IQVIA Quarterly Pharmaceutical

Market Outlook
Quarterly Report: August 2023
Data Month Ending: June 2023

European Thought Leadership

© 2023. All rights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States, the European Union, and various other countries.
IQVIA Quarterly Pharmaceutical Market Outlook
+ Global Adult Vaccination Trends

+ Deep Dive into COVID-19 Vaccination

+ Channel Preference Survey 2023 Results

+ New Active Substance, plus Innovative Launch Analysis

+ Medicine Demand and Supply

+ Engagement with Health Care Professionals

+ Appendix

1
Global Adult Vaccination
Trends

2
Global adult vaccinations show steady progression for 2013-2020, then
declined between 2020-2022 due to COVID-19 pandemic
Impact of COVID-19 on global adult vaccination doses

• Vaccine-preventable diseases (VPDs) may present serious burden on the public healthcare system in terms of treatment cost and may also
increase the risk of other co-morbidities such as cardiovascular, cerebrovascular, neurological, renal complications etc.
• In the EU, VPD causes estimated ~94,000 deaths annually with a significant number of hospitalizations1

Global adult vaccination doses (M), 2013-20221

In 2013-2020, the number of adult vaccination doses grew at a CAGR
of ~9% (221 M in 2013 to 400 M in 2020), whereas in 2020-2022, the
400 number of doses reduced 12% (400 M in 2020 to 351 M
+9% 19
363
in 2022)
349 30 351
15
322 17 12 14
+8%
304 32 45
28
33 In 2021-2022, globally received vaccination doses for other VPDs are
17 10
275 17 22 15 44
11 16.2 doses/100 adults, in contrast to global COVID-19 vaccination
256 16 15
17 15 45 of 132 doses/100 adults (2022) excluding booster doses
244 52
18 17 52
221 15 19 16 53
12 25 18
16 17 53 Among other vaccines, the number of Influenza vaccine doses
21 50
58
increased continuously in between 2013-2020, but reduced
53 295
265 247
significantly in between 2020-20221
217 232
203
171
152
119 128
• The disruption in immunization services and economic loss due to
COVID-19 possibly resulted in sudden decline in adult vaccination doses
2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
• Adverse effects presented in the form of missed adult vaccination doses
Pneumococcal Herpes zoster Hepatitis B Td/TdaP Influenza require more focus and in-depth analysis
Note: Adult vaccinations include Influenza, Td/TdaP, Hepatitis B, Herpes zoster, Pneumococcal vaccines; Source: 1IQVIA Institute Report 2023
Abbreviation: Td- diphtheria and tetanus; TdaP- diphtheria, tetanus and pertussis; VPD- Vaccine-preventable diseases

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 3

Globally ~100 M adult vaccination doses are missed, although the adult
vaccination spend has moderately increased in Europe
Missed doses and spend of adult vaccination

Estimated adult vaccine missed doses in 2021 and 2022 Adult vaccination spend in Europe as a share of
In Europe, the adult vaccination
total pharmaceutical expenditure (2013-2022)
expenses show a moderate
440 428 0.7%
increase of 0.2%-0.3% of total
0.6% 0.6%
420 404 408 pharmaceutical expenditure over
400
400 387 0.4% 0.4% 0.4% 0.4% time (2013-2022)
380 0.3% 0.3% 0.3%
380 365 363
351
EU4 & UK countries show
360
substantial variations in adult
340 vaccination spend with Germany
2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
320 spending the maximum share
2020 2021 2022
(1.7%) and Spain spending the
Adult vaccination spend in EU4 & UK as a share
Actual Trendline 1 (2013-2019) Trendline 2 (2013-2020) of total pharmaceutical expenditure (2023) minimum (0.1%) as a share of
total pharmaceutical expenditure
1.7%
(2023)
The estimated number of missed adult vaccine
doses are ~100 M between 2021-2022 for Increasing proportion of elderly
Influenza, Td/TdaP, Hepatitis B, Herpes zoster and 0.7% individuals (≥65 years) among
Pneumococcal (as per the derivation from the mid- 0.3% 0.4% adult populations in Europe
point of two historical trend lines for the periods, 0.1% requires additional investments
2013-2019 and 2013-2020 respectively) for adult vaccinations1,2
UK France Germany Italy Spain

• Other than infectious disease prevention, adult vaccinations lead to avoidance of long-term co-morbidity risks, hospitalizations and premature deaths, and provides
extensive individual, social and economic benefits, particularly in elderly adults 1,2
Note: Adult vaccinations include Influenza, Td/TdaP, Hepatitis B, Herpes zoster, Pneumococcal vaccines; Source: 1IQVIA Institute Report 2023; 2Eurostat 2023
Abbreviation: Td- diphtheria and tetanus; TdaP- diphtheria, tetanus and pertussis

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 4

Improved access, increased awareness and routine follow-up may help to
recover adult vaccination programs
Strategies to overcome declination in adult vaccination
Possible approaches to expand adult EU/National initiatives for adult
vaccination vaccination recovery

• Adult vaccination as a standard of care: Ensuring appropriate financing for the The European Immunization Agenda 2030 (EIA2030)
implementation of accessible vaccination programs with a focus on prevention • Implementation of the experiences gained during COVID-19 in strengthening the
• Improved accessibility to vaccination programs: Increasing the number of vaccination of older adults or adults with co-morbidities throughout the life course
vaccinators (e.g., including pharmacists) and creating additional access points for • Exploring and establishing collaborations within and outside the health sector to
vaccination facilities supported by laws and regulations promote the life course approaches, such as maternal health services, occupational
• Monitoring progress and follow-up: Capturing, analyzing and reporting health, social care services for older adults etc.
vaccination data to track progress and enable follow-up along with improving the • Expansion and diversification of vaccination pathways including vaccination
availability of digital data infrastructure during pregnancy, in health workers and in older adults.2
• Increased awareness among citizens: Providing support, encouragement and
incentives to the HCPs to have routine conversations about vaccination with the Four action plans for prioritizing adult vaccination
patients. Raising media and public awareness about the consequences of infectious
diseases and the importance of adult vaccination may also be beneficial1 • To prioritize and incorporate adult vaccination in national immunization plans
• Increase awareness and education among citizens, patients and HCPs on the
consequences of VPDs and the benefits of adult vaccinations
• Extending the scope of vaccination by HCPs, pharmacies, workplaces etc.
• Establishing and expanding E-vaccination cards, national digitalized registries for
adult vaccination including reminder and recall system for improved effects 3
The Adult Immunization Board (AIB)
• Reduce the impact of VPDs in European adults
• Provide evidence-based guidance on fundamental technical and strategic issues
• Monitor the progress of adult vaccination programs4

• COVID-19 pandemic resulted in substantial decline on routine vaccination programs in adults, which impacted the overall health, quality of life and mortality in adults
• Establishment of regulatory policies and improvement of vaccination strategies are necessary for improving coverage rates and the protection of adults, especially
elderly population and adults with co-morbidities
Source: 1IQVIA Institute Report 2023; 2EIA2030; 3Vaccines Europe 2022; 4The Adult Immunization Board 2023; Abbreviation: VPD – vaccine preventable disease

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 5

Deep Dive into
COVID-19 Vaccination

6
 By August 2023, more than 13 billion vaccines have been administered
globally
Top 10 countries – Total vaccinations (Total number of COVID-19 vaccination doses administered, M)
0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,000 11,000 12,000 13,000 14,000

China (9th Feb) 3,491.1

India (12th Aug) 2,206.7

US (9th May) 676.7

Brazil (22nd Mar) 486.4

Indonesia (6th Jun) 447.6

Japan (7th May) 383.7

Bangladesh (12th Aug) 361.5

Pakistan (6th Aug) 339.9

Vietnam (30th Jun) 266.5

Mexico (7th Oct) 223.2

Others 4,585.8

World 13,469.3

Sources: IQVIA European Thought Leadership, 31/08/2023. Vaccine rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at
OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’ on 14/08/2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 7

There are more than one type of COVID vaccine approved, even in the least
vaccinated countries
Bottom 10 reporting countries – Vaccine doses per 100 people^
0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180

Burundi (23rd Jul) 0.32

Yemen (20th Jun) 3.81

Haiti (2nd Jun) 5.73

PNG (1st May) 7.27

Madagascar (16th Jul) 10.41

Congo (31st Jul) 13.96

Cameroon (23rd Jul) 17.17

Senegal (23rd Jul) 17.86

DRC (4th Jun) 19.00

Syria (18th Apr) 23.01

Other (Avg) 175.23

World (Avg) 169.74

Sources: IQVIA European Thought Leadership, 31/08/2023. Vaccine rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at
OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’ on 14/08/2023. ^Excludes Eritrea, Marshall Islands, Micronesia and the Vatican which have not reported vaccine doses in OWID.
PNG = Papua New Guinea, DRC = The Democratic Republic of the Congo

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 8

Across the EU4 & UK, on average more than two doses have been
administered per person

Sources: IQVIA European Thought Leadership 31/08/2023. Vaccine rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at
OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’ on 14/08/2023. Vaccine approval data: https://COVID19.trackvaccines.org/vaccines/, https://www.nytimes.com/, https://www.ft.com/,
https://www.raps.org/
Note: Doses per person are inclusive of all age groups

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 9

Majority of the bottom 10 reporting countries are from Africa, in terms of
proportion of population vaccinated
Bottom ten countries by absolute number of fully vaccinated people, represent a mix of low to lower-middle
income countries
Bottom 10 countries – Fully vaccinated people (Thousands)^ Bottom 10 countries – Share of population fully vaccinated (%)^
0 5 10 15 20 25 30 35 40 45 50 5,159,515 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70
San Marino (22nd May) 23.6 Burundi (14th May) 0.28
*Monaco (21st Dec) 25.7 Yemen (20th Jun) 2.36
SKN (2nd Dec) 27.0 Haiti (2nd Jun) 3.02
Dominica (7th Oct) 30.7 PNG (1st May) 3.17
SVG (31st Mar) 31.6 Senegal (23rd Jul) 8.68
Burundi (14th May) 36.3 Madagascar (16th Jul) 8.84
Greenland (14th Mar) 38.5 Syria (18th Apr) 10.66
Grenada (17th Mar) 39.0 Gabon (5th Feb) 10.78
Andorra (21st May) 53.5 Congo (31st Jul) 10.96
Saint Lucia (2nd Dec) 55.0 Cameroon (23rd Jul) 11.27
Other (Sum) 5,159,149.3 Other (Avg) 66.32
World (Sum) 5,159,510.2 World (Avg) 65.02

• Graphs represents the number/share that have received all doses prescribed by the vaccination protocol
• Individuals are counted if they have received one dose of a vaccine with a one dose protocol or two doses of a vaccine with a two dose protocol
• Data is only available for countries which report the breakdown of doses administered by first and second doses

Sources: IQVIA European Thought Leadership, 31/08/2023 analysis of data provided on the OurWorldinData.org website. Vaccine rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) -
"Coronavirus Pandemic (COVID-19)". Published online at OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’ on 14/08/2023.
Notes: SKN = St. Kitts and Nevis, SVG = St Vincent and the Grenadines, PNG = Papua New Guinea; *denotes year 2021
^Excludes Eritrea, Marshall Islands, Micronesia, the Vatican, Liechtenstein and Switzerland which have not reported fully vaccinated people in OWID

