Generic Growth Strategies. Market Driven by Impending Patent Cliff, Declining R&D Productivity and Government Initiatives to Reduce Healthcare Costs

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Generic Growth Strategies Market Driven by Impending Patent Cliff, Declining R&D Productivity and Government Initiatives to Reduce Healthcare Costs

GBI Research Report Guidance GBI Research Report Guidance Chapter three gives an overview of the generic pharmaceutical market. It includes a list of leading generic pharmaceutical companies, the generic market share of select countries, and drivers and restraints of the generic pharmaceutical market. Chapter four describes the regulatory landscape of the generic drugs industry in the US, major European countries such as the UK, Germany, France, Italy and Spain, and Japan. This section details the current and upcoming regulations that are expected to have an impact on the growth of the generics market. Chapter five gives details of the major growth strategies adopted in the generics drugs industry. Case studies accompany the strategies to show their real market impact. Chapter six is focused on competitive profiling. This section includes detailed profiles of the top companies operating in the generics market, along with their generic growth strategies. Page 2

Executive Summary Executive Summary Leading Generic Companies Resort to Multiple Strategies for Growth Most of the leading generic giants such as Teva, Sandoz, Mylan and Watson use multiple options to ensure a high market share and future growth. The strategies used include applying for generic approvals with the Food and Drug Administration (FDA) and European Medicines Agency (EMA), Mergers and Acquisitions (M&As), developing a strong and innovative generic drug pipeline, improving infrastructure to enhance manufacturing and Research and Development (R&D) capabilities, new product launches, and geographic expansion. Generic and innovative pharmaceutical companies are exploring all of the ways available to increase their presence in the generic pharmaceutical market, given the current scenario where governments are encouraging the increased use of generics to bring down healthcare costs. For instance, Hospira is reaching out to cover new geographies in order to develop their presence in generics across the world, and also increasing their product coverage by offering generics that are available in the market but not included in their product portfolio. The advantage of being the first to launch a generic in the market has been capitalized on by companies such as Hospira, by challenging the intellectual property of proprietary pharmaceutical companies. The strategy has resulted in generating generic blockbusters, such as in the case of Sandoz s generic enoxaparin. With the regulatory landscape in biosimilars taking shape, many pharmaceutical companies are developing biosimilars of potential reference biologics that are soon going off-patent. Difficult-to-Reproduce Generics Being Developed to Beat Competition Some of the generic companies are focusing on a new trend by offering generics that have high barriers to entry and are as a result available at higher prices. These are called super generics, and are developed as value-added reformulations of off-patent drugs that require New Drug Application (NDA) submissions. Super generics offer a means of differentiation in the industry. For the development of super generics, these companies have to invest in R&D to launch reformulated versions of off-patent drugs, or apply a complex manufacturing process. Significant potential for super generics lies in specific therapeutic areas. Super generics producers focus on areas of unmet medical needs that are not satisfied by the current therapies, in high sales potential areas such as Central Nervous System (CNS) and cancer. Areas where innovators have already patented extensively and developed several line extensions in easy-to-formulate markets, such as cardiovascular drugs, have less attractiveness to super generics manufacturers. There are several types of reformulation strategy that are adopted to make super generics out of off-patent drugs, such as new dose forms (injection to oral forms, extended release), new combinations and new salts. For instance, Dr. Reddy s Laboratories (DRL) sells fondaparinux, which is the generic version of GlaxoSmithKline s (GSK) Arixtra, in the US. Alchemia develops the product with the help of a novel, costeffective synthesis for the manufacture of fondaparinux at commercial scale. The process is patent protected until 2021 (fondaparinux product website, 2012). There is no risk of raw material contamination with fondaparinux since it is a purely synthetic compound. Generic fondaparinux has a superior efficacy and safety profile when compared to other heparin drugs. The bulk manufacturer, DRL, produces fondaparinux at a reasonably competitive price in the US market. Page 3

