FRESENIUS KABI SOUTHERN AFRICAN EXPERIENCE Fresenius Kabi South Africa Reproductive Health Supplies Coalition (RHSC) Market Development Approaches (MDA) Working Group – Working with Industry Consultative Forum FRESENIUS KABI SOUTHERN AFRICAN EXPERIENCE Arlington, USA 1 - 2 October 2007 John-Heyns Ferreira Beijing Nov 2006

9 PROVINCES IN SOUTH AFRICA Fresenius Kabi South Africa 9 PROVINCES IN SOUTH AFRICA Beijing Nov 2006

RH BACKGROUND IN SOUTH AFRICA Fresenius Kabi South Africa RH BACKGROUND IN SOUTH AFRICA Healthcare Services are provided by both Government (service and products are for free) and Private Health institutions Reproductive Health forms part of Primary Health Care in South Africa The bulk of Reproductive Health is provided by the government and private institutions account for a small percentage Contraceptive State tender runs for two years with accurate quantity forecasts

RH in SOUTH AFRICA – Market development by Fresenius Kabi Fresenius Kabi South Africa RH in SOUTH AFRICA – Market development by Fresenius Kabi South African market is covered by a Brand Manager and 5 representatives calling mainly on state clinics and other relevant parties Brand Manager – calls on key opinion leaders and buyers and manages the brand locally Education and continued reliable supply is key Evidence that this approach is working – is the resultant unit and sales growth

DOMESTIC SALES UNIT GROWTH 2006 vs 2007 Fresenius Kabi South Africa DOMESTIC SALES UNIT GROWTH 2006 vs 2007 Local activities proven effective by increased sales

% SALES AND UNIT GROWTH 2006 -2007 Market % Growth South Africa 9.2% Fresenius Kabi South Africa % SALES AND UNIT GROWTH 2006 -2007 Local and Export activities proven by increased sales Market % Growth South Africa 9.2% Export > 20% Beijing Nov 2006

STATE CONTRACEPTIVE MARKET – SOUTH AFRICA Fresenius Kabi South Africa STATE CONTRACEPTIVE MARKET – SOUTH AFRICA Method used % Usage** Injectables 41% Pill (oral) 12.3% Condoms 2.1% Female sterilization 12% Male sterilization 1.7% IUD 1.9% Other 29% **Department of Health and Family Planning Beijing Nov 2006

DMPA – A GLOBALLY AVAILABLE PRODUCT Fresenius Kabi South Africa DMPA – A GLOBALLY AVAILABLE PRODUCT Depot Medroxyprogesterone Acetate 3 monthly injection (4 / year) progestogen-only injectable arguably the most extensively studied and widely used hormonal injectable available registered and available in >130 countries used by millions of females globally for many years Depo Provera developed by Pfizer – the brand has been extensively used by Aid Agencies Beijing Nov 2006

FRESENIUS ACTIVITY IN SOUTHERN AFRICA Fresenius Kabi South Africa FRESENIUS ACTIVITY IN SOUTHERN AFRICA BOTSWANA NAMIBIA SWAZILAND LESOTHO RSA Beijing Nov 2006

FRESENIUS KABI SOUTHERN AFRICAN TERRITORIES – MARKET APPROACH Fresenius Kabi South Africa FRESENIUS KABI SOUTHERN AFRICAN TERRITORIES – MARKET APPROACH The product is Petogen (generic DMPA - (depot medroxyprogesterone acetate) Supplied to the surrounding countries on the same basis as the domestic product Fresenius Kabi has built up good working relationships with these various country authorities to allow for no interruption of supply Consultative forecasting of production happens as part of the supply conditions Beijing Nov 2006

CONTRACEPTIVE SECURITY AND STRATEGY EFFECT Fresenius Kabi South Africa CONTRACEPTIVE SECURITY AND STRATEGY EFFECT Manufacturing capacity should be in line with supply requirements to neighbouring and other potential territories Improve relationships with NGO’s and Donors Fresenius Kabi aims to deliver sustainably, a product of assured quality at an affordably low cost to achieving supply security for Petogen A part of a growth strategy, Fresenius Kabi aims to make available a quality product to donor agencies, governments and social marketing organizations at affordable prices

CONTRACEPTIVE SECURITY AND STRATEGY EFFECT Fresenius Kabi South Africa CONTRACEPTIVE SECURITY AND STRATEGY EFFECT Local manufacturer – In Africa for Africa and beyond Quality Generic - Internationally accepted Cost-effective -Internationally competitive DMPA POI of choice - International Dedicated sales and marketing team - South Africa and International Substantial market share gain both locally and internationally Beijing Nov 2006

ONGOING CHALLENGES FOR FRESENIUS Fresenius Kabi South Africa ONGOING CHALLENGES FOR FRESENIUS CAPACITY – sufficient to meet expanding demand CURRENCY – ongoing fluctuations TENDERS – risky nature of the business WHO – pre-qualification and compliance DEMAND– aim to smooth demand / forecast EDUCATION – all markets PACKAGING – variations in format and kits REGULATORY – variations per country Beijing Nov 2006

OVERCOMING CHALLENGES Fresenius Kabi South Africa OVERCOMING CHALLENGES INVEST – increased manufacturing capacity & quality BALANCE –ongoing demand/capacity STABLE – supply by co-operation and agreement RELATIONSHIPS – ongoing building with relevant parties MARKETING – affordable generic and social marketing Beijing Nov 2006

IN CONCLUSION CONSTRUCTIVE INPUT – dialogue and communication Fresenius Kabi South Africa IN CONCLUSION CONSTRUCTIVE INPUT – dialogue and communication CO-OPERATION – all stakeholders in this market PRODUCT – provide a quality product at globally affordable price SUPPLY – the correct product at the right time and right place Beijing Nov 2006