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 10

 While high population countries dominate absolute numbers of fully
vaccinated people, small-mid sized nations dominate doses per person
Top 10 countries by number of doses per person
1,300 4.5
Fully vaccinated individuals (millions)

1,200
1,100 4.0 Cuba
1,000 China begins
reporting

Doses per person

900 3.5
800 Japan
Brunei Chile
700
3.0 Qatar Cambodia
600 Taiwan
500 Vietnam
2.5 Portugal Peru
400
300
200 2.0
100
0 1.5
01/2020 07/20 01/21 07/21 01/22 07/22 01/23 07/23 0 10 20 40 60 70 80 90 100 110 120 130
China United States Indonesia Pakistan Vietnam Population (millions)
India Brazil Bangladesh Japan Mexico

• Graphs represent the number/share that have received all initial doses prescribed by the vaccination protocol
• Individuals are counted if they have received one dose of a vaccine with a one dose initial protocol, two doses of an initial two dose protocol, etc.
• Data is only available for countries which report the breakdown of doses administered
Source: IQVIA European Thought Leadership, 31/08/2023 analysis of data provided on the OurWorldinData.org website. Vaccine rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) -
"Coronavirus Pandemic (COVID-19)". Published online at OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’ on 14/08/2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 11

In the EU4 & UK, on average ~79% of the population is fully vaccinated;
Spain is leading with ~86% of individuals fully vaccinated

Sources: IQVIA European Thought Leadership, 31/08/2023. Vaccine rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at
OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’ on 14/08/2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 12

Among EU nations, Belgium, Sweden and Italy are in the top ten countries
administering the maximum number of booster shots per hundred people
Top 10 countries by booster doses and the countries with the highest share of omicron cases sequenced
illustrates how the variant spread globally in a short period of time
Top 10 countries by highest share of sequenced
Booster doses per hundred people
cases of omicron in the past four weeks*
Japan (6th May) 141.7 Argentina 80.0% 20.0%

Chile (7th Feb) 140.2 Ecuador 60.0% 40.0%

Taiwan (16th Jul) 106.4 Puerto Rico 50.0% 50.0%

Belgium (25th May) 99.8 Mexico 50.0% 50.0%

Sweden (19th Mar) 93.2 Sint Maarten 50.0% 50.0%

Uruguay (14th Dec) 91.1 Guatemala 46.0% 54.0%

Peru (4th Aug) 90.8 Netherlands 27.7% 72.3%

Malta (1st Aug) 87.2 Austria 25.0% 75.0%

Bhutan (30th Oct) 81.1 Omicron Spain 22.5% 77.5%

(XBB.1.5+XBB.1.5.*)
Italy (30th Jun) 80.9 Brazil 22.2% 77.8%
Other variants

Booster doses are doses administered beyond those prescribed by the original Note that Variants of Concern may be overrepresented, as suspected cases
vaccination protocol – for example a 3rd dose of the Comirnaty vaccine are likely to be sequenced preferentially or faster than other cases

Source: IQVIA European Thought Leadership 31/08/2023. Booster shot rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at
OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus on 14/08/2023. *Excludes results with 100% of sequenced cases as omicron, as these countries likely only sent omicron cases to be sequenced
and confirmed, as at 16/08/2023 https://www.gisaid.org/hcov19-variants/

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 13

Vaccination and booster dose strategies adopted by countries
As per the recommendation of the Joint Committee of Vaccination and Immunization (JCVI), the UK government is offering
COVID-19 booster dose in Autumn 2023 to adults ≥65 years, residents in a care home for older adults, clinical risk group aged
6 months- 64 years, frontline health and social care workers, household contact individuals of age 12-64 years for people with
immunosuppression and caregiver or staffs of age 16-64 years for care homes for older adults. JCVI also advised the autumn
program should aim to complete vaccination by early December 2023 (Aug 2023)1

The Standing Committee on Vaccination (STIKO) recommends further booster doses for people >6 months with increased risk,
people >60 years of age, residents of care facilities, medical and nursing staff, preferably with a variant adapted mRNA vaccine
(July 2023)2. Pregnant women, regardless of their age, should be vaccinated with Comirnaty and not Spikevax. Basic immunization
and a booster is recommended to unvaccinated pregnant women in their second trimester (July 2023)3
The Ministry of Health of Italy announces a national vaccination campaign against COVID-19 (2023/2024) to prevent mortality,
hospitalization and severity of COVID-19 in elderly, highly frail people, pregnant women and health and social health workers. It is
expected to be launched with the use of new updated monovalent XBB 1.5 formulation of mRNA and protein vaccines (expected to be
approved by EMA and AIFA for late summer/early autumn and doses are expected to be available by October) (Aug 2023)4

Spain Ministry of Health declares the end of health crisis caused by COVID-19 and continues its work to establish appropriate
recommendation for COVID-19 vaccination and to integrate it into national vaccination programs (July 2023)5

France Ministry of Health and Prevention has prepared for autumn vaccination campaign for COVID-19 in 2023-2024. The
campaign targets risk groups recommended by the French National Authority for Health (HAS) are people of ≥65 years, people with
co-morbidities, pregnant women, immunocompromised people, health workers and caregivers (July 2023)6. HAS is evaluating the
place of Bimerax vaccine in the vaccination strategy and requires additional data from clinical trials and longer follow-up period before
considering its use (June 2023)7
Sources: 1JCVI recommendation; 2STIKO Germany; 3STIKO Germany pregnant women; 4Ministry of Health Italy; 5Ministry of Health Spain; 6France autumn booster campaign; 7HAS evaluating Bimerax

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 14

As of August 2023, EU4 and UK countries have administered ~748 M doses
Total COVID-19 vaccine doses administered at the regional level
Total vaccinations (M of doses)
0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000
UK
Germany 154
EU4 + UK 748
France 192
151 145 106
Italy
Spain Japan 384
China
India
Brazil Pharmerging 3,491 2,207 486 2,525 8,709
Other Pharmering (Sum)
Iran
143
Thailand RoW 2,524 2,951
155
South Korea 130
Other RoW (Sum)
US 677

Sources: IQVIA European Thought Leadership, 31/08/2023. Vaccine rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at
OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’ on 14/08/2023.
Note: Pharmerging countries include China, India, Brazil, Turkey, Russia, Indonesia, Bangladesh, Mexico, Saudi Arabia, Pakistan, Egypt, Algeria, Colombia; South Africa, Ukraine, Phillipines and Vietnam

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 15

EU4 and the UK have administered more vaccines per hundred people than
the United States and Japan
Vaccine doses per 100 people
Vaccine doses per
Country
100 people 0 50 100 150 200 250 300 350
Italy 244.9
Germany 230.6 EU4 & UK 230.1
France 227.8
United Kingdom 224.0
Pharmerging 187.1
Spain 222.5
China 244.8
Brazil 225.9 118.4
RoW
India 155.7
Other Pharmerging
158.0
(Avg)
United States 200.0
South Korea 250.2
Thailand 198.9
Iran 175.5 Japan 309.6
Other RoW (Avg) 110.7
Sources: IQVIA European Thought Leadership, 31/08/2023. Vaccine rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at
OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’ on 14/08/2023.
Note: Pharmerging countries include China, India, Brazil, Turkey, Russia, Indonesia, Bangladesh, Mexico, Saudi Arabia, Pakistan, Egypt, Algeria, Colombia,
South Africa, Ukraine, Phillipines and Vietnam

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 16

In European countries, the Pfizer vaccine is the most widely used vaccine,
followed by the Moderna vaccine
Vaccine rollout by product in reporting countries (M of doses)

United States (22nd Mar) 60% 37% 3% 672.6

Japan (7th May) 78% 22% 383.7

Germany (7th Apr) 74% 17% 7% 2% 186.5

France (10th Jul) 79% 16% 1% 154.5

5%
Italy (10th Aug) 67% 24% 8% 1% 144.6

Argentina (12th Aug) 18% 15% 23% 18% 25% 1% 116.0

Spain (9th Jun) 68% 22% 9% 2% 112.9

Canada (4th Dec) 67% 30% 3% 95.2

Peru (13th Aug) 60% 7% 9% 24% 90.1

South Korea (26th May) 60% 15% 23% 2% 87.5

Valneva Sanofi/GSK Novavax Sinopharm/Beijing Johnson&Johnson Moderna

SKYCovione Medicago CanSino Sputnik V Oxford/AstraZeneca Pfizer/BioNTech
Sources: IQVIA European Thought Leadership, 31/08/2023. Vaccine rollout data: Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at
OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’ on 14/08/2023
Note: Vaccine rollout data by product is not reported for UK in OurWorldInData.org

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 17

Current COVID-19 pipeline is dominated by therapeutics; EU4 & UK-based
companies account for ~14 % of total drugs under development
As more drugs are developed, the majority of clinical trials for therapeutics are in early phases
Drug records (%) by
Number of drugs by phase Number of Drugs by type of platform/class
Corporation nationality* • Drugs under
DNA based vaccine 9 development by
31 US 39%
corporation
Inactivated Virus 10
RoW 24% nationality, EU4 &
Live attenuated virus 3 UK contribute ~14%
Pharmerging 16% of therapies in
Protein subunit 29
36 Recombinant protein vaccine 1 EU4 & UK 14% development,
whereas the US
35 RNA based vaccine 40
174 Japan 6% lead with ~39%
Viral vector (Non-replicating) 14
• The most prevalent
103 Viral vector (Replicating) 4 # of drugs by formulation COVID-19 therapy
79 Virus like particle 9 formulations in
injection 295 development are
19 Other 5
3 Oral 147 injectables and oral
3 4
inhalation 18 medications
Pre-reg
Phase I

Phase III
Phase II

Registered

intranasal 18
Biologic Non-Biologic
Inhalation/ Injection 5
166 197 topical 2
Therapeutics
transdermal 1
Vaccines Therapeutics
sublingual 1
Source: IQVIA Pipeline Intelligence. Data exported on 11/08/2023; Notes: Data is excluded for vaccine candidates which are pre-clinical or terminated in development. Vector NR = Vector Non-replicating. Vector R = Vector
Replicating. VLP = Virus Like Particle; *Corporation Nationality: Nationality of a corporation with a specific licensing relationship in a region or therapy franchise