Executive Summary By 2015, branded products with sales of up to $XX billion will go off-patent, giving generic pharmaceutical companies immense opportunities to capitalize on the market Opportunities Worth More than $XX billion in Generics and Biosimilars The looming drug patent expiration loss the industry is presently facing is unprecedented, in terms of both the number of drugs and the magnitude of the total hit. However, this same situation presents a huge opportunity for the generic drug makers. The figure below is an illustration of the global revenues of the top 10 drugs that are set to lose their patent protection between 2013 and 2020. Generic Growth Strategies, Global, Revenues of the Top 10 Drugs Due for Patent Expiry ($m), 2013-2020 Humira Remicade Enbrel Crestor Rituxan/mabThera Avastin Herceptin Lantus Abilify Januvia/Janumet Revenues ($m) Source: GBI Research; GBI Research s Proprietary Products Database [accessed on: September 20, 2012] Note: The patent of blockbuster drug Enbrel has been extended to 2028 The pharmaceutical industry will experience major patent expiries during 2013-2020, of which 2014 to 2017 are expected to be peak years, with the loss of patents for drugs whose sales were worth more than $XX billion during 2011. By 2015, branded products with sales of up to $XX billion will go off-patent, giving generic pharmaceutical companies immense opportunities to capitalize on the market (Teva, 2011). Along with generic drugs, pharmaceutical companies will also have the opportunity to develop biosimilars, as biologics with 2011 sales of approximately $XX billion will go off-patent over the next five years (Novartis, 2012). Page 4

Table of Contents 1 Table of Contents 1 Table of Contents... 7 1.1 List of Tables...10 1.2 List of Figures...10 2 Generic Growth Strategies - Introduction...11 3 Generic Growth Strategies - Market Overview...12 3.1 Overview of the Generics Market...12 3.1.1 Leading Generics Companies...12 3.1.2 Generics Market Share...14 3.2 Drivers and Restraints...15 3.2.1 Drivers...16 3.2.2 Restraints...21 4 Generic Growth Strategies - Regulatory Landscape...23 4.1 The US...23 4.1.1 Hatch-Waxman Act and ANDA...23 4.1.2 Shortening Market Exclusivity of Biopharmaceuticals and Impact on Generics...25 4.1.3 Pay-For-Delay Ban to be Detrimental to Innovators as Well as Generics...25 4.1.4 Cost-sharing of Generic Drugs...25 4.1.5 Impact of Supplemental Examination Provision of Patent Reform Act on Generics...26 4.1.6 Biologics Price Competition and Innovation Act Falls Short...26 4.2 Europe...28 4.2.1 Generic Penetration...28 4.2.2 Generic Substitution...29 4.2.3 Pricing and Reimbursement...29 4.2.4 Marketing Authorization for Generics...29 4.2.5 Generic Landscape in Leading European Markets...29 4.2.6 Common European Union Patent System...31 4.2.7 Tendering...32 4.2.8 Regulatory Landscape for Biosimilars...32 4.2.9 The Future of Biosimilars is Advancing Along a Path Smoothened by European Groundwork...32 4.3 Japan...33 4.3.1 Generics...33 4.3.2 Biosimilar...34 5 Generic Growth Strategies - Major Strategies...35 5.1 Authorized Generics...35 5.1.1 Case Study...37 5.2 Mergers and Acquisitions...37 5.2.1 Vertical Integration...39 5.2.2 Therapeutic Expansion - Biosimilars...39 5.3 Outsourcing...40 5.3.1 Outsourcing Opportunities in Biosimilars...40 5.3.2 Outsourcing is Also a Source of Income for Generics Companies...40 5.4 Marketing Partnership...41 5.4.1 Case Studies...41 5.5 Paragraph IV Certifications...42 5.5.1 Case Studies...42 5.5.2 Example of a Paragraph IV Challenge That Did Not Work Out for a Generic...42 5.6 R&D Strategies Employed by Key Players in the Generics Market...43 5.6.1 Super Generics...43 5.6.2 Biosimilars...44 Page 7

