1. Hale & Tempest Global Generics Marketplace Dr. Brian W Tempest www.briantempest.com brian.tempest@clara.co.uk UK 18,19,20 March 2014

2. Hale & Tempest

3. 1. Global Healthcare 2. Big Pharma 3.Global Generic Marketplace 4.Global Generic Companies 5.Indian Generic Marketplace 6.Indian Generic Companies 7. Country Generic Markets 8. Biosimilars 9. Generic Distribution 10. Over The Counter Consumer Medines 11. Contract Manufacturers

4. Hale & Tempest Global Healthcare & Big Pharma Chesapeake Dr. Brian W Tempest www.briantempest.com brian.tempest@clara.co.uk UK March 2014

5. Hale & Tempest 1. Global Healthcare

6. Hale & Tempest There are only a few certain things Source: T Stevenson, Fidelity Worldwide Investment Director, S Telegraph April 21 2013 Populations growth Ageing Expansion of the World’s Middle Classes Increasing demand for healthcare is as close to given as investors can hope for

7. Hale & Tempest Rise of the Middle Classes source: Frost & Sullivan

8. Hale & Tempest Aging in OECD source: EGA

9. Hale & Tempest Global Healthcare Growth by Region Source: Sunday Telegraph April 21 2013

10. Hale & Tempest Healthcare costs versus GDP & Wages

11. Hale & Tempest Public Health as % of GDP Source: UNDP 15 October 2012 Cuba 9.7% USA 9.5% France 9.3% UK 8.1% Brazil 4.2% RSA 3.9% Russia 3.2% China 2.7% India 1.2%

12. Hale & Tempest Military vs Health source: FT 24February 2014

13. Hale & Tempest Public Health Reform Everywhere

14. Hale & Tempest OECD Healthcare Expenditure Growth source: Annalisa Belloni OECD at EGA Conference 13 June 2013

15. Hale & Tempest Everybody Concerned about Health Costs

16. Hale & Tempest Healthcare as % of Government Spend source: WHO, Jefferies

17. Hale & Tempest Public & Private Healthcare as % of GDP source: WHO, India is <4%

18. Hale & Tempest How Easy to Start a Business in EMs source: Mint 13 October 2013

19. Hale & Tempest Number of Companies with Active R&D Pipelines source: Citeline Pharma R&D Annual Review 2013

20. Hale & Tempest Worldwide R&D Spend source: Evaluate Pharma 23 June 2013

21. Hale & Tempest R&D Spending by Country source: Economist March 22 2014

22. Hale & Tempest Rise of Asia R&D source: Economist March 22 2014

23. Hale & Tempest Emerging Markets Pharma Markets, $b Source: Citi Research August 2013

24. Hale & Tempest Value of EM Bourses - limited availability source: January 18 2014 Economist

25. Hale & Tempest OECD vs. BRICS source: FT 9 October 2013

26. Hale & Tempest Emerging Markets source: Business India December 8 2013

27. Hale & Tempest The Need for Universal Healthcare source: ET 2 Aug 2013

28. Hale & Tempest Healthcare will explode further in Asia

29. Hale & Tempest Asian Healthcare Expenditure $b source: EIU for countries PRC, HK, I, Ind, M, P, Si, SK, Tw, Th, V

30. Hale & Tempest Pharmaceutical Imports into USA source: Chemistry World July 2012

31. Hale & Tempest Cipla - Washington Post Ad

32. Hale & Tempest Sovaldi (sofosbuvir) for Hepatitis C Source: Pharmatimes February 7 2014 In USA Gilead Sciences charges Sovaldi at $1000 a day for a 12 week course -$84,000 The cost of manufacture of the same 12 week course is $68 to $136 according to MSF generating a gross profit over 99% In India and other emerging markets Gilead plans to charge $2,000 for a 24 week course leading to a gross profit of 86%

