BMI View: From a number of viewpoints, Peru offers considerable rewards to pharmaceutical and healthcare industry players, not least due to its fast-developing economy. However, per capita spending and incomes are low, which is not conducive to sales of higher-price medicines, especially in an environment lacking formal price controls and a stricter separation of prescription and non-prescription medicines in the retail channels. In the short to medium term, we expect more emphasis on costcontainment, which is likely to result in the introduction of downward pressures on pharmaceutical prices.
Headline Expenditure Projections
?? Pharmaceuticals: PEN3.07bn (US$1.09bn) in 2010 to PEN3.22bn (US$1.26bn) in 2011; +5% in local currency terms and +15.5% in US dollar terms. Forecast unchanged from Q311.
?? Healthcare: PEN18.42bn (US$6.57bn) in 2010 to PEN19.39bn (US$7.60bn) in 2011; +5.3% in local currency terms and +15.8% in US dollar terms. Forecast slightly down from Q311 due to the use of new historical data.
?? Medical devices: PEN833mn (US$297mn) in 2010 to PEN908mn (US$356mn) in 2011; +9.0% in local currency terms and +19.9% in US dollar terms. Forecast unchanged from Q311.
Business Environment Rating: Peru’s composite score for the quarter has remained unchanged from Q311. The country remains placed 10th out of the 17 countries surveyed within our Business Environment Rating (BER) matrix for the Americas region, with its Risk profile slightly more promising than its Rewards score. Globally, Peru ranks 65th out of the new total of 85 markets surveyed within our pharmaceuticals universe.
Key Trends & Developments
?? In June 2011, the Andean Drug Price Observatory was launched, with a view to collating medicine prices from six countries – Bolivia, Chile, Colombia, Ecuador, Peru and Venezuela.
Peru's Minister of Health, who is leading the initiative, explained that the online database will provide a better assessment of the region's pharmaceutical market and enable governments to evaluate their procurement strategies. However, while there is little doubt the initiative will provide member countries with the information needed to make better purchasing decisions, BMI is sceptical that the programme's low-cost, volume-driven procurement ambitions will materialise in a healthcare market as fragmented as Latin America's.
?? In a bid to improve and rationalise healthcare finances, Peru's new Health Minister announced a national audit of government hospitals, looking for administrative irregularities and misappropriated funds. We also note that the new Health Minister has also announced plans to make healthcare access a priority for his administration, which is to be achieved through an increased access to generic medicines.
BMI Economic View: Despite the currently positive economic picture, we see risks to our outlook in the event that global risk aversion persists and hurts our growth forecast for Peru. As an export-driven economy, Peru is particularly vulnerable to a global slowdown or China landing hard. In that case, the new president could be driven to pursue more expensive social policies in order to protect Peru's poorest social segments, which would lead to friction with private enterprise, including companies in the pharmaceutical industry, although this is not our core view.
BMI Political View: We maintain our view that markets have overreacted to President Ollanta Humala's election and, despite global risk aversion, we see a short term rally in Peruvian equities. Furthermore, our view that Humala is going to pursue a moderate economic policy is supported by his appointment of centrist and market-friendly figures as chief of cabinet and minister of economy and finance. As a result, we believe policy continuity is largely assured in Peru, which should provide for a solid basis for the continuation of the government’s efforts to improve the nation’s health and access to services.

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SWOT Analysis 7
Peru: Pharmaceuticals And Healthcare Industry SWOT 7
Peru Political SWOT 8
Peru Economic SWOT 8
Peru Business Environment SWOT 9
Pharmaceutical Business Environment Ratings 10
Table: Americas – Regional Pharmaceutical Business Environment Ratings, Q411 10
Rewards 11
Risks 12
Peru – Market Summary 13
Regulatory Regime 14
Recent Regulatory Developments 15
OTC Medicines 16
Intellectual Property Regime 16
IP Shortcomings 17
Counterfeit Pharmaceuticals 18
Trade Agreements 19
Pricing Regime 21
Government Tenders 22
Reimbursement Regime 23
Recent Pricing and Reimbursement Developments 23
Industry Developments 26
Epidemiology 26
Non-Communicable Diseases 27
Communicable Diseases 28
Healthcare Sector 29
Healthcare Finances 30
Healthcare Provision 31
Table - Key Goals of Parsalud II in Nine Regions* 32
Health Insurance 32
Clinical Trials 33
Medical Devices 34
Industry Forecast Scenario 36
Overall Market Forecast 36
Table: Pharmaceutical Sales Indicators 2007-2015 37
Key Growth Factors – Industry 38
Table: Healthcare Expenditure Indicators 2007-2015 39
Table: Government Healthcare Expenditure Indicators 2007-2015 39
Table: Private Healthcare Expenditure Indicators 2007-2015 40
Key Growth Factors – Macroeconomic 41
Table: Peru – Economic Activity 43
Prescription Drug Market Forecast 44
Table: Prescription Drug Sales Indicators 2007-2015 45
Patented Drug Market Forecast 46
Table: Patented Drug Market Indicators 2007-2015 47
Generic Drug Market Forecast 48
Table: Generic Drug Sales Indicators 2007-2015 50
OTC Medicine Market Forecast 51
Table: OTC Medicine Sales Indicators 2007-2015 52
Medical Device Market Forecast 53
Table: Medical Devices 2007-2015 54
Pharmaceutical Trade Forecast 55
Table: Exports and Imports Indicators 2007-2015 57
Other Healthcare Data Forecasts 58
Key Risks To BMI’s Forecast Scenario 58
Competitive Landscape 60
Pharmaceutical Sector 60
Table: Peruvian Pharmaceutical Companies That Acquired GMP Accreditation In 2006 60
Foreign Industry 61
Domestic Industry 62
Pharmaceutical Distribution And Retail 63
Company Profiles 65
Indigenous Manufacturer Profiles 65
Farmaindustria 65
Unimed 67
Hersil 68
Leading Multinationals 69
Sanofi-Aventis 69
Merck & Co 70
GlaxoSmithKline 71
Novartis 72
Pfizer 73
AstraZeneca 74
Teva (Corporación Medco) 75
Country Snapshot: Peru Demographic Data 77
Section 1: Population 77
Section 2: Education And Healthcare 78
Section 3: Labour Market And Spending Power 79
Table: Consumer Expenditure, 2000-2012 (US$) 80
Table: Average Annual Manufacturing Wages, 2000-2012 80
Glossary 81
BMI Methodology 83
How We Generate Our Pharmaceutical Industry Forecasts 83
Pharmaceuticals Business Environment Ratings 84
Risk/Reward Ratings Methodology 84
Ratings Overview 84
Table: Pharmaceutical Business Environment Indicators 85
Weighting 86
Table: Weighting Of Components 86
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