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 18

COVID-19 vaccination – Recent news updates

Vaccine manufacturers and regulatory authorities are focusing on updating booster shots for the
new variants
• EMA’s Emergency Task Force has recommended updating vaccines to target the dominant XBB
Vaccine updates strains of Omicron. The European Medicines Agency (EMA) and the European Centre for Disease
Prevention and Control (ECDC) also noted that monovalent vaccines may provide protection against
for new variants
present dominant and emerging strains (June 2023)1
• EU Committee for Medicinal Products for Human Use (CHMP) recommends extension of marketing
authorization for Spikevax Bivalent Original/Omicron BA.4-5 for active immunization to prevent COVID-19
in individuals ≥6 months of age (July 2023)2
Globally, vaccine approvals continue for novel vaccines and approved vaccines are extended for
wider age groups
• The Vaccine and Related Biological Products Advisory Committee (VRBPAC) of US FDA recommended
COVID-19 vaccines to be updated with a monovalent formulation to provide protection against the
Omicron variant XBB.1.5 for use by the fall of 2023 (June 2023)3
Further vaccine • Daiichi-Sankyo’s DAICHIRONA (monovalent- original strain) is the first Japan-made mRNA vaccine for
updates globally COVID-19 that has been approved in Japan for manufacturing and marketing (August 2023)4
• Public Health Agency of Canada (PHAC) released updated guidelines on the use of COVID-19 vaccine.
Updates include recommendations for the use of Moderna Spikevax Bivalent vaccine(Original/Omicron
BA.1 and Original/Omicron BA.4/5) as a booster dose for individuals 6-17 years of age. Use of Novavax
Nuvaxovid vaccine is also recommended as a primary series in individuals ≥12 years of age and as a
booster dose for adults ≥18 years of age (June 2023)5
Sources: IQVIA European Thought Leadership 31/08/2023. 1EU vaccine update; 2Moderna; 3US FDA recommendation; 4Japan monovalent vaccine; 5Canada vaccine update

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 19

Channel Preference
Survey 2023 results

20
Engaging with health systems requires an orchestrated omnichannel
approach to meet customer needs
Six enablers for successful post-pandemic customer engagement

Channel mix

Content

Customer focus

People

Technology

Change Agility

Target Group IQVIA

Source: IQVIA EMEA Thought Leadership

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 21

Countries are now finding a new post-pandemic equilibrium for traditional
and digital interactions
F2F and virtual remote contacts with HCPs

Traditional (F2F 1:1 visits) Digital (Remote 1:1 calls)

14,000 1,200
Number of Contacts (‘000s)

Number of Contacts (‘000s)

12,000 1,000
10,000
800
8,000
600
6,000
400
4,000
2,000 200

0 0
Q4 2019
Q1 2020
Q2 2020
Q3 2020
Q4 2020
Q1 2021
Q2 2021
Q3 2021
Q4 2021
Q1 2022
Q2 2022
Q3 2022
Q4 2022
Q1 2023
Q2 2023

Q4 2019
Q1 2020
Q2 2020
Q3 2020
Q4 2020
Q1 2021
Q2 2021
Q3 2021
Q4 2021
Q1 2022
Q2 2022
Q3 2022
Q4 2022
Q1 2023
Q2 2023
France Germany Italy Spain UK France Germany Italy Spain UK

• Culture and expectations

• Limitations on in-person interactions
• HCP channel preferences
• Promotional necessity
• COVID-19 response
• Schedule around clinic time
• Access to physicians
Source: IQVIA EMEA Thought Leadership; IQVIA ChannelDynamics™ Data (EU4 & UK, all specialties, all therapy areas)

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 22

 Life sciences companies need to make the most of interactive time
with HCPs, which remains below pre-pandemic levels
Spain and the UK show the highest affinity for remote engagement
1:1 Interactive Contact Time by Channel

Germany France Italy Spain UK US

100% 100% 100% 100% 100% 122%

3% 3% 1%
5% 6% 114% 8%
88% 88% 88% 108%
84% 7% 5% 13% 7%
82% 100%
75% 18% 2%
6% 75% 20% 11% 8% 90% 26% 9%
6% 72% 71% 71% 73%
69% 4% 67% 3% 5% 4%
4% 5% 6% 15% 12% 16%
63% 63% 3%
62% 3% 61% 63% 27%
16% 58% 6% 5% 4% 18% 12%
10% 6% 54% 13%
11% 12% 22% 16%
5%
97% 97% 98% 12% 16%
25%
93% 93% 21% 45%
85%
97%
87% 95% 82% 86% 77%
91% 94% 91% 94% 70%
80% 85% 89% 85% 63% 30%
62%
63% 67%
83% 57%
63% 65%

25%

H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H1
2019 2020 2021 2022 2023 2019 2020 2021 2022 2023 2019 2020 2021 2022 2023 2019 2020 2021 2022 2023 2019 2020 2021 2022 2023 2019 2020 2021 2022 2023

Virtual 1:1 call Telephone F2F Detail

Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 23

The 2023 IQVIA ChannelDynamics™ Channel Preference Survey
covered over 23,000 HCPs across 38 countries
“Please enter - as a percentage – the mix of interactions you would generally prefer over the course of a year.
For example, if you would prefer about half of your interactions to be face-to-face, 1:1 in-person visits, please indicate 50%”

Respondents by Specialty Split of respondents by

Total 23,253 care setting
GPs
1,102 Pharmacists
Cardiologists
Gynaecologists
12%
1,597 19% Internal Medicine 44%
2% Psychiatrists
2% Oncologists 76%
3,419 2%
Paediatricians 90% 86% 83%
3%
Rheumatologists
3% 8% Gastroenterologists
1,751
3% Opthamologists
Dermatologists 56%
3%
969 5% Pulmonologists
3% Neurologists 24%
5% 14% 17%
4% Urologists 10%
1,845 4% Diabetologists
4%

APAC

Nordics
EU4+UK

US
LATAM
4% 4% Haematologists
4% 4%
Orthopaediatricians
+33 other Nephrologists
12,570
countries Others Primary Secondary
Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 24

F2F visits, in-person conferences and emails uphold the top three
positions as the most preferred channels over time
Aggregated EU4 & UK and US channel preference splits

100% Online resources Telephone Podcasts

Instant Other
3% 2%
90% message/text 0%
Podcasts
4%
80% Telephone Remote 1:1
video call
70% Instant 4%
9% 9% message/text
Post / mail F2F 1:1 visit
60% 1:1 video call
11% 5% 41%
18%
50% Post / mail On-demand 2023
presentations
40% On-demand 6%
presentations
30% Remote
conferences Remote, live-
51%
44% Email streamed
20% conferences
Email
9%
In-person 10%
10%
conference In-person
F2F 1:1 visit conferences
0%
16%
2021 2022
Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 25

Globally, F2F is the most preferred channel but there is significant
regional and country-level variation
2023 preferred channel mix across major markets

Regional Analysis Country Analysis

100% 100%
Podcasts
90% 90%
Telephone 80%
80%
70%
70% Instant message
12% 9% 10% 60%
7% / text
60% 7% 11% 14%
Remote 1:1 video 50%
50% 17% 20% 17% call
15% 19% 40%
11%
40% On-demand 30%
24%
presentations
30% Remote 20%
conferences 10%
20% 39% 42% 42% 40% 42% 41%
Post / Mail 0%
28%
10%

Spain

Denmark
Greece

Finland

Sweden
Italy

Turkey

France

Norway

United Kingdom
Poland
Belgium

United States

Germany
Switzerland
Portugal

Ireland
Email
0%
Nordics

Rest of Europe

US
APAC

EU4+UK

LATAM

Rest of World

In-person
conferences
Face-to-face 1:1
visits
Face-to-face 1:1 visits In-person conferences Email Remote
Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 26

Significant country level variation in channel preference continues into 2023
HCP Promotional Channel Preference over time (July 2019 – July 2023)

Germany France Italy

34% 25% 35% 26% 33% 29%

44% 36%
54% 48% 52% 54%
23% 64% 67% 62%
26% 19% 17%
22% 26% 28%
22%
27% 23% 24%
9% 12% 29% 53% 13%
42% 52% 21% 23% 48% 47%
17% 37% 18% 18% 19% 17%
16% 4% 14%
10% 12% 15% 4% 8% 7% 6% 5%
1% 1% 1%
2019 2020 2021 2022 2023 2019 2020 2021 2022 2023 2019 2020 2021 2022 2023

Spain UK US

32% 31% 29% 39% 35% 36%

41% 47% 52% 49%
58% 56% 54% 63%
71% 22%
20% 21% 17%
20% 27%
30% 17% 18%
21% 17%
24% 21% 10%
47% 48% 11% 38% 49% 27% 46% 23%
18% 19% 24% 35% 20% 25%
14% 5% 13%
1% 1% 4% 5% 1% 1% 6% 6% 11% 7% 6% 11%
2019 2020 2021 2022 2023 2019 2020 2021 2022 2023 2019 2020 2021 2022 2023

Individual Interactions Meetings/Events/Seminars Online Resources Other

Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023; Individual interactions refers to face to face rep visits, one to one telephone and video call; meetings/events cover live and remote conferences;
online resources refer to email, online information resources, self guided presentation and podcasts (2023); other cover instant messaging and postal mailing

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 27

HCP preference for individual interactions has remained higher than
pre-pandemic in France, Italy, Spain and the US
HCP Preference for Individual Interactions (2019-2023)

2019 Pre-pandemic 2021 Without restrictions 2022 Without restrictions 2023 channel preference
Individual Interactions
70%
Face-to-face, one-to-one visits
66%
64% 63%
62%
1:1 Telephone call (audio only)
56% 54%
54% 54%
1:1 video call (e.g., via Zoom, 50% 49%
48% 48% 47% 46%
Teams etc.) 44%
41%
39%
Instant message/text (e.g., via 36% 35%
34% 35% 33% 32%
WhatsApp)

Germany France Italy Spain UK US

Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 28

Remote channels contribute to 25-43% of overall preference, showing
how a shift from F2F are needed in certain markets
Building the case for omnichannel interactions across the EU4 & UK

100%
Podcasts
90%
25% 25% Instant messaging
30%
39% 35%
80% 43% Telephone
70%
Live video call with individual rep
60%
On-demand presentations
50%
Post
40% Virtual conferences
30% Remote
47% 49%
20% 42% 41% Email
31%
10% 24%
In-person conferences

0% F2F 1:1 visits

France Germany Italy Spain UK US

France Germany Italy Spain UK US

Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 29

Digital natives and immigrants show significant channel preference
alignment, with natives preferring marginally less F2F
Life sciences companies need to engage with an older demographic today but also need to focus on a
younger, more digitally astute customer base in future
% of medical doctors >55 years by country 2023 channel preference analysis split by age
60% segment across the EU4 & UK
56%
100%
50% 90% 5%
45% 80% 7%
42%
70% 11%
40% 12%
60%
32% 50% 17%
19%
30% 40%
30%
20% 20% 45% 38%
14% 10%
10% 0%
Digital Immigrant Digital Native
(Born pre-1980, n=4,804) (Born post-1980, n=997)
0%
Face-to-face 1:1 visits In-person conferences
Denmark
Romania

Greece
Finland

Spain

Latvia
Isreal
Italy
Luxembourg

Hungary
UK
Turkey

Croatia

Austria
Czech Republic

Iceland

France

Estonia
Netherlands

Switzerland

Germany
Portugal
Ireland

Bulgaria
Sweden

Belgium

Email Post / Mail

Remote conferences On-demand presentations
Remote 1:1 video call Instant message / text
Telephone Podcasts
Source: IQVIA EMEA Thought Leadership; % Medical doctors aged 55 and above by country (World Health Organisation); Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 30

The 2023 survey shows limited differences in channel preferences
between men and women
EU4 & UK and US channel preferences, split by gender