Table of Contents 5.7 Increasing Awareness and Acceptance...46 6 Generic Growth Strategies - Competitive Landscape...47 6.1 Teva Pharmaceutical Industries Limited...47 6.1.1 Overview...47 6.1.2 Revenue Analysis...47 6.1.3 Therapeutic Focus...48 6.1.4 Geographic Focus...48 6.1.5 Generic Growth Strategies...48 6.1.6 SWOT...51 6.2 Sandoz...52 6.2.1 Overview...52 6.2.2 Revenue Analysis...52 6.2.3 Therapeutic Focus...52 6.2.4 Geographic Focus...52 6.2.5 Generic Growth Strategies...53 6.2.6 SWOT...54 6.3 Mylan...55 6.3.1 Overview...55 6.3.2 Revenue Analysis...55 6.3.3 Therapeutic Focus...55 6.3.4 Geographic Focus...55 6.3.5 Generic Growth Strategies...57 6.3.6 SWOT...58 6.4 Watson...59 6.4.1 Overview...59 6.4.2 Revenue Analysis...59 6.4.3 Therapeutic Focus...59 6.4.4 Geographic Focus...59 6.4.5 Generic Growth Strategies...60 6.4.6 SWOT...61 6.5 Actavis...62 6.5.1 Overview...62 6.5.2 Revenue Analysis...62 6.5.3 Therapeutic Focus...62 6.5.4 Geographic Focus...62 6.5.5 Generic Growth Strategies...62 6.5.6 SWOT...63 6.6 Hospira...64 6.6.1 Overview...64 6.6.2 Revenue Analysis...64 6.6.3 Therapeutic Focus...64 6.6.4 Geographic Focus...64 6.6.5 Generic Growth Strategies...65 6.6.6 SWOT...66 6.7 Sanofi...67 6.7.1 Overview...67 6.7.2 Revenue Analysis...67 6.7.3 Geographic Focus...67 6.7.4 Generic Growth Strategies...67 6.7.5 SWOT...68 6.8 Daiichi Sankyo...68 6.8.1 Overview...68 Page 8

Table of Contents 6.8.2 Revenue Analysis...68 6.8.3 Geographic Focus...68 6.8.4 Generic Growth Strategies...68 6.8.5 SWOT...69 6.9 Aspen...69 6.9.1 Overview...69 6.9.2 Revenue Analysis...69 6.9.3 Geographic Focus...69 6.9.4 Generic Growth Strategies...70 6.9.5 SWOT...70 6.10 STADA...71 6.10.1 Overview...71 6.10.2 Revenue Analysis...71 6.10.3 Therapeutic Focus...71 6.10.4 Geographic Focus...71 6.10.5 Generic Growth Strategies...72 6.10.6 SWOT...72 7 Generic Growth Strategies - Conclusion...73 8 Generic Growth Strategies - Appendix...74 8.1 Market Definitions...74 8.2 Abbreviations...74 8.3 Bibliography...75 8.4 Research Methodology...77 8.4.1 Coverage...77 8.4.2 Secondary Research...77 8.4.3 Primary Research...78 8.4.4 Expert Panel Validation...78 8.5 Contact Us...78 8.6 Disclaimer...78 Page 9

