDrugs with Old Active

Ingredients

Source: National Institute for Health Care Management


11,874.017,222.5 18,499.3

21,363.723,887.8

6,802.9

1,617.4

3,333.5

6,454.9

4,667.1

4,219.63,839.0

0

5,000

10,000

15,000

20,000

25,000

30,000

1990 1995 1998 1999 2000 2001e

R&D Spending Continues to Increase, Mostly in the US

Source: PhRMA, Pharmaceutical Industry Profile 2002

R&D Expendituresin $ Millions

Research and development abroad

US Research and development


Approval Times Beginning to Rise

Source: US FDA, 2001

26 2522

28

53

39

30

35

2724

19

1012141618202224262830323436384042444648505254

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

Mean approval time (months)

Total # new molecular entitiesapproved each year


71% 11% 12% 4% 2%

6,2256,225

935935 1,0671,067

328328 167167

PRECLINICAL PHASE I PHASE II PHASE III PRE-REG/REG

Source: IMS Lifecycle CD ROM December 2001

2001 Global Pipeline Is Fully Loaded

To December 2001 8,722 Products

New

Products


Importation & Reimportation Concerns

• Fear of Tampering• Counterfeit Medicines• Regulatory Supervision• Poisoning by Terrorists

The Number of FDA Criminal Counterfeit Cases is Growing1999 6 cases2000 10 cases2001 23 cases2002 YTD 16 cases


Generics are Gaining Traction

Source: IMS HEALTH: NPA+7, Method of Payment Report, YE 2001

84 85 86 85 84

50 51 51 51 50

9 8 8 9

12 12 11 11 11

7 7 6 7 8

38 38 38 38 39

9

0

10

20

30

40

50

60

70

80

90

100

1998 1999 2000 2001 2002Est

1998 1999 2000 2001 2002Est

Brands Branded Generics Generics

% Dollars % Total Prescriptions Dispensed


2002 Patent Expirations Product Company 2001 Sales

Glucophage BMS $2.0 Billion

Prilosec AZ $4.6 Billion

Zestril AZ $933 Million

Prinivil Merck $683 Million

Accutane Roche $566 Million

Augmentin GlaxoSmithkline $1.6 Billion

Claritin Schering $1.3 Billion

Ultram J&J $600 Million


Other Possible Patent Expirations 2002 2004Intron A LovenoxAxid DiflucanRelafen Lupron

Lamisil2003 ParaplatinCipro XenicalSingulairFlovent 2005Flonase Zocor ZofranEngerix B Prevacid Aredia

Zoloft ZoladexPravacholZithromaxBiaxin

Source: Generic Pharmaceutical Associations


Generics Gain Quick Acceptance when Patents Expire

7072747678808284868890

After 5 Weeks After 10 Weeks Current 9/ 6/ 02

Generics Share of NRX’s

IMS NPA Plus


The Top 10 Manufacturers Represent 58.0% of the US Rx Industry

Leading corporations. Prescription products and insulin. All Audited Channels. Excludes co-marketing and JV agreements. Data run by custom redesign to include recent M&As.

Source: IMS HEALTH: Retail & Provider Perspective, 2002

High Growth

MAT September 2002

1. Pfizer 19,319 10.1 + 15%2. GlaxoSK 17,292 9.0 + 16% 3. Merck 12,917 6.7 + 11%4. Johnson & Johnson 12,470 6.5 + 24%5. Astra Zeneca 10,969 5.7 + 16%6. BMS 9,436 4.9 - 7%7. Novartis 7,608 4.0 + 18%8. Wyeth 7,397 3.9 + 14%9. Pharmacia 7,069 3.7 + 13%10. Lilly 6,668 3.5 - 13%

Corp by Legend Drugs $ in Mil % Shr % Chg


The Top 10 Manufacturers Represent 61.2% of the US Rx Industry



High Growth

MAT September 2002

1. Pfizer/Pharmacia 26,968 13.8 + 15%2. GlaxoSK 17,292 9.0 + 16% 3. Merck 12,917 6.7 + 11%4. Johnson & Johnson 12,470 6.5 + 24%5. AstraZeneca 10,969 5.7 + 16%6. BMS 9,436 4.9 - 7%7. Novartis 7,608 4.0 + 18%8. Wyeth 7,397 3.9 + 14%9. Lilly 6,668 3.5 -13%10. Schering 6,061 3.2 +

2%



Top 20 Companies Represent 79.0% of US Market


High Growth

MAT September 2002

11. Schering Plough 6,061 3.2 + 2%12. Aventis 5,878 3.1 + 26%13. Amgen 5,275 2.8 + 21%14. Abbott 5,265 2.8 + 9%15. TAP 4,684 2.4 + 6%16. Hoffman-LaRoche 4,165 2.2 + 11%17. Boehringer Ingelheim 2,448 1.3 + 27%18. Forest 2,161 1.1 +33%19. Teva 2,145 1.1 + 37%20. Mylan 1,977 1.0 +22%




Absolute Growth- Corporations12 Months ending September 2002

Dollars Inc. $ Mil. TRX Dispensed Inc TRX’s Mil.