Aggregated channel preference Gender splits by country

100% Male
Podcasts France
Female
90%
Text / Instant message Male
80% Germany
Female
70% Telephone
Male
60% Italy
Remote 1:1 video call Female
50% Male
Post / Mail
Spain
40% Female
On-demand
30% presentations Male
UK
43% Remote conferences Female
20% 38%
Male
10% Email US
Female
0% In-person conference
Male Female 0% 20% 40% 60% 80% 100%
(n=6,947) (n=3,696) Individual Interactions Meetings/Events/Seminars Online Resources Other
Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 31

Secondary care HCPs prefer more group events than HCPs from
primary care
Primary vs. secondary HCP channel preferences in US, EU4 & UK

Individual interactions Meetings/events/seminars Online resources Other

100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
France
1º 2º Germany
1º 2º Italy
1º 2º Spain
1º 2º United
1º 2º United
1º 2º
Kingdom States

France Germany Italy Spain UK US

Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 32

GPs show an affinity towards individual interactions in the EU4 but in
the UK many prefer online resources
HCP specialty level analysis across EU4 & UK

Individual interactions Meetings/events/seminars Online resources Other

GPs
UK Oncologists
Cardiologists
Oncologists
Spain Cardiologists
GPs
Oncologists
Italy Cardiologists
GPs
Cardiologists
Germany Oncologists
GPs
Cardiologists
France Oncologists
GPs

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Source: IQVIA EMEA Thought Leadership; Channel Preference Survey 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 33

What are the strongest factors influencing the commercial approach for life
sciences companies?
Four key components from the Channel Preference Survey to create HCP personae

Country
• Culture, historical expectations and access

Specialty Building
• Different priorities, workloads and patient HCP personae
groups

Age HCP archetypes need to reflect channel

preferences and desire to interact
• Digital affinity, social media and
generational norms E.g., traditional in-person, digital-only, hybrid
etc. (weekly, monthly)
Incorporate multiple data sources
Gender E.g., age, gender, specialty, engagement
• Limited differences in channel preference history, prescription volumes, social media
presence and digital affinity
Source: IQVIA EMEA Thought Leadership

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 34

New Active Substance,
plus Innovative Launch
Analysis

35
 Top 8
On average, post-pandemic launch trajectories still underperform, and
the most recent cohort perform worst
Performance of innovative launches pre-COVID versus post-COVID
Median cumulative sales for innovative launches across the Top 8 markets
6

5
Median cumulative sales

Pre-pandemic
4 2020 Pandemic/
(Mn USD)

2021 Post-Pandemic
3
H1 2022 Average
H2 2022

2
Excludes
-27%
• COVID-19 vaccines and
1 treatments
• Hep C products

0
1 2 3 4 5 6 7 8 9 10 11 12

Months since launch

Source: IQVIA EMEA Thought Leadership; IQVIA MIDAS Monthly June 2023; Notes: Rx only; USD in CER; Pre-pandemic launches: H2 2016 to 2019; Includes NAS launches as well as other launches considered to be
significantly innovative (e.g. non-NAS launches in a new therapy area, orphan disease or new combinations including an innovative branded medicine); Excludes Hep C products, COVID-19 Vaccines and Treatments;
Countries included are US, China, Japan, UK, Germany, Italy, France, Spain

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 36

You can explore more Thought Leadership on Launch on the IQVIA website
Post Pandemic Commercial model Real World Evidence/Medical Affairs
Launch Environment Editing the DNA of Pharma’s Excellent launches are winning the evidence battle
Launch Excellence VIII Go to Market model Making Real World Evidence meaningful and actionable
Overcoming Pharma's Launch HCP Channel Preference in an increasingly Their Finest Hour:
Performance Problem complex landscape Medical Affairs in a Disrupted World – IQVIA
Success Multiplied: Riding out the storm: The future of post- Medical affairs next frontier:
Launch Excellence for Multi- Pandemic customer engagement Unlocking Omnichannel Engagement
Indication Assets Transcending the traditional focus of In the thick of it:
Launch Excellence VII oncology commercialisation Medical Affairs, strategic partner to other functions

OPEX Therapy area Company type

Re-defining OPEX Modelling for A new dawn: At the cusp of the CNS decade Large pharma launch issues:
a Competitive Future Paving the path in haematological cancers No more surprises:
Growth through Commercial In the Eye of the Storm: PD-(L)1 inhibitors Understanding predictors of Launch success (with AZ)
Cell, Gene and RNA: A decade of progress Launch Excellence: Escaping the complexity Trap
EBP launch issues:
Emerging Biopharma challenges of
European commercialisation

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 37

Sign up for our
September 14th
Launch Excellence
webinar
https://www.iqvia.com/events/2023/08/l
aunch-excellence-viii-building-
excellent-launches-in-the-post-
pandemic-environment

38
Medicine Demand
and Supply

39
Increase in Volume growth in Germany & UK across all segments YTD 2023
compared to the same period last year

COVID-19 Reported Total Cases 25,940,840 38,437,756 13,980,340 40,086,999 24,680,562

Numbers** Total Deaths 191,211 174,979 121,852 171,684 228,802

YTD-2023 vs. 20221 -9.8% 4.1% -24.6% -4.0% 0.3%

CH Market Units Growth
Latest Month4 -9.2% -2.9% -23.3% -1.6% 3.3%

YTD-2023 vs. 20222 -2.0% 4.7% 3.0% 0.3% 4.6%

Rx Retail Units Growth
Latest Month4 -2.4% 8.0% 0.2% 1.5% 9.7%

Rx Hospital Units YTD-2023 vs. 20223 2.2% 3.2% 4.4% 7.3% 5.5%
Growth Latest Month4 0.6% 3.6% -2.8% 10.9% 10.4%

Note: Retail pharmacy sales/Rx data has been used across countries. Any cross-country analysis needs to account for differences in healthcare systems.
1IQVIA CH Customized Insights – Italy, Germany, Spain, France (Monthly sell-out data), UK (Monthly sell-in data); Only OTC segment coverage for UK
2IQVIA MIDAS data – Retail panel – Italy, Germany, Spain, France (Monthly sell-out data), UK (Monthly sell-in data)
3Monthly IQVIA MIDAS data – Hospital panel – Italy, Germany, Spain, France, UK
4Latest month – August 2023

**Source: COVID-19 Epi data in the WHO European Region (WHO), data extracted on 29th August 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 40

 UK and France showed highest volume growth in retail and hospital market
respectively in June 2023
The consumer health market is declining, except in the UK
Retail Rx market Hospital market Consumer Health market
% Growth – Units Current Year vs. % Growth – Units Current Year vs. % Growth – Units Current Year vs.
Same Month Previous Year Same Month Previous Year Same Month Previous Year
80%
EU4 & UK EU4 & UK 80%
EU4 & UK
80%

60% 60% 60%

% Growth – Units
% Growth – Units

% Growth – Units
40% 40% 40%

20% 20% 20%

0% 0% 0%

-20% -20% -20%

-40% -40% -40%

Mar-22

Mar-23
Dec-21

Dec-22
Sep-21

Jun-22

Sep-22

Jun-23

Mar-22

Mar-23
Dec-21

Dec-22
Sep-21

Jun-22

Sep-22

Jun-23
Mar-22

Mar-23
Sep-21

Dec-21

Sep-22

Dec-22
Jun-22

Jun-23
Months Months Months

Italy Germany Spain France UK

Source: IQVIA CH Customized Insights, IQVIA MIDAS data (Retail panel) – Italy, Germany, Spain, France (Monthly sell-out data), UK (Monthly sell-in data); Monthly IQVIA MIDAS data – Hospital panel; August 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 41

 The Italian retail prescription volume sales declined by 2% YTD 2023
compared to the same period last year
% Growth – Units Current Year vs. Same Month Previous Year Top* 2 ATC3 classes within Top* 5 Units Growth Units Growth Units Growth
Total market and Top 5* YTD 2023 ATC1 classes by Units Growth YTD Jan 2023 Latest month YTD 2023
80% 2023 vs. YTD 2022 vs. 2022 2023 vs. 2022 vs. 2022
Rx Market -0.9% -2.4% -2.0%
60% Antiparasitic products, insecticides and
31.5% 17.6% 26.0%
repellents
40% Anti-Malarials 75.0% 20.0% 32.3%
% Growth – Units

Anthelmintics 25.0% 17.5% 23.6%

20% Antiinfectives for systemic use 26.0% -0.7% 18.8%
Cephalosporins & Combs 56.7% 7.4% 36.0%
0% Broad Spectr.Penicillins 39.3% 2.8% 26.5%
Respiratory system 35.6% 2.3% 8.7%
-20%
Corticoids 107.5% -9.7% 35.8%
Anticholinergics In Combination With
-40% 50.8% 26.8% 29.9%
B2-Agonists
Sensory organs 11.1% 2.3% 6.4%
-60%
Ophth A-Inflam+A-Infect 24.2% 12.4% 15.8%
May-22

May-23
Feb-22

Mar-22

Jul-22
Apr-22

Feb-23

Mar-23

Apr-23
Oct-21

Nov-21

Dec-21

Oct-22

Nov-22

Dec-22
Sep-21

Jan-22

Jun-22

Aug-22

Sep-22

Jan-23

Jun-23
Miotics+Antiglauc.Preps. 2.3% -2.1% 0.3%
Systemic hormonal preparations,
Months 17.9% -2.7% 3.7%
excluding sex hormones and insulins
Rx Market
Plain Corticosteroids 27.4% -6.5% 5.7%
Antiparasitic products, insecticides and repellents
Antiinfectives for systemic use Thyroid Preparations 6.2% 1.5% 1.5%
Respiratory system
Sensory organs
Systemic hormonal preparations, excluding sex hormones and insulins

*Top in terms of YTD 2023 Growth

Source: IQVIA MIDAS monthly sell-out data – August 2023 | Retail pharmacy panel – captures sales of Rx products only

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 42

 The hospital market in Italy grew by 2.2% in YTD 2023 compared to 2022
% Growth – Units in Current Year vs. Same Month Previous Year
Units Growth Units Growth Units Growth
Total hospital market and Top 5* YTD 2023 Top* 6 ATC Classes by Units
Jan 2023 Latest month YTD 2023
500% Growth YTD 2023 vs. YTD 2022
vs. 2022 2023 vs. 2022 vs. 2022

Hospital Market 5.5% 0.6% 2.2%

400%
Antiparasitic products, insecticides and
300.0% 140.0% 133.3%
repellents
% Growth – Units

300%
Respiratory system 31.9% 3.3% 15.4%
Antineoplastic and immunomodulating
200% 10.2% 5.9% 6.8%
agents
Sensory organs 25.6% 3.1% 6.3%
100%
Musculo-skeletal system 7.6% 1.5% 5.0%

0% Genito-urinary system and sex

6.3% 9.5% 4.0%
hormones

-100%
May-22

May-23
Feb-22

Mar-22

Jul-22
Apr-22

Feb-23

Mar-23

Apr-23
Oct-21

Nov-21

Dec-21

Oct-22

Nov-22

Dec-22
Sep-21

Jan-22

Jun-22

Aug-22

Sep-22

Jan-23

Jun-23
Months
Hospital total
Antiparasitic products, insecticides and repellents
Respiratory system
Antineoplastic and immunomodulating agents
Sensory organs
Musculo-skeletal system