Table of Contents 1.1 List of Tables Table 1: Generic Growth Strategies, Global, Revenues of Leading Generic Companies ($bn), 2010-201113 Table 2: Generic Growth Strategies, Global, Revenues of Major Drugs Due for Patent Expiry ($m), 2013-2020...17 Table 3: Generic Growth Strategies, Number of Generic ANDA Filed and Approvals, 2006-2011...18 Table 4: Generic Growth Strategies, ANDA Approvals by Month, The US, 2011-2012...19 Table 5: Generic Growth Strategies, Number of EMA Authorized Generics, Europe, 2007-2012...20 Table 6: Generic Growth Strategies, Number of Biosimilars Authorized by the EMA, Europe, 2006-201222 Table 7: Generic Growth Strategies, The US, Generic Drug Cost-Sharing (%), 2011-2020...26 Table 8: Generic Growth Strategies, Notable Authorized Generics Entry, The US, 2010-2012...35 Table 9: Generic Growth Strategies, Generic Products Launched, Teva, The US, 2011...49 Table 10: Generic Growth Strategies, Top Five Generic Active Ingredients, STADA Group, Revenue ($m), 2011...71 1.2 List of Figures Figure 1: Generic Growth Strategies, Global, Revenues of Leading Generic Companies ($bn), 2010-201113 Figure 2: Generic Growth Strategies, Generic Market Share in Selected Countries, 2010...14 Figure 3: Generic Growth Strategies, Drivers and Restraints, 2012...15 Figure 4: Generic Growth Strategies, Global, Revenues of Top 10 Drugs Due for Patent Expiry ($m), 2013-2020...16 Figure 5: Generic Growth Strategies, Number of Generic ANDA Filed and Approvals, 2006-2011...18 Figure 6: Generic Growth Strategies, ANDA Approvals by Month, The US, 2011-2012...19 Figure 7: Generic Growth Strategies, Number of EMA Authorized Generics, Europe, 2007-2012...20 Figure 8: Generic Growth Strategies, Number of Biosimilars Authorized by the EMA, Europe, 2006-201222 Figure 9: Generic Growth Strategies, The US, Generic Drug Cost-Sharing (%), 2011-2020...25 Figure 10: Generic Growth Strategies, SWOT Analysis, Teva, 2012...51 Figure 11: Generic Growth Strategies, SWOT Analysis, Sandoz, 2012...54 Figure 12: Generic Growth Strategies, SWOT Analysis, Mylan, 2012...58 Figure 13: Generic Growth Strategies, SWOT Analysis, Watson, 2012...61 Figure 14: Generic Growth Strategies, SWOT Analysis, Actavis, 2012...63 Figure 15: Generic Growth Strategies, SWOT Analysis, Hospira, 2012...66 Figure 16: Generic Growth Strategies, SWOT Analysis, Sanofi, 2012...68 Figure 17: Generic Growth Strategies, SWOT Analysis, Daiichi Sankyo, 2012...69 Figure 18: Generic Growth Strategies, SWOT Analysis, Aspen, 2012...70 Figure 19: Generic Growth Strategies, SWOT Analysis, STADA Arzneimittel AG, 2012...72 Page 10

Generic Growth Strategies: Introduction 2 Generic Growth Strategies - Introduction Generic drugs have the same active ingredient as their corresponding innovative drugs, and are therefore an equivalent but cheaper therapeutic option compared to innovative drugs, due to less cost and time being required in their development process. Generic drugs need to meet similar governmental regulatory requirements as those for innovative drugs, and should be approved by regulatory authorities to be sold in particular countries. The demand for generic drugs is growing continuously due to the need to control rising healthcare expenditure, particularly with regard to the increasing elderly population. In the US, generic drugs can cost up to XX% less than branded drugs (Federal Trade Commission, 2010). Generics bring relief to payers by lowering healthcare costs. Meanwhile, demand for high-quality generics is expected to increase in the future, with a number of branded drugs going off-patent. The use of generics has saved the US healthcare system over $XX trillion from 2000 through 2010 (Generic Pharmaceutical Association (GPhA), press release, August 2, 2012). In pure generic markets such as the US, the UK, the Netherlands and Israel, generic pharmaceuticals are substituted by the pharmacist for their brand name equivalent. In these markets, physicians or patients have little control over the choice of generic manufacturer. Moreover, generic drugs are not actively promoted to physicians, and the relationship between the generic manufacturer, pharmacy chains, distributors, health funds, and other health insurers is important. In branded generic markets such as Poland, Austria, Hungary, and some Asian and Latin American countries, generics are sold under brand names, alongside the originator brand. In these markets, pharmacists dispense the drug prescribed by the physician. Substitution between originator brands, branded generic and/or generic drugs is often limited without the physician s consent. Generic products are actively promoted and a sales force is necessary. In hybrid markets, such as Germany, France, Italy and Spain, both elements are visible. In other markets, substitution is permitted but may be limited by market forces such as brand strength and reimbursement policies. To attain profits, some companies use Authorized Generics (AGs), which gives access to significant profits without the filing of patent challenges that they are unlikely to win due to various constraints. However, the present scenario sees much synergy between generic companies and innovator companies. Biosimilars are expected to give a significant push to the generic drug and biotechnology companies, provided the regulatory frameworks for their approval are made hassle-free in the major markets such as the US and Europe. Mergers and Acquisitions (M&As) are undertaken for a wide gamut of reasons, the most popular reasons being vertical integration, therapeutic expansion, geographic expansion and diversification. Page 11