33. Hale & Tempest Evolving Emerging Markets IP Policy Source: Leaky Pharma 27 Jan 2014 “This is genocide, This can sentence South Africans to death” – RSA Health Minister (Motsoaldi) 1998 Big Pharma, Merck vs Mandela, PR disaster Enhanced Therapeutic Efficacy vs Incremental Efficacy 2014 Merck, PhRMA, Lobbyist PAE vs RSA IP policy OECD growth +1-4% vs Emerging Markets at +10-13% WHO Executive Board – “we cannot be sidetracked from our course of action of defending public health and the right to life” (DG Precious Matsoso)

34. Hale & Tempest Davos 2014 -Ten Global Risks of Highest Concern source: Davos 2014

35. Hale & Tempest Aid by Country source: Economist 12 April 2014

36. Hale & Tempest 2. Big Pharma

37. Hale & Tempest Big Pharma Business Model Broken source: Pharmatimes World News April 2012

38. Hale & Tempest Pharma in Crisis Source: Pharmatimes February 2013

39. Hale & Tempest A Slide from a UK Headhunter

40. Hale & Tempest Top 10 Marketing Settlements Source: Fiercepharma 26 June 2012  GSK $3b 2012  Pfizer $2.3b 2009  J&J $2.2b 2012  Abbott 1.6b 2012  Lilly $1.4b 2009  Merck $1.0b 2011  Serono $0.7b 2005  Perdue $0.7b 2007  Allergan $0.6b 2010

41. Hale & Tempest A Pfizer Decade of Bribery source: FT August 7 2012

42. Hale & Tempest The Biggest Healthcare Fraud in History Source: Daily Mail 3 July 2012

43. Hale & Tempest China Bribery Investigations source: Jefferies November 2013

44. Hale & Tempest Emerging Markets are Not so Easy

45. Hale & Tempest Will Big Pharma Change?

46. Hale & Tempest Or be like Popeye the sailor man “I Yam what I Yam what I Yam”

47. Hale & Tempest The Strategic Changes by Big Pharma Source: FT December 5 2012, Franz Humer, Roche Chairman Possible to cut 30-50% off development costs via CT efficiencies Shift from product focus to patient focus using diagnostic tools In Europe there isn’t one Government or politician interested in the health of the Industry USA & Latin American countries open to rewarding innovation Industry has to change fundamentally how it manages costs Leaner headquarters & smaller central functions Division of the industry into 2 parts A Innovative businesses able to charge a premium price B Large scale manufacturers who can compete on cost

48. Hale & Tempest Divestment & Spin Off Strategies Source: IPA 2013 Novartis - Blood Diagnostics, Animal Health, OTC, Vaccines Bayer - Bayer Material Sciences likely Abbott - Abbvie (pharma assets) Pfizer - Nutrition, Zoetis Animal Health Merck - separate growth businesses from value businesses, Consumer OTC GSK - tail products to Aspen, drinks brands J&J - Diagnostics

49. Hale & Tempest 2013 The Year of 8 Blockbusters source: Evaluate March 2014

50. Hale & Tempest 2013 the 8 Blockbusters source: Evaluate March 2014

51. Hale & Tempest Big Pharma Top 10 by 2012 Sales Source: FiercePharma 29 November 2013

52. Hale & Tempest Top 10 Medtech Companies source: Evaluate Pharma, 23 September 2013

53. Hale & Tempest Pharma & Medtech Global Markets source: Evaluate 23 September 2013

54. Hale & Tempest Global Pharma Sales source: Evaluate April 2014

55. Hale & Tempest Sales at Risk source: Evaluate April 2014

56. Hale & Tempest Global Pharma sales lost & sales gained source: Evaluate March 2014

57. Hale & Tempest Biggest Expected Launches of 2014 source: EvaluatePharma

58. Hale & Tempest Strength of Local Companies source: IMS May 2012

59. Hale & Tempest Big Pharma Top Risers & Fallers in 2013 source: Evaluate March 2014

60. Hale & Tempest 2013 a healthy year for Pharma source: Evaluate March 2014

61. Hale & Tempest Thank You brian.tempest@clara.co.uk www.briantempest.com