*Top in terms of YTD 2023 Growth

Source: IQVIA MIDAS monthly data – August 2023 | Hospital panel

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 43

 The Consumer health market in Italy declined by 9.8% in YTD 2023 compared
to the same period last year
% Growth – Units Current Year vs. Same Month Previous Year CH Categories and top* 2 classes Units Growth Units Growth Units Growth
CH market and CH categories within each category by Units Growth Jan 2023 Latest month YTD 2023
180% YTD 2023 vs. 2022 vs. 2022 2023 vs. 2022 vs. 2022
CH Market -15.0% -9.2% -9.8%
130% Nutrition (NTR) -3.7% -5.1% -5.4%

Gluten-Free & Low Prot.Prds -2.2% -0.6% -2.7%

% Growth – Units

80%
Food For Adults -4.7% -9.2% -7.1%

Over-the-Counter Drugs (OTC) 7.83% -5.0% 3.2%

30%
Cough, Cold and Other Respiratory
23.5% -14.3% 14.8%
Products
-20% Digest & Oth Intest Prod 14.1% 2.0% 9.0%

Patient Care (PAC) -60.2% -32.2% -44.8%

-70%
Incontinence Care Prds 6.7% 2.5% 3.2%

-120% Prds For Bladder Problems -1.3% -0.6% -0.8%

Mar-22

May-22

Jul-22

Mar-23

May-23
Apr-22

Apr-23
Oct-21

Feb-22

Oct-22

Feb-23
Sep-21

Nov-21

Dec-21

Aug-22

Sep-22

Nov-22

Dec-22
Jan-22

Jun-22

Jan-23

Jun-23
Personal Care (PEC) -1.9% -5.3% -3.7%

Beauty Products For Women 12.8% 2.8% 4.7%

Months
Unisex Beauty Products 11.2% 0.8% -0.2%

CH Market NTR OTC PAC PEC

*Top in terms of YTD 2023 Growth

Source: IQVIA CH Customized Insights monthly sell-out data – August 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 44

 The German retail market grew by 4.7% YTD 2023 compared to the same
period last year
% Growth – Units Current Year vs. Same Month Previous Year Top* 2 ATC3 classes within Top* 5 Units Growth Units Growth Units Growth
Total market and Top 5* YTD 2023 ATC1 classes by Units Growth YTD Jan 2023 Latest month YTD 2023
160% 2023 vs. YTD 2022 vs. 2022 2023 vs. 2022 vs. 2022
140% Rx Market 10.0% 8.0% 4.7%
Antiparasitic products, insecticides and
120% 28.7% 22.5% 25.7%
repellents
100% Ectoparas.Incl Scabicide 26.9% 15.2% 24.6%
% Growth – Units

Anthelmintics 10.0% 17.9% 14.4%

80%
Antiinfectives for systemic use -2.1% 18.9% 17.4%
60%
Bacterial Vaccines 38.9% 25.0% 24.5%
40% Polyval Immuno-Globl I.V 0.0% 18.2% 7.2%
20% Sensory organs 19.7% 27.5% 17.0%

0% Miotics+Antiglauc.Preps. 4.8% 9.5% 3.7%

Ocular Antineovasc.Prods -9.2% 8.9% -0.6%
-20%
Respiratory system 28.0% 2.5% 11.0%
-40%
All Oth A-Asthma & Copd 14.3% 42.9% 22.7%
Mar-22

Apr-22

May-22

Jul-22

Mar-23

Apr-23

May-23
Oct-21

Feb-22

Oct-22

Feb-23
Sep-21

Nov-21

Dec-21

Jan-22

Jun-22

Aug-22

Sep-22

Nov-22

Dec-22

Jan-23

Jun-23
Cystic Fibrosis Products 20.0% 14.3% 13.5%
Antineoplastic and immunomodulating
10.5% 10.3% 4.9%
Months agents
Rx Market Interleukin Inhibitors 21.9% 23.5% 19.0%
Antiparasitic products, insecticides and repellents Protein Kinase Inhibitor Antineoplastics 12.1% 14.3% 11.5%
Antiinfectives for systemic use
Sensory organs
Respiratory system
Antineoplastic and immunomodulating agents

*Top in terms of YTD 2023 Growth

Source: IQVIA MIDAS monthly sell-out data – August 2023 | Retail pharmacy panel – captures sales of Rx products only

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 45

 The German hospital market grew by 3.2% in YTD 2023 compared to the
same period last year
% Growth – Units in Current Year vs. Same Month Previous Year Units Growth Units Growth Units Growth
Total hospital market and Top 5* YTD 2023 Top* 6 ATC Classes by Units Growth
Jan 2023 Latest month YTD 2023
80% YTD 2023 vs. YTD 2022
vs. 2022 2023 vs. 2022 vs. 2022
Hospital Market 6.9% 3.6% 3.2%
60% Antiparasitic products, insecticides and
39.3% 44.2% 29.7%
repellents
40%
% Growth – Units

Respiratory system 26.1% 10.3% 19.9%

20%
Sensory organs 10.9% 9.5% 6.3%

0% Antiinfectives for systemic use 12.2% 1.4% 5.6%

-20% Nervous system 8.4% 2.0% 5.4%

-40% Cardiovascular system 11.3% 1.5% 4.9%

-60%
May-22

May-23
Feb-22

Mar-22

Jul-22
Apr-22

Feb-23

Mar-23

Apr-23
Oct-21

Nov-21

Dec-21

Oct-22

Nov-22

Dec-22
Sep-21

Jan-22

Jun-22

Aug-22

Sep-22

Jan-23

Jun-23
Months
Hospital total
Antiparasitic products, insecticides and repellents
Respiratory system
Sensory organs
Antiinfectives for systemic use
Nervous system

*Top in terms of YTD 2023 Growth

Source: IQVIA MIDAS monthly data – August 2023 | Hospital panel

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 46

 The consumer health market in Germany grew by 4.1% YTD 2023 compared
to the same period last year
% Growth – Units Current Year vs. Same Month Previous Year CH Categories and top* 2 classes Units Growth Units Growth Units Growth
Total market and Top 5* YTD 2023 within each category by Units Growth Jan 2023 Latest month YTD 2023
100% YTD 2023 vs. 2022 vs. 2022 2023 vs. 2022 vs. 2022
CH Market 7.2% -2.9% 4.1%
80% Nutrition (NTR) 3.2% -0.5% 2.0%
Enteral Nutrition Products 28.6% 9.3% 13.3%
60%
% Growth – Units

Baby Foods -17.7% -27.6% -19.9%

40% Over-the-Counter Drugs (OTC) 12.36% -2.4% 7.9%
Cough, Cold And Other Respiratory
30.2% -9.5% 16.6%
20% Products
Vitamins, Minerals And Nutritional
0% Supplements, Tonics And Other 6.5% 6.3% 7.4%
Stimulants
-20% Patient Care (PAC) -25.5% -15.8% -22.8%
Incontinence Care Prds 7.8% 10.2% 9.1%
-40% Advanced Dressings 7.5% 3.5% 1.9%
Mar-22

May-22

Jul-22

Mar-23

May-23
Apr-22

Apr-23
Oct-21

Feb-22

Oct-22

Feb-23
Nov-21

Dec-21

Nov-22

Dec-22
Sep-21

Jan-22

Jun-22

Aug-22

Sep-22

Jan-23

Jun-23
Personal Care (PEC) 5.4% 10.8% 3.6%
Unisex Beauty Products 8.9% 20.5% 5.4%
Months
Beauty Products For Women 2.8% 5.1% 2.5%
CH Market NTR OTC PAC PEC

*Top in terms of YTD 2023 Growth

Source: IQVIA CH Customized Insights monthly sell-out data – August 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 47

 The Spanish retail market grew by 3% YTD 2023 compared to the same
period last year
% Growth – Units Current Year vs. Same Month Previous Year Top* 2 ATC3 classes within Top* 5 Units Growth Units Growth Units Growth
Total market and Top 5* YTD 2023 ATC1 classes by Units Growth YTD Jan 2023 Latest month YTD 2023
120% 2023 vs. YTD 2022 vs. 2022 2023 vs. 2022 vs. 2022
Rx Market 7.3% 0.2% 3.0%
100% Antiparasitic products, insecticides and
63.0% 44.6% 36.6%
repellents
80% Anti-Malarials 100.0% 34.8% 51.5%
% Growth – Units

Anthelmintics 58.4% 37.6% 38.4%

60% Antiinfectives for systemic use 34.4% -1.2% 19.0%
Broad Spectr.Penicillins 44.2% 4.1% 26.7%
40% Cephalosporins & Combs 40.2% 1.8% 22.1%
Respiratory system 25.2% -11.1% 7.7%
20%
Anticholinergics In Combination With
23.4% 19.0% 19.7%
B2-Agonists
0% Antihistamines Systemic 29.9% -11.6% 9.9%
Genito-urinary system and sex
-20% 5.4% 8.1% 4.6%
hormones
May-22

May-23
Apr-22

Apr-23
Oct-21

Feb-22

Mar-22

Jul-22

Oct-22

Feb-23

Mar-23
Sep-21

Nov-21

Dec-21

Aug-22

Sep-22

Nov-22

Dec-22
Jan-22

Jun-22

Jan-23

Jun-23
Urinary Incontinence Prd 7.5% 7.8% 6.9%
Bph Products 3.8% 4.0% 4.7%
Months Sensory organs 14.7% -0.6% 4.6%
Rx Market
Anti-Infectives-Eye 34.1% -0.9% 11.4%
Antiparasitic products, insecticides and repellents
Antiinfectives for systemic use Ocul.A-Aller.Decon.A-Sep 3.1% -14.5% 2.5%
Respiratory system
Genito-urinary system and sex hormones
Sensory organs

*Top in terms of YTD 2023 Growth

Source: IQVIA MIDAS monthly sell-out data – August 2023 | Retail pharmacy panel – captures sales of Rx products only

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 48

 The Spanish hospital market grew by 4.4% YTD 2023 compared to the same
period last year
% Growth – Units in Current Year vs. Same Month Previous Year Units Growth Units Growth Units Growth
Total hospital market and Top 5* YTD 2023 Top* 6 ATC Classes by Units
Jan 2023 Latest month YTD 2023
500% Growth YTD 2023 vs. YTD 2022
vs. 2022 2023 vs. 2022 vs. 2022
Hospital Market 9.0% -2.8% 4.4%
400% Antiparasitic products, insecticides and
50.0% 12.5% 70.1%
repellents
% Growth – Units

300% Respiratory system 42.9% 6.5% 26.4%

Antineoplastic and immunomodulating

14.1% 6.1% 10.4%
200% agents

Sensory organs 26.4% 7.2% 8.3%

100% Genito-urinary system and sex
17.8% 0.9% 8.2%
hormones
0% Antiinfectives for systemic use 13.2% -0.6% 6.2%

-100%
Mar-22

Apr-22

May-22

Jul-22

Mar-23

Apr-23

May-23
Oct-21

Feb-22

Oct-22

Feb-23
Sep-21

Nov-21

Dec-21

Aug-22

Sep-22

Nov-22

Dec-22
Jan-22

Jun-22

Jan-23

Jun-23
Months
Hospital Market
Antiparasitic products, insecticides and repellents
Respiratory system
Antineoplastic and immunomodulating agents
Sensory organs
Genito-urinary system and sex hormones
*Top in terms of YTD 2023 Growth
Source: IQVIA MIDAS monthly data – August 2023 | Hospital panel