Generic Growth Strategies: Market Overview 3.2.1.2 ANDA Applications and Approvals are on the Rise The number of ANDAs filed by generic companies has significantly increased between 2006 and 2011, indicating upcoming generic competition. The figure below displays the number of generic ANDA approvals by the FDA between 2006 and 2011. Figure 5: Generic Growth Strategies, Number of Generic ANDA Filed and Approvals, 2006-2011 2006 2007 2008 2009 2010 2011 Generic ANDA filed Generic ANDA approvals Source: GBI Research; FDA, 2012a Table 3: Generic Growth Strategies, Number of Generic ANDA Filed and Approvals, 2006-2011 Year 2006 2007 2008 2009 2010 2011 Generic ANDA filed Generic ANDA approvals Source: GBI Research; FDA, 2012a Page 18

Generic Growth Strategies: Market Overview 3.2.1.3 Generic Drug Opportunities in the European Market The figure below displays the number of generic drug marketing authorizations by the EMA from 2007-2012. Figure 7: Generic Growth Strategies, Number of EMA Authorized Generics, Europe, 2007-2012 Number of EMA authorisations 2007 2008 2009 2010 2011 2012 Source: GBI Research; EMA, 2012 Table 5: Generic Growth Strategies, Number of EMA Authorized Generics, Europe, 2007-2012 Year 2007 2008 2009 2010 2011 2012 Number of EMA authorized generics Source: GBI Research; EMA, 2012 In Europe, according to the figures available from the European Medicines Agency (EMA), the number of marketing authorizations for generics is tilted significantly in favor of small molecule generic drugs in the generic drug products landscape, as observed between 2007 and 2012. In fact, the number of authorizations of generic drugs was highest in 2009, following which there have been over XX authorizations every year. The trend is expected to continue in the years to come, with patent expiries due for several small molecules. Page 20

Generic Growth Strategies: Appendix 8 Generic Growth Strategies - Appendix 8.1 Market Definitions Generic Growth Strategies - Strategies employed to increase the market size of a generic drug. Patent - A set of exclusive rights granted by a state or national government to an inventor/innovator or their assignee for a predefined period of time. Biosimilars - Also known as follow-on biologics, they are subsequent versions of innovator biologic products produced after the patent and exclusivity expiry on the original product. Contract Sales Organization - A company that assists other companies in the sales and marketing of products or services. Contract Manufacturing Organization - A company that assists pharmaceutical and other companies by providing services in drug development and manufacturing. AB-rated Drugs - Multisource drugs which have the same strength and belong to the same category are rated AB by the FDA if their bioequivalence study has been submitted. 8.2 Abbreviations ACA - AG - AIDS - ANDA - APAC - API - ARV - Affordable Care Act Authorized Generic Acquired Immune Deficiency Syndrome Abbreviated New Drug Application Asia-Pacific Active Pharmaceutical Ingredient Antiretroviral BGMA - British Generic Manufacturers Association BPCIA - Biologics Price Competition and Innovation Act CHMP - Committee for Medicinal Products for Human Use CMO - CNS - CRO - DH - DRL - EDL - EMA - EMEA - FDA - FTC - FTF - G-CSF - GSK - HGH - HIV - Contract Manufacturing Organization Central Nervous System Clinical Research Organization Department of Health Dr. Reddy s Laboratories Essential Drug List European Medicines Agency Europe, Middle East and Africa Food and Drug Administration Federal Trade Commission First-To-File Granulocyte Colony-Stimulating Factor GlaxoSmithKline Human Growth Hormone Human Immunodeficiency Virus Page 74