Pfizer +2.55 Pfizer +20.1

Johnson & Johnson

+2.40 Barr Labs +18.2

GlaxoSmithkline +2.37 Mylan Labs +17.5

AstraZeneca +1.49 Par +14.3

Merck +1.29 Mallinkrodt +13.0

Aventis +1.21 AstraZeneca +10.2

Novartis +1.16 Ranbaxy +9.9

Amgen +.90 URL/Mutual +9.6

Wyeth +.89 Upsher Smith +8.9

Pharmacia +.83 Qualitest +8.2


Cholesterol Reducers Are the Leading Class By Sales Volume


CATEGORY $ (Mil) % Chg

1. Cholesterol Reducers 12,138 20%2. Proton Pump Inhibitors 11,202 23%3. SSRI/SNRI 9,991 10%4. Anti-psychotics 5,925 27%5. Erythropoietins 5,670 26%6. Seizure Disorders 5,045 26%7. Cox-2 Inhibitors 4,833 12%8. Anti-histamines 4,704 22%9. Calcium Blockers 4,554 1%10. Ace Inhibitors 3,964 12%

MAT September 2002

Leading USC 4 classes. All Audited Channels. Prescription products and insulin


Lipitor is the Top Dollar Product 12 Months ending September 2002

Brand Mfgr 2002 Rank

MAT Sept 2002 $ Vol

2002 % Change

Share of Market

Lipitor® Pfizer 1 $6.0 +22 3.1

Zocor ® Merck 2 4.3 +29 2.2

Prilosec ® AstraZeneca 3 3.9 -16 2.0

Prevacid ® TAP 4 3.7 +6 1.9

Procrit ® J&J 5 3.0 +33 1.6

Zyprexa ® Lilly 6 2.8 +20 1.5

Epogen ® Amgen 7 2.8 +16 1.5

Celebrex ® Pharmacia 8 2.7 +6 1.4

Zoloft ® Pfizer 9 2.5 +28 1.3

Paxil ® Glaxo 10 2.4 +18 1.3

Source: IMS HEALTH Retail & Provider Perspective


Absolute Growth- Products12 Months ending September 2002

Dollars Inc. $ Mil.

TRX Dispensed Inc TRX’s Mil.

Nexium (AZ) +1.40 Nexium (AZ) +10.9

Lipitor (Pfizer) +1.07 HYCD/APAP (MKR) +9.2

Advair Diskus (GSK) +1.05 Lipitor (Pfizer) +8.6

Zocor (Merck) +.95 Advair Diskus (GSK) +7.8

Procrit (J&J) +.76 Fluoxetine (Barr) +6.9

Protonix (Wyeth) +.59 Celexa (Forest) +6.2

Aciphex (Eisai) +.54 Toprol-XL (AZ) +6.1

Plavix (BMS/Sanofi) +.54 Protonix (Wyeth) +6.0

Celexa (Forest) +.53 Fosamax (Merck) +5.1

Zyprexa (Lilly) +.47 Glucophage XR (BMS) +5.0


Worldwide Biotechnology Dollar Sales 1992-2002*

0

4

8

12

16

20

24

28

32

36

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002*

US

$b

n

*Estimated 2002 Sales


Worldwide Biotechnology Dollar Sales 1992-2002*

0

4

8

12

16

20

24

28

32

36

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002*

GLOBALUSAROWU

S$

bn

*Estimated 2002 Sales


The Top 10 US Biotech Companies Account for 88.1% of Dollar Sales

(MAT June 2002)

1.6%

2.1%

2.1%

2.7%

3.1%

4.7%

8.4%

10.2%

24.0%

29.2%

Schering AG

Serono

Novo Nordisk

Medimmune

Schering

Biogen

Genentech

Lilly

J&J

Amgen/Immunex


The Top 10 US Biotech Products Account for 66.4% of Dollar Sales

(MAT June 2002)

2.1%

2.1%

2.6%

4.7%

4.8%

5.0%

5.7%

7.0%

15.4%

17.0%

Humulin NPH

Humalog

Synagis

Avonex

Rituzan

Enbrel

Remicade

Neupogen

Epogen

Procrit


Fastest Growing U.S. Biotech CorporationsMat/June/2002 Based Absolute Growth

Top 10 Corporations Rank Absolute Growth ($ Millions)

