South Africa Pharmacy Landscape 9/22/2018 South Africa Pharmacy Landscape Dirk Myburgh Manager Supplier Services 26 July 2017

South Africa: Supply Chain South Africa’s pharmaceuticals supply chain is fragmented and complex FICCI – Africa Conclave 15 June 2017

Pending Healthcare Legislation South Africa: Pending Healthcare Legislation International Benchmark Pricing 2 National Healthcare Insurance 1 Removal of discounts and bonuses 3 Amendment of IP legislation 4 Health Technology Assessments 6 Complementary & Alternative Medicines 5 Regulation of logistics fees 7 Protection of personal information Act 8 SAHPRA 9 FICCI – Africa Conclave 15 June 2017

Tap into our superior global resources & experience South Africa: Global Perspective Tap into our superior global resources & experience Exploring New Opportunities in Real-World Insights (RWI) 9/22/2018 The depth of experience available through QuintilesIMS is well-recognized in the industry, as is the commitment to monitor and evaluate safety, benefit/risk, efficacy, effectiveness, quality of care and value. Our resources are dedicated to your success our experience and resources available to you through partnering with QuintilesIMS. We are able to leverage experienced resources around the world to deliver real-world insights. Ranked 7th Pharmaceutical Market, MEA region 7.0% CAGR (forecasted) Between 2017 – 2020 vs US growth of 7.7% CAGR of 7.8% Between 2010 - 2017 5.6% Contribution to MEA Pharma Market Value = USD 3.0bn Pharmerging Countries Main concerns High Inflation Growing Population Access to Healthcare 1.8% Contribution to the BRICS Pharma Market BRICS value USD254bn 15.9% Contribution to African Pharma Market PPG of 6.0% From 2016 Ranked 18th on Pharmerging list and Contribute 1.1% in 2017 FICCI – Africa Conclave 15 June 2017

South Africa: Demographics 40.7% drugs dispensed 56.6% drugs dispensed South African population size n 55 908 900 Pop. growth: 10.5% in 5 years Ranked 25th in Population Size Accounts for 0.7% of world’s Pop. Population estimates by gender 2016 Female Male 51% 49% Life Expectancy: 61 years Growing at 11.6% 40.7% drugs dispensed Life Expectancy: 64 years Growing at 9.4% 56.6% drugs dispensed Very young population – Youth account for One Third of the Population FICCI – Africa Conclave 15 June 2017

South Africa: Demographics FICCI – Africa Conclave 15 June 2017

South Africa: Economic Indicators GDP growth GDP per capita (USD) 55 36 35.9 31.7 2014 2015 2016 2017 2016 – Economy grew by ONLY 0.4% 2017 Expected growth – 1.1%, Q1 2017 Actual growth -0.7% leading SA into recession 2016 Number 1 ranking – Largest economy in Africa Top decile = 58% of country’s income Bottom decile = 0.5% of country’s income Ranked 87th out of 198 countries in terms of GDP per Capita FICCI – Africa Conclave 15 June 2017

Healthcare expenditure as % of GDP Medical inflation and CPI South Africa: Economic Indicators Healthcare expenditure as % of GDP Medical inflation and CPI South Africa Healthcare expenditure more than double the WHO recommended 5% This is mainly to fit the bill for National Health Insurance piloting Increasing medical cost the reason for Medical inflation surpassing general inflation FICCI – Africa Conclave 15 June 2017

Private Pharma Market Performance South Africa: Private Pharma Market Performance 471 million Unit Sales Pharma Market USD3billion >60% units from Top 5 Pharma (Aspen, Adcock, Sanofi, Cipla & Pfizer, ) Only Adcock & Cipla growing faster than market Top 4 Selling products all from Adcock (Units) Adco-Dol leading product in Units. 28 Years on Market – 21.4 % Growth Value – SA market PY Growth 6.0% vs Global Market Growth of 3.3% (Priv. 8.9%) Largest Revenue generating product - Tribuss FICCI – Africa Conclave 15 June 2017

South Africa: Market Break Down FICCI – Africa Conclave 15 June 2017

Originators vs Generics South Africa: Originators vs Generics % Value Share % Unit Share Source: IMS Dataview TPM April 2017 FICCI – Africa Conclave 15 June 2017

84% of the market is driven by only 8 ATC1 classes South Africa: 84% of the market is driven by only 8 ATC1 classes Contribution # Companies # Companies (80%) % Companies (80%) Leader Million USD MAT/4/2017 18% 121 11 9% Aspen N NERVOUS SYSTEM 504 16% 246 18 7% Sanofi A ALIMENTARY TR+METABOLISM 448 J SYSTEMIC ANTI-INFECTIVES 375 13% 69 12 17% Aspen 12% 126 13 10% Aspen R RESPIRATORY SYSTEM 332 9% 89 12 13% Pharma Dynamics C CARDIOVASCULAR SYSTEM 249 6% 120 12 10% Pfizer M MUSCULO-SKELETAL SYSTEM 155 5% 135 11 8% Bayer G G.U.SYSTEM+ SEX HORMONES 153 153 5% 37 9 24% Roche L ANTINEOPLAST+IMMUNOMODUL OTHER (8 ATC1 Classes) 446 FICCI – Africa Conclave 15 June 2017

61% of the market is driven by the top10 companies South Africa: 61% of the market is driven by the top10 companies Contribution # ATC1 # ATC1 (80%) % ATC1 (80%) Top ATC Million USD MAT/4/2017 ASPEN 386 14% 15 6 40% NERVOUS SYSTEM ADCOCK INGRAM 248 9% 15 4 27% NERVOUS SYSTEM SANOFI 196 7% 15 4 27% NERVOUS SYSTEM CIPLA 164 6% 14 5 36% NERVOUS SYSTEM PFIZER 161 6% 14 6 43% NERVOUS SYSTEM NOVARTIS 150 5% 13 6 46% CARDIOVASCULAR SYSTEM JOHNSON & JOHNSON 109 4% 13 4 31% NERVOUS SYSTEM MERCK & CO 104 4% 12 5 42% SYSTEMIC ANTI-INFECTIVES BAYER 100 4% 13 4 31% GU SYSTEM + SEX HORM. ROCHE 88 3% 12 3 25% ANTINEOPLAST + IMMUNO. FICCI – Africa Conclave 15 June 2017

South Africa: Top 10 Corporations Below National Growth Above National Growth FICCI – Africa Conclave 15 June 2017

South Africa: Top 10 Products Below National Growth Above National Growth FICCI – Africa Conclave 15 June 2017

TPM customer outlet type value % contribution –May 2017 FICCI – Africa Conclave 15 June 2017

Trade Channel Analysis Growth Chains – 12% Couriers – 9.8% Independent – 2.8% FICCI – Africa Conclave 15 June 2017

Questions? FICCI – Africa Conclave 15 June 2017

9/22/2018