Generic Growth Strategies: Appendix INN - LIS - International Nonproprietary Name Low Income Subsidy LMWH - low Molecular Weight Heparin M&A - mab - Mergers and Acquisitions Monoclonal Antibody MHLW - Ministry of Health, Labour and Welfare MPD - NCE - NDA - Medicare Part D New Chemical Entity New Drug Application NHS BSA - National Health Service Business Services Authority OTC - Over-the-Counter PMDA - Pharmaceutical and Medical Device Agency R&D - rfsh - ROW - SHI - TNF - WHO - Research and Development Recombinant Follicle Stimulating Hormone Rest of the World Statutory Health Insurance Tumor Necrosis Factor World Health Organization 8.3 Bibliography Actavis (2012). Newsroom. Available from: http://www.actavis.com/en/media+center/newsroom/default.htm [Accessed on September 11, 2012]. Aspen (2012). Annual report 2011. Available from: http://www.aspenpharma.com/ [Accessed August 2, 2012]. AstraZeneca (2012). Annual report and Form 20-F information 2011. Available from: http://www.astrazeneca-annualreports.com/2011/ [Accessed September 18, 2012]. Barlas S (2011). President Obama re-opens debate on patented biologics. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3086118/ [Accessed August 7, 2012]. Biocon (2012). Annual Report 2011. Available from: http://www.biocon.com/biocon_invrelation_annual_reports.asp?sublink=finance [Accessed May 2012]. Daichii Sankyo (2012). Annual Report 2012. Available from: http://www.daiichisankyo.com/ir/index.html [Accessed September 4, 2102]. EMA (2012). European public assessment reports. Available from: http://www.ema.europa.eu/ema/index.jsp?curl=pages%2fmedicines%2flanding%2fepar_search.jsp& mid=wc0b01ac058001d124&searchtab=searchbyauthtype&alreadyloaded=true&isnewquery=true& status=authorised&keyword=enter+keywords&searchtype=name&taxonomypath=&treenumber=&se archgenerictype=generics&genericskeywordsearch=submit [Accessed August 28, 2012]. FDA (2012a). FDA Update: Generic Drug Applications. Available from: http://www.fda.gov/ucm/groups/fdagov-public/@fdagov-afdaorgs/documents/document/ucm299785.pdf [Accessed September 18, 2012]. FDA (2012b). Facts about generic drugs. Available from: http://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/understandinggen ericdrugs/ucm167991.htm [Accessed September 14, 2012]. Page 75

Generic Growth Strategies: Appendix FDA (2012c). ANDA (generic) drug approvals in 2011. Available from: http://www.fda.gov/drugs/developmentapprovalprocess/howdrugsaredevelopedandapproved/drug andbiologicapprovalreports/andagenericdrugapprovals/ucm292212.htm [Accessed September 3, 2012]. FDA (2012d). FDA listing of authorized generics. Available from: http://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cder/ucm12639 1.htm [Accessed August 29, 2012]. Federal Trade Comission (2011). Pay-for-Delay: How Drug Company Pay-Offs Cost Consumers Billions. Available from: http://www.ftc.gov/os/2010/01/100112payfordelayrpt.pdf [Accessed September 11, 2012]. Fondaparinux (2012). Product website. Alchemia Limited. Available from: http://www.alchemia.com.au/irm/content/products.html [Accessed September 27, 2012]. GBI Research (2012). Biosimilars in Emerging Economies, June 2012, GBIHC209MR. Hospira (2012). Annual report 2011. Available from: http://www.hospirainvestor.com/phoenix.zhtml?c=175550&p=irol-reportsannual [Accessed August 29, 2012]. Indian Drug Manufacturers Association (2012). Visioning India as global generics supplier. Available from: http://www.google.co.in/url?sa=t&rct=j&q=because+of+patent+expirations+of+blockbuster+drugs%2 C+Indian+firms+are+expected+to+actively+participate+in+the+production+of+generic+version+of+the se+products&source=web&cd=1&ved=0ccmqfjaa&url=http%3a%2f%2fwww.idma- assn.org%2findia%2520as%2520global%2520generics%2520supplier.ppt&ei=olj- UOOrE8zIrQfTloCIBg&usg=AFQjCNHmPpNZfxhmExSoxtey1_8gSry2fQ [Accessed August 20, 2012] Medicare (2012). Costs in the coverage gap. Available from: http://www.medicare.gov/partd/costs/coverage-gap/part-d-coverage-gap.html [Accessed August 21, 2012]. Ministry of Health, Labor and Welfare (2012). Promotion of the use of generic drugs. Available from: http://www.mhlw.go.jp/english/policy_report/2012/09/120921.html [Accessed September 25, 2012]. Mylan (2012). Form 10-K 2011. Available from: http://investor.mylan.com/investorkit.cfm [Accessed September 6, 2012]. Novartis (2012). Focused diversification. Available from: http://www.novartis.is/innovation/focuseddiversification/index.shtml [Accessed September 12, 2012]. Pharma China (2012). China pharmaceutical guide 2012. Available from: http://www.pharmachinaonline.com/upfiles/uploadfiles/20124555743498.pdf [Accessed August 8, 2012]. Sanofi (2012). Form 20-F 2011. Available from: http://en.sanofi.com/investors/investors.aspx [Accessed August 7, 2012]. STADA (2012). Annual report 2011. Available from: http://www.stada.de/english/investorrelations/financial_reports/ [Accessed September 26, 2012]. Teva (2012). Form 20-F 2011. Available from: http://ir.tevapharm.com/phoenix.zhtml?c=73925&p=irol-reportsannual [Accessed August 22, 2012]. Watson (2012). Annual report 2011. Available from: http://ir.watson.com/phoenix.zhtml?c=65778&p=irol-reportsannual [Accessed August 10, 2012]. Page 76