% Change

U.S. Biotech Market +3,304.9

J & J 2 1,274.4 47.0

Amgen/Immunex 1 710.6 17.2

Roche (Genentech) 4 344.1 32.7

Lilly 3 241.2 16.6

Aventis 12 154.1 313.9

Biogen 5 151.9 24.2

Schering Plough 10 147.4 131.3

Novo Nordisk 8 87.0 32.4

Pharmacia Corp 18 81.0 145.1

CSL 22 54.8 980.1


U.S. Leading Biotech ProductsMat/June/2002 Based on US Dollar Sales

Top 10 Products Rank US $ (Millions) % Change

U.S. Biotech Market 16,587.1 24.9

Erypo/Procrit 1 2,825.1 38.7

Epogen 2 2,554.0 12.9

Neupogen 3 1,153.0 11.7

Remicade 4 940.1 103.0

Enbrel 5 827.3 13.8

Mabthera/Rituxan 6 803.0 58.4

Avonex 7 780.3 24.2

Synagis 8 424.8 14.2

Humalog 9 346.1 57.0

Humulin NPH 10 343.1 -6.7


Syntex

Copyright IMS HEALTHRetail Perspective, Provider PerspectiveNumbers Are In Thousands (000)s

Tot DollarsCalYr/12/1992

MAT OCT/02 DOL TOT

Growth In Dollar Sales

ANAPROX 187,423 4,898 -97%CARDENE 62,342 13,516 -78%CELLCEPT 434,665 FEMSTAT 11,736 79 -99%LIDEX 42,977 7,227 -83%NAPROSYN 561,727 10,430 -98%NASALIDE 29,025 7,898 -73%NORINYL 39,079 14,649 -63%SYNALAR 8,095 1,665 -79%SYNAREL 18,705 4,780 -74%TICLID 22,176 6,937 -69%TORADOL 201,228 2,281 -99%VAGITROL 179 -100%

1,184,693 509,025


Syntex

Twelve Months of Sales in 1992 Compared to Twelve Months of Sales Ending October 2002

-

100,000

200,000

300,000

400,000

500,000

600,000

ANAPROX

CARDENE

CELLCEPT

FEMSTAT

LIDEX

NAPROSYN

NASALIDE

NORINYL

SYNALAR

SYNAREL

TICLID

TORADOL

VAGITROL

Products

Dollars (000's)

Tot DollarsCalYr/12/1992

MAT OCT/02 DOL TOT


Syntex

Copyright IMS HEALTHNPA 20K - Monthly Rx AuditNumbers Are In Thousands (000)s

Dispensed NRXCalYr/12/1992

MAT NOV/02 NRX

Dispensed TRXCalYr/12/1992

MAT NOV/02 TRX

Growth In NRx's

Growth In TRx's

ANAPROX 921 49 1,338 82 -95% -94%CARDENE 511 25 1,699 99 -95% -94%CELLCEPT 690 674FEMSTAT 516 1 654 1 -100% -100%LIDEX 989 87 1,529 131 -91% -91%NAPROSYN 8,019 71 13,349 120 -99% -99%NASALIDE 647 41 1,246 93 -94% -93%NORINYL 282 29 1,208 119 -90% -90%SYNALAR 268 28 389 38 -90% -90%SYNAREL 28 4 62 8 -86% -87%TICLID 149 12 322 47 -92% -85%TORADOL 2,309 27 2,793 36 -99% -99%VAGITROL 1 1 -100% -100%


Syntex

New Prescriptions For Twelve Months in 1992 Compared to New Prescriptions For Twelve Months Ending October 2002

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

ANAPROX

CARDENE

CELLCEPT

FEMSTAT

LIDEX

NAPROSYN

NASALIDE

NORINYL

SYNALAR

SYNAREL

TICLID

TORADOL

VAGITROL

Products

Prescriptions (000's)

Dispensed NRXCalYr/12/1992

MAT NOV/02 NRX


Syntex

Total Prescriptions For Twelve Months in 1992 Compared to Total Prescriptions For Twelve Months Ending October 2002

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

ANAPROX

CARDENE

CELLCEPT

FEMSTAT

LIDEX

NAPROSYN

NASALIDE

NORINYL

SYNALAR

SYNAREL

TICLID

TORADOL

VAGITROL

Products

Prescriptions (000's)

Dispensed TRXCalYr/12/1992

MAT NOV/02 TRX


The Future Looks Good, But More Challenging

•Price restraint•Formulary enforcement

•Generic exposure•Recession pressures•Delayed launches•Negative public opinion

•Demographics–Older–Smarter

•Med/tech advances

–Pipeline•Expanded access & awareness

11-14%

CAGR2003-2006

+_

Year End 2002

Copyright 2002, IMS HEALTH. No portion of this document may be reproduced, used or distributed in any form without written authorization. All trademarks assumed.

Jack TuttleIMS HEALTH

copyright 2002, ims health. no portion of this document may be reproduced, used or distributed in...

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