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 49

 The Spanish consumer health market declined by 24.6% in YTD 2023
compared to the same period in 2022
% Growth – Units Current Year vs. Same Month Previous Year CH Categories and top* 2 classes Units Growth Units Growth Units Growth
CH market and CH categories within each category by Units Growth Jan 2023 Latest month YTD 2023
300% YTD 2023 vs. 2022 vs. 2022 2023 vs. 2022 vs. 2022
CH Market -40.0% -23.3% -24.6%
250%
Nutrition (NTR) 5.5% -4.3% 0.4%
200% Enteral Nutrition Products 9.1% -0.4% 5.4%
% Growth – Units

150% Baby Foods 5.8% -1.5% 3.0%

Over-the-Counter Drugs (OTC) 11.19% -9.2% 3.3%

100%
Cough, Cold And Other Respiratory
36.1% -28.0% 13.0%
50% Products
Digest & Oth Intest Prod 11.0% -1.1% 4.1%
0%
Patient Care (PAC) -73.8% -52.6% -59.1%
-50% Stomacare Products 6.7% 9.1% 7.2%

-100% Orthopaed/Antirheum Aid 10.7% 9.5% 5.2%

Mar-22

Apr-22

May-22

Jul-22

Mar-23

Apr-23

May-23
Oct-21

Feb-22

Oct-22

Feb-23
Nov-21

Dec-21

Nov-22

Dec-22
Sep-21

Jan-22

Jun-22

Aug-22

Sep-22

Jan-23

Jun-23
Personal Care (PEC) 7.3% -0.4% 2.6%

Unisex Beauty Products 31.8% 0.2% 12.4%

Months
Beauty Products For Women 11.5% 0.5% 5.9%
CH Market NTR OTC PAC PEC

*Top in terms of YTD 2023 Growth

Source: IQVIA CH Customized Insights monthly sell-out data – August 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 50

 The French retail market grew by 0.3% YTD 2023 compared to the same
period year ago
% Growth – Units Current Year vs. Same Month Previous Year Top* 2 ATC3 classes within Top* 5 Units Growth Units Growth Units Growth
Total market and Top 5* YTD 2023 ATC1 classes by Units Growth YTD Jan 2023 Latest month YTD 2023
50% 2023 vs. YTD 2022 vs. 2022 2023 vs. 2022 vs. 2022
Rx Market 4.1% 1.5% 0.3%
40% Antineoplastic and immunomodulating
7.8% 5.7% 5.0%
agents
30% Anti-Tnf Products 14.4% 9.4% 9.8%
% Growth – Units

Protein Kinase Inhibitor

9.0% 9.7% 7.2%
Antineoplastics
20%
Sensory organs 9.3% 7.0% 4.7%
Ocular Antineovasc.Prods 12.0% 7.0% 7.6%
10%
Miotics+Antiglauc.Preps. 3.9% 2.2% 1.6%
0% Genito-urinary system and sex
3.3% 2.0% 0.9%
hormones
Erectile Dysfunction Prd 10.8% 6.0% 5.7%
-10%
Gonadotrophins 7.5% 5.4% 4.7%
Respiratory system 6.5% 6.1% 0.8%
-20%
Anticholinergics In Combination With
May-22

May-23
Apr-22

Apr-23
Oct-21

Feb-22

Mar-22

Jul-22

Oct-22

Feb-23

Mar-23
Sep-21

Nov-21

Dec-21

Aug-22

Sep-22

Nov-22

Dec-22
Jan-22

Jun-22

Jan-23

Jun-23
14.0% 12.2% 10.6%
B2-Agonists
All Oth A-Asthma & Copd 9.1% 6.4% 5.9%
Months Alimentary tract and metabolism 2.9% 2.1% 0.8%
Rx Market Glp-1 Agonist A-Diabs 25.0% 21.4% 21.2%
Antineoplastic and immunomodulating agents
Sensory organs Other Metabolic Products 3.6% 5.7% 2.9%
Genito-urinary system and sex hormones
Respiratory system
Alimentary tract and metabolism

*Top in terms of YTD 2023 Growth

Source: IQVIA MIDAS monthly sell-out data – August 2023 | Retail pharmacy panel – captures sales of Rx products only

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 51

 The Hospital market in France grew 7.3% YTD compared to the same period
last year
% Growth – Units in Current Year vs. Same Month Previous Year Units Growth Units Growth Units Growth
Total hospital market and Top 5* YTD 2023 Top* 6 ATC Classes by Units Growth
Jan 2023 Latest month YTD 2023
50% YTD 2023 vs. YTD 2022
vs. 2022 2023 vs. 2022 vs. 2022

40% Hospital Market 6.9% 10.9% 7.3%

Respiratory system 12.8% 18.2% 12.9%
30%
Antineoplastic and immunomodulating
% Growth – Units

20% 7.2% 13.2% 10.5%

agents
10% Genito-urinary system and sex
10.3% 13.0% 9.1%
hormones
0%
Alimentary tract and metabolism 6.9% 14.1% 8.7%
-10% Systemic hormonal preparations,
9.1% 14.9% 8.7%
excluding sex hormones and insulins
-20%
Cardiovascular system 8.5% 13.3% 8.3%
-30%

-40%
Mar-22

Apr-22

May-22

Jul-22

Mar-23

Apr-23

May-23
Oct-21

Feb-22

Oct-22

Feb-23
Sep-21

Nov-21

Dec-21

Aug-22

Sep-22

Nov-22

Dec-22
Jan-22

Jun-22

Jan-23

Jun-23
Months
Hospital Market
Respiratory system
Antineoplastic and immunomodulating agents
Genito-urinary system and sex hormones
Alimentary tract and metabolism
Systemic hormonal preparations, excluding sex hormones and insulins

*Top in terms of YTD 2023 Growth

Source: IQVIA MIDAS monthly data – August 2023 | Hospital panel

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 52

 The French consumer health market declined by 4% YTD 2023 compared to
the same period last year
% Growth – Units Current Year vs. Same Month Previous Year CH Categories and top* 2 classes Units Growth Units Growth Units Growth
CH market and CH categories within each category by Units Growth Jan 2023 Latest month YTD 2023
140% YTD 2023 vs. 2022 vs. 2022 2023 vs. 2022 vs. 2022

120% CH Market -4.9% -1.6% -4.0%

Nutrition (NTR) 8.2% 4.6% 4.5%
100%
Enteral Nutrition Products 11.7% 7.5% 6.8%
80%
% Growth – Units

Baby Foods -0.5% -2.6% -1.8%

60%
Over-the-Counter Drugs (OTC) -0.04% -3.0% -2.7%
40%
Eye Care 12.0% 15.3% 7.9%
20%
Cough, Cold And Other Respiratory
0% 15.1% -12.4% 3.3%
Products
-20% Patient Care (PAC) -39.4% -13.9% -24.0%

-40% Advanced Dressings 14.9% 7.6% 6.1%

-60% Surgical Absorbents 5.5% 4.1% 0.2%

May-22

May-23
Apr-22

Apr-23
Oct-21

Feb-22

Mar-22

Jul-22

Oct-22

Feb-23

Mar-23
Sep-21

Nov-21

Dec-21

Aug-22

Sep-22

Nov-22

Dec-22
Jan-22

Jun-22

Jan-23

Jun-23
Personal Care (PEC) 0.8% 9.8% 2.1%

Unisex Beauty Products 9.4% 25.2% 10.3%

Months
Beauty Products For Women 6.2% 6.9% 4.6%
CH Market NTR OTC PAC PEC

*Top in terms of YTD 2023 Growth

Source: IQVIA CH Customized Insights monthly sell-out data – August 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 53

 The UK retail prescription market grew by 4.6% in YTD 2023 compared to
same period last year
% Growth – Units Current Year vs. Same Month Previous Year Top* 2 ATC3 classes within Top* 5 Units Growth Units Growth Units Growth
Total retail Rx market and Top 5* ATC classes ATC1 classes by Units Growth YTD Jan 2023 Latest month YTD 2023
80% 2023 vs. YTD 2022 vs. 2022 2023 vs. 2022 vs. 2022
Rx Market 6.3% 9.7% 4.6%
60% Antiinfectives for systemic use 36.8% 8.9% 18.1%
Viral Vaccines 49.2% 32.7% 33.7%
40% Broad Spectr.Penicillins 62.5% 7.1% 30.0%
% Growth – Rx

Genito-urinary system and sex

17.4% 18.9% 14.2%
hormones
20%
Urinary Anti-Infectives 5.1% 21.8% 13.0%
Erectile Dysfunction Prd 5.0% 13.3% 5.8%
0%
Sensory organs 6.7% 12.3% 6.4%
Ocul.A-Aller.Decon.A-Sep 3.1% 22.6% 8.5%
-20%
Miotics+Antiglauc.Preps. 4.4% 8.4% 3.3%
Cardiovascular system 5.3% 11.4% 5.0%
-40%
Mar-22

Apr-22

May-22

Jul-22

Mar-23

Apr-23

May-23
Oct-21

Feb-22

Oct-22

Feb-23
Sep-21

Nov-21

Dec-21

Aug-22

Sep-22

Nov-22

Dec-22
Jan-22

Jun-22

Jan-23

Jun-23
Cholest&Trigly.Regulator 7.4% 15.5% 8.0%
Calcium Antagonist Plain 7.6% 13.3% 7.2%

Months Alimentary tract and metabolism 5.4% 10.0% 4.5%

Sglt2 Inhibitor Antidiabetics 47.6% 49.4% 44.3%
Rx Market
Antiinfectives for systemic use Glp-1 Agonist A-Diabs 28.8% 33.1% 23.5%
Genito-urinary system and sex hormones
Sensory organs
Cardiovascular system
Alimentary tract and metabolism
*Top in terms of YTD 2023 Growth
Source: IQVIA MIDAS monthly sell-in data – August 2023 | Retail pharmacy panel – captures sales of Rx products only

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 54

 The UK hospital market grew by 5.5% YTD 2023 compared to the same
period in 2022
% Growth – Units in Current Year vs. Same Month Previous Year Units Growth Units Growth Units Growth
Total hospital market and Top 5* YTD 2023 Top* 6 ATC Classes by Units
Jan 2023 Latest month YTD 2023
Growth YTD 2023 vs. YTD 2022
200% vs. 2022 2023 vs. 2022 vs. 2022
Hospital Market 12.2% 10.4% 5.5%
Antineoplastic and immunomodulating
150% 14.2% 15.6% 9.9%
agents
Antiparasitic products, insecticides an
21.4% 6.7% 8.8%
% Growth – Units

d repellents
100%
Respiratory system 22.5% 7.9% 7.9%

50% Nervous system 12.8% 9.8% 6.7%

Systemic hormonal preparations,

15.1% 8.5% 6.4%
excluding sex hormones and insulins
0%
Alimentary tract and metabolism 8.8% 15.9% 6.3%