Generic Growth Strategies: Appendix 8.4 Research Methodology GBI Research s dedicated research and analysis teams consist of experienced professionals with a pedigree in marketing, market research, consulting backgrounds in the medical devices industry, and advanced statistical expertise. GBI Research adheres to the codes of practice of the Market Research Society (www.mrs.org.uk) and the Strategic and Competitive Intelligence Professionals (www.scip.org). All GBI Research databases are continuously updated and revised. 8.4.1 Coverage The objective of updating GBI Research s coverage is to ensure that it represents the most up-to-date vision of the industry possible. Changes to the industry taxonomy are decided on the basis of extensive research of company, association and competitor sources. Company coverage is based on three key factors: market capitalization, revenues, and media attention/innovation/market potential. An exhaustive search of 56 member exchanges is conducted, and companies are prioritized on the basis of their market capitalization; The estimated revenues of all major companies, including private and governmental, are gathered and used to prioritize coverage; and, Companies which are making the news, or which are of particular interest due to their innovative approach, are prioritized. GBI Research aims to cover all major news events and deals in the medical industry, with its databases updated on a daily basis. The coverage is further streamlined and strengthened with additional inputs from GBI Research s expert panel (see below). 8.4.2 Secondary Research The research process begins with exhaustive secondary research on internal and external sources being carried out to source qualitative and quantitative information relating to each market. The secondary research sources that are typically referred to include, but are not limited to: Company websites, annual reports, financial reports, broker reports, investor presentations and US Securities and Exchanges Commission (SEC) filings. Industry trade journals, scientific journals and other technical literature. Internal and external proprietary databases. Relevant patent and regulatory databases. National government documents, statistical databases and market reports. Procedure registries. News articles, press releases and webcasts specific to the companies operating in the market. Page 77

Generic Growth Strategies: Appendix 8.4.3 Primary Research GBI Research conducts hundreds of primary interviews each year with industry participants and commentators, in order to validate its data and analysis. A typical research interview fulfills the following functions: It provides first-hand information on the market size, market trends, growth trends, competitive landscape, future outlook, etc. Helps in validating and strengthening the secondary research findings; and Further develops the analysis team s expertise and market understanding. Primary research involves email interactions, telephone interviews, and face-to-face interviews for each market, category, segment and sub-segment across geographies. The participants who typically take part in such a process include, but are not limited to: Industry participants: CEOs, VPs, marketing/product managers, market intelligence managers and national sales managers. Hospital stores, laboratories, pharmacies, distributors and paramedics. Outside experts: Investment bankers, valuation experts, research analysts specializing in specific pharmaceutical and healthcare markets; and Key Opinion Leaders: Physicians and surgeons specializing in different therapeutic areas. 8.4.4 Expert Panel Validation GBI Research uses a panel of experts to cross-verify its databases and forecasts. GBI Research s expert panel comprises marketing managers, product specialists, international sales managers from pharmaceutical companies, academics from research universities, and key opinion leaders from hospitals. Historic data and forecasts are relayed to GBI Research s expert panel for feedback and adjusted in accordance with their feedback. 8.6 Disclaimer All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher, GBI Research. Page 78