-50%
Mar-22

Apr-22

May-22

Jul-22

Mar-23

Apr-23

May-23
Oct-21

Feb-22

Oct-22

Feb-23
Sep-21

Nov-21

Dec-21

Aug-22

Sep-22

Nov-22

Dec-22
Jan-22

Jun-22

Jan-23

Jun-23
Months
Hospital Market
Antineoplastic and immunomodulating agents
Antiparasitic products, insecticides and repellents
Respiratory system
Nervous system
Systemic hormonal preparations, excluding sex hormones and insulins

*Top in terms of YTD 2023 Growth

Source: IQVIA MIDAS monthly data – August 2023 | Hospital panel

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 55

 The UK consumer health market grew by 0.3% YTD compared to the same
period last year
% Growth – Units Current Year vs. Same Month Previous Year CH Categories and top* 2 classes Units Growth Units Growth Units Growth
CH market and CH categories within each category by Units Growth Jan 2023 Latest month YTD 2023
20% YTD 2023 vs. 2022 vs. 2022 2023 vs. 2022 vs. 2022
CH Market 11.6% 3.3% 0.3%
15% Over-the-Counter Drugs (OTC) 11.6% 3.3% 0.3%
Cough, Cold And Other Respiratory
38.9% 6.2% 8.5%
% Growth – Units

10% Products
Vitamins, Minerals And Nutritional
Supplements, Tonics And Other 2.4% 7.4% 0.9%
5% Stimulants
Skin Treatment 1.4% 11.5% 0.0%
0%
Digest & Oth Intest Prod 5.6% 3.3% -0.7%

-5% Pain Relief 14.3% -4.0% -4.6%

-10%
May-22

May-23
Feb-22

Mar-22

Jul-22
Apr-22

Feb-23

Mar-23

Apr-23
Oct-21

Nov-21

Dec-21

Oct-22

Nov-22

Dec-22
Sep-21

Jan-22

Jun-22

Aug-22

Sep-22

Jan-23

Jun-23
Months

Rx market OTC

*Top in terms of YTD 2023 Growth

Note: IQVIA CH Customized Insights Data has coverage of only OTC segment (CHC 1-19,97 classes)
Source: IQVIA CH Customized Insights monthly sell-in data – August 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 56

Engagement with Health
Care Professionals

57
ChannelDynamics: Channel volume trends
Major markets: Full year 2019 vs. 2020 vs. 2021 vs. 2022 and MAT July 2023
Share of F2F & Remote interaction in promotional volume
-27% -31% -39% -29% -39%

-12%

-3% +9% 0% -1% +4%

+5%

+12% +12%
-5% -6% -1%
-4%
-3% -1%

93% 91%
97% 97% 98% 59% 71% 32%
42% 55% 63%
84% 86%
88% 90% 82% 75%
92% 86% 94%
93% 89% 89% 95% 96%

68%
58%
41% 45%
29% 37%
18% 25%
12% 14% 16% 14% 9%
10% 8% 11% 11% 7%
3% 7% 3% 2% 6% 5% 4%
2019 2020 2021 2022 MAT 2019 2020 2021 2022 MAT 2019 2020 2021 2022 MAT 2019 2020 2021 2022 MAT 2019 2020 2021 2022 MAT
2023 2023 2023 2023 2023

France Germany Italy Spain UK

Source: IQVIA ChannelDynamics, F2F includes F2F detailing and F2F meetings, Remote includes phone detailing, e-detailing (live), e-meetings (live)

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 58

 ChannelDynamics: Channel volume and performance trends
Italy: Full year 2019 vs. 2020 vs. 2021 vs. 2022 and year-to-date trends over 5-years
Share of projected promotional volume
NPS Category share
-39%
-33% YTD 2019 38% 43% 20%
31.9 M
50.8 M YTD 2020 37% 43% 20%

YTD 2021 39% 42% 19%

+20%
+10% -4%
-3% 0% YTD 2022 40% 42% 18%
F2F - Detailing with Rep
23.2 M 40% 42% 18%
37.2 M 36.2 M 22.2 M 22.3 M F2F - Meetings/Events YTD 2023
33.8 M Remote - Detailing with Rep (Telephone, voice only)
19.4 M
Remote - Detailing with Rep (Online)
Promoters Passives Detractors
Remote - Meetings/Events (Live, Streaming)
95%
95% Digital - Detailing (Automated, Self guided)
85% Digital - Meetings/Events (Prerecorded, Streaming) Converted Calls
78% 84% 84% 85% 84%
75% Digital - E-Mailing
Digital - Instant Messaging/Texting
0% YTD 2019 55% 45%
0% 0% 0% 3% 1% Mailing (Postal)
3% 6% 1% 3% 4% 2% 1% 1% YTD 2020 56% 44%
0% 0% 0% 0% 1% 0% 0% 0% 0% 2%
1% 1% 0% 4% 2% 0% 1% 1% 8% 2% 4% 2% 2% 3% 0% YTD 2021 56% 44%
0% 0% 2%0% 0% 2% 1% 0% 0% 0% 0% 0%
2% 1% 0%9% 1% 8% 0% 8% 1% 2% 0% 10% 1% 7% 0% 8% 1% 10% 1% YTD 2022 57% 43%
2019 2020 2021 2022 YTD YTD YTD YTD YTD YTD 2023 56% 44%
Jul Jul Jul Jul Jul
2019 2020 2021 2022 2023
Converted Calls Non Converted Calls
Source: IQVIA Global ChannelDynamics
Note: YTD data is till July for 2019, 2020, 2021, 2022 and 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 59

 ChannelDynamics: Channel volume and performance trends
Germany: Full year 2019 vs. 2020 vs. 2021 vs. 2022 and year-to-date trends over 5-years
Share of projected promotional volume
NPS Category share
+6%
+5% -16%
-15% +5%
+3% YTD 2019 25% 29% 46%
36.9 M
62.7 M 34.8 M YTD 2020 23% 29% 48%
59.5 M 33.2 M 14%
-2%
57.9 M YTD 2021 22% 29% 49%
16%
53.4 M 19% 0% 4% 31.0 M 30.5 M
19%0% 1% 1% YTD 2022 24% 27% 49%
1%
1% 3% 0% 1% F2F - Detailing with Rep
1% 1% 34% 1% 3% 0% 20%
33% 1%
0% 20% 1% 0% 2% 21% 1% F2F - Meetings/Events YTD 2023 22% 29% 48%
3% 1% 1% 1% 1%
1% 1% 24% 0% 1% Remote - Detailing with Rep (Telephone, voice only)
1% 24% 2% 1% 1%
1% 1% 19% 0% Remote - Detailing with Rep (Online)
20% 1% 0% 1%
0% 1% 1% Promoters Passives Detractors
0%
0% 11% 0% 22%
0% 0% 10% 0% 0% 22%
26% 0%
Remote - Meetings/Events (Live, Streaming)
0% Digital - Detailing (Automated, Self guided)
1% 0% Digital - Meetings/Events (Prerecorded, Streaming)
1% Converted Calls
Digital - E-Mailing
Digital - Instant Messaging/Texting
54% 56% 55% YTD 2019 41% 59%
53% 56% 53% Mailing (Postal)
53% 53% 49% YTD 2020 36% 64%

YTD 2021 36% 64%

YTD 2022 37% 63%

2019 2020 2021 2022 YTD YTD YTD YTD YTD YTD 2023 36% 64%
Jul Jul Jul Jul Jul
2019 2020 2021 2022 2023
Converted Calls Non Converted Calls
Source: IQVIA Global ChannelDynamics
Note: YTD data is till July for 2019, 2020, 2021, 2022 and 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 60

 ChannelDynamics: Channel volume and performance trends
Spain: Full year 2019 vs. 2020 vs. 2021 vs. 2022 and year-to-date trends over 5-years
Share of projected promotional volume
NPS Category share
-18%
-15% YTD 2019 36% 42% 22%
+7% 18.9 M +9%
0% 0%
31.2 M -1% YTD 2020 37% 40% 23%
28.5 M 28.1 M 16.9 M 17.0 M 17.0 M
YTD 2021 39% 40% 21%
26.6 M 15.5 M
YTD 2022 41% 39% 20%
F2F - Detailing with Rep
F2F - Meetings/Events YTD 2023 49% 36% 15%
50% Remote - Detailing with Rep (Telephone, voice only)
45% 55% 49%
67% 69% Remote - Detailing with Rep (Online)
67% 86% Promoters Passives Detractors
85% Remote - Meetings/Events (Live, Streaming)
Digital - Detailing (Automated, Self guided)
1% 0% Digital - Meetings/Events (Prerecorded, Streaming)
1% Converted Calls
18% 1% 14% Digital - E-Mailing
13% 17%
Digital - Instant Messaging/Texting
1% 1% 1% YTD 2019 60% 40%
13% 8% 12%
8% Mailing (Postal)
10% 10% 6%
1% 1% 5% 4%
2% 1% 4% 0% 2% 7% YTD 2020 53% 47%
2% 7% 6% 5% 1% 0% 3% 0%
0% 0% 0% 6% 0% 5% 0% 0%
4% 0% 1% 4% 0% YTD 2021 56% 44%
15% 16%
2% 0% 15% 14% 0% 14% 0% 0% 2% 0% 14% 13% 0%
4% 1% 1% 1% 1% 4% 1% 1% 1% 1% YTD 2022 58% 42%
1% 0%
2019 2020 2021 2022 YTD YTD YTD YTD YTD YTD 2023 57% 43%
Jul Jul Jul Jul Jul
2019 2020 2021 2022 2023 Converted Calls Non Converted Calls
Source: IQVIA Global ChannelDynamics
Note: YTD data is till July for 2019, 2020, 2021, 2022 and 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 61

 ChannelDynamics: Channel volume and performance trends
France: Full year 2019 vs. 2020 vs. 2021 vs. 2022 and year-to-date trends over 5-years
Share of projected promotional volume
-16% NPS Category share
+1% +1% +10%
-17% YTD 2019 24% 37% 38%
-7%
29.0 M 29.3 M 29.6 M 17.4 M
18.0 M YTD 2020 22% 34% 44%
-19%
16.3 M YTD 2021 22% 35% 43%
24.7 M 15.0 M YTD 2022 21% 34% 45%
37% 39% F2F - Detailing with Rep
41%
F2F - Meetings/Events YTD 2023 23% 40% 37%
35%
55% 56% 12.1 M Remote - Detailing with Rep (Telephone, voice only)
1%
1% 1% 42% 1% 0% 42% Remote - Detailing with Rep (Online)
4% 1% 3% 1% 1% 2% Promoters Passives Detractors
1%
0% 0% 4% 0% 3% 1% 1% Remote - Meetings/Events (Live, Streaming)
0% 1% 0% 2% 48%
1% 2% 1% Digital - Detailing (Automated, Self guided)
2% 2% 1% 0% 1%
2% 0% Digital - Meetings/Events (Prerecorded, Streaming)
0% 2% 0% 0%
0% Converted Calls
0% 0% 0% 0% 2% Digital - E-Mailing
0%
0% 46% 0% 2%
46% 1% 47% 43% Digital - Instant Messaging/Texting
1% YTD 2019 47% 53%
0% Mailing (Postal)
29% 44% 27% 45% 0%
38% YTD 2020 40% 60%

YTD 2021 42% 58%

0%
12% 11% 0% 12% 11% 0% 0%
9% 8% 10% 8% 9% YTD 2022 40% 60%
2019 2020 2021 2022 YTD YTD YTD YTD YTD YTD 2023 44% 56%
Jul Jul Jul Jul Jul
2019 2020 2021 2022 2023
Converted Calls Non Converted Calls
Source: IQVIA Global ChannelDynamics
Note: YTD data is till July for 2019, 2020, 2021, 2022 and 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 62

 ChannelDynamics: Channel volume and performance trends
UK: Full year 2019 vs. 2020 vs. 2021 vs. 2022 and year-to-date trends over 5-years
Share of projected promotional volume
NPS Category share
+8% +2%
+5% -2%
+2% 0% YTD 2019 21% 38% 41%
22.8 M 22.7 M
0% 13.0 M 13.3 M 13.1 M
3% YTD 2020 20% 38% 42%
1% 8%
21.3 M 21.7 M 4%
1% 8%
12.1 M 12.0 M
6% 2%
11%
6% 2% 3% YTD 2021 22% 37% 41%
5% 9% 4%
1% 4% 2% 4% 3% 5%
5% 3% 3% 2% 4% 3%
5% 2% 1% 1% 1% YTD 2022 23% 37% 40%
24% 3% 1% 2% 26% 2% F2F - Detailing with Rep
1% 1% 0% 0% 1%
2% 2% 0% YTD 2023 24% 39% 37%
0% 2% 1% 0% F2F - Meetings/Events
0% 3% 0% 0% Remote - Detailing with Rep (Telephone, voice only)
3%
2% 0% 0%
1% Remote - Detailing with Rep (Online)
1% Promoters Passives Detractors
0% 0% 44% 52% Remote - Meetings/Events (Live, Streaming)
47% 53% 53%
52% 54% Digital - Detailing (Automated, Self guided)
33% 31%
Digital - Meetings/Events (Prerecorded, Streaming) Converted Calls
Digital - E-Mailing

0% Digital - Instant Messaging/Texting

1% 1% YTD 2019 45% 55%
1% 1% Mailing (Postal)
1%
YTD 2020 42% 58%
35% 33% 36% 35%
28% 26% 28% 25% 43% 57%
22% YTD 2021

YTD 2022 45% 55%

2019 2020 2021 2022 YTD YTD YTD YTD YTD YTD 2023 44% 56%
Jul Jul Jul Jul Jul
2019 2020 2021 2022 2023
Converted Calls Non Converted Calls
Source: IQVIA Global ChannelDynamics
Note: YTD data is till July for 2019, 2020, 2021, 2022 and 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 63

Appendix: Data Sources
and Methodology

64
Sources from secondary data research

Global adult vaccination trends (Slide 5)

Slide 5
• IQVIA Institute Report 2023
• EIA2030
• Vaccines Europe 2022
• The Adult Immunization Board 2023

Please note: IQVIA is not accountable for the accuracy of information from external data sources

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 65

IQVIA Sales Data Offerings Used and Methodology (1/2)
Geographic scope of Measures used
Data source Frequency Data source description Calculations applied
data used in this report for analysis
Sell-out Data Monthly Details on sales of products • Italy: Rx and CH • Italy: Units Italy, Germany, Spain, France:
(IQVIA MIDAS, dispensed at retail markets • Germany: Units • Units Growth Jan 2023 vs. 2022 –
IQVIA CH pharmacies • Germany: Rx and CH • Spain: Units To provide base view of the market from pre
Customized This includes both prescription markets • France: Units COVID-19 period (2019) in the years 2020,
Insights) and non-prescription products • Spain: Rx and CH 2021 and 2022
Prescription products are markets • Units Growth Latest month 2023vs. 2022 –
classified using ATC • France: Rx and CH To provide the latest trend in the market to
classification markets understand the dynamic changes in trends
Consumer health products • Units Growth YTD 2023 vs. 2022 – To
cover products from OTC, provide the YTD trend in the market to
PAC, PEC and NTR understand the long-term changes in trends
Sell-in Data Monthly Details on sales of products • UK: Rx and CH • UK: Units UK:
(IQVIA MIDAS, dispensed at retail markets • Units Growth Jan 2023 vs. 2022 –
IQVIA CH pharmacies To provide base view of the market from pre
Customized This includes both COVID-19 period (2019) in the year 2020,
Insights) prescription and non- 2021 and 2022
prescription products • Units Growth Latest month 2023 vs. 2022 –
Prescription products are To provide the latest trend in the market to
classified using ATC understand the dynamic changes in trends
classification. • Units Growth YTD 2023 vs. 2022 – To
Consumer health products provide the YTD trend in the market to
covers products from only understand the long-term changes in trends
OTC segment

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 66

IQVIA Sales Data Offerings Used and Methodology (2/2)
Geographic scope of Measures used
Data source Frequency Data source description Calculations applied
data used in this report for analysis
IQVIA MIDAS Monthly Details on hospital panel • Italy hospital market • Italy: Units Italy, Germany, Spain, France, UK:
Data retail sales • Germany hospital • Germany: Units • Units Growth May 2021 to YTD 2023 – To
market provide the latest trend in the market to
• Spain: Units
understand the dynamic changes in trends
• Spain hospital market • France: Units
• France hospital market • UK: Units
• UK hospital market

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 67

Market definitions – at ATC3 level of classification
Oncology Respiratory Diabetes Vaccines Cardiovascular
L1A: Alkylating agents Anti-asthma and Cough, cold A10C: Human insulin J7B: Antihypertensives: Anticoagulants:
L1B: Antimetabolites COPD: including Flu anti- + analogues Combination of C2A: Antihypertensives (of non herbal B1A: Vit K antagonists
L1C: Plant-based R3A: B2-agonists virals: A10D: Animal insulin vaccines origin) plain B1B: Heparins
antineoplastics R3B: Xanthines R5A: Cold A10H: Sulphonylurea J7D: Bacterial C2B: Antihypertensives (of non herbal B1C: Platelet aggregation inhibitors
L1D: Antineoplastic R3C: N-steroidal preparations antidiabetics vaccines origin), combination with diuretics B1D: Fibrinolytics
antibiotics respiratory anti- R5B: Cough/cold A10J: Biguanide J7E: Viral C2C: Rauwolfia alkaloids and other B1E: Direct thrombin inhibitors
L1F: Platinum inflammatory preparations with antidiabetics vaccines antihypertensives of herbal origin
anti-infectives B1F: Direct Factor XA inhibitors
antineoplastics R3D: Corticoids A10K: Glitazone J7X: All other C2D: Rauwolfia alkaloids and other
R5C: Expectorants vaccine-like B1X: Other antithrombotic agents
L1G: Monoclonal R3E: B2-agonist antidiabetics antihypertensives of herbal origin in
R5D: Antitussives products combination with diuretics B2C: Proteinase inhibitors
antibody antineoplastics and R3C A10L:Alpha-
L1H: Protein kinase combinations R5F: Other cough glucosidase inhibitor C3A: Diuretics
inhibitor antineoplastics R3F: B2-agonist and and cold antidiabetics C7A: Beta-blocking agents, plain
L1X: All other corticoid preparations A10M: Glinide C7B: Beta-blocking agents, Lipid regulators:
antineoplastics combinations R4A: Chest rubs antidiabetics combinations C10A: Cholesterol and triglyceride
L2A: Cytostatic R3H: PDE4 and other inhalants A10N: DPP-IV C8A: Calcium antagonists, plain regulating preparations
hormones inhibitors, R2A: Throat inhibitor antidiabetics C8B: Calcium antagonists, C10C: Lipid regulators, in
L2B: Cyto hormone asthma/COPD preparations A10P: SGLT2 combinations combinations with other lipid regulators
antagonists R3I: Devices J5B: Antivirals, inhibitor antidiabetics C9A: ACE inhibitors, plain C11A: Lipid-regulating cardiovascular
V3C: asthmatic conditions other A10S: GLP-1 agonist multi-therapy combination products
C9B: ACE inhibitors, combinations
Radiopharmaceuticals R3J: Antileukotriene anti-diabetics
C9C: Angiotensin-II antagonists, plain
anti-asthmatics A10X: Other drugs
C9D: Angiotensin-II antagonists,
R3X: All other anti- for diabetes
combinations
asthma and COPD H4B: Glucagon
products C9X: Other renin-angiotensin agents

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 68

Market definitions – at ATC3 level of classification and Oral vs. IV/SC
Immunology Pain NFC 1 Category
L4B: Anti-Tnf Products M1A: Antirheumatic N-Steroid A (ORAL SOLID ORDINARY) Oral
M1C: Spec Antirheumatic Agent M1B: Antirheumat Steroid Comb
M2A: Top A-Rheumatics & Analg B (ORAL SOLID LONG-ACTING) Oral
M3A: Muscle Relaxant,Peripher
D (ORAL LIQUID ORDINARY) Oral
M5X: Oth Musculo-Skeletal Prd
N2A: Narcotic Analgesics E (ORAL LIQUID LONG-ACTING) Oral
N2B: Non-Narcotic Analgesics
N2C: Anti-Migraine Preps F (PARENTERAL ORDINARY) IV/SC formulations
N1A: Anaesthetics General
N1B: Anaesthetics, Local G (PARENTERAL LONG-ACTING) IV/SC formulations

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 69

Channel Definitions (Slides 58-63)

F2F Detailing: Sales Rep face-to-face detailing

Face to face
interactions
F2F Meetings: Meetings, events, congresses, seminars

E-Detailing: Online presentations – live with a rep or automated, self guided

Phone Detailing: Telephone communication with reps

Remote
E-Meetings: Streaming video – live webinar or pre-recorded webcast
interactions

Email: Opened email communication

Postal: Opened paper mail received by post

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 70

2023 Channel Preference: aggregated interaction and channel groupings
(slides 21-34)
Grouped channel Options in survey Interaction
Face-to-face, one-to-one sales representative visits F2F interactive
One-to-one telephone call with a live sales representative (audio only, without an
Individual Interactions internet presentation)
Remote interactive
One-to-one video call with a live sales representative via Zoom, Teams, Skype etc.
Instant messaging/texting via WhatsApp, Skype, Facebook Messenger etc.
Attendance at on-site/live, in-person medical conferences, group meetings, symposia,
F2F interactive
congresses etc.
Meetings/Events/Seminars
Remote, live streaming medical conferences, group meetings, symposia etc. Remote interactive

Emails

Podcasts (2023)
Online resources
On-demand online access to self-guided or automated online presentations and Non-interactive
reference resources
Online information resources such as websites and mobile apps (2021, 2022)
Postal mailing
Other
Other (Please specify) Others
Source: EMEA Thought Leadership; IQVIA ChannelDynamics™ Channel Preference Survey July 2023

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 71

2023 Channel Preference: Number of HCP responses (slides 21-34)
Countries/Regions Number of responses

Germany 1102

France 1597

Italy 3419 EU4 & UK 8,838

Spain 1751

UK 969
Nordics 371
Rest of Europe 2,331
US 1,845
APAC 7,443

LATAM 1,737

Rest of World 688

Grand total (38 countries) 23,253

IQVIA Quarterly Pharmaceutical Market Outlook - August 2023 72

Thank You