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68   PHARMACEUTICAL EXECUTIVE




         Megamergers shook up the industry in 2009, shuffling the deck
         of pharma’s top companies. Find out which companies emerged on
         top, who might be next, and how those best positioned to weather
         a challenging business environment are poised to rip the rankings
                           apart over the next few years


                                By Patrick Clinton and Mark Mozeson
MAY 2010 www.pharmexec.com   69




                                                                                        The PHARM EXEC 50
T
      he Pharm Exec 50 ranks the world’s largest pharmaceutical companies by
      global sales of prescription drugs. The most striking theme in this year’s list    1.   Pfizer
      is the continued pace of sector consolidation: many companies have disap-          2.   Sanofi -Aventis
peared from the list as a result of mergers over the course of 2009. And not just        3.   Novartis
smaller companies: Wyeth, last year’s number 10, is now part of Pfizer, providing        4.   GlaxoSmithKline
our almost perennial number one company with a solid entrée into biologics and           5.   Roche
vaccines as well as a return to OTC medicines. Schering-Plough (last year’s num-         6.   AstraZeneca
ber 15) has been combined in a reverse merger with Merck, creating a company             7.   Merck
that should rise to the number-four slot next year, with Rx revenues of about            8.   Johnson & Johnson
$40 billion. Genentech (19) was acquired by Roche, and Solvay (32) by Abbott,            9.   Eli Lilly
while Procter & Gamble’s pharmaceutical unit (39) has become part of Warner-            10.   Bristol-Myers Squibb
Chilcott, an Irish firm that has never appeared on the 50 before—but will jump          11.   Abbott
to the middle of the list next year thanks to P&G’s Avonex business.                    12.   Bayer
    Growth by acquisition is not always a sign of strength, of course, and it           13.   Boehringer Ingelheim
doesn’t always feed into continued organic growth. The track record of the in-          14.   Amgen
dustry is mixed when it comes to mergers, but in the current climate, with new          15.   Takeda
drug approvals slowing to a trickle, the merger wave is far from over. Where in         16.   Teva
recent years, Pharma M&A has been dominated by mid-size deals and “bolt-                17.   Novo Nordisk
on” acquisitions, the transformational deals of the past year seem likely to            18.   Astellas
inspire renewed interest in mega-mergers. “Big Pharma” is getting bigger, and           19.   Daiichi Sankyo
the question is whether it makes sense to try to keep up.                               20.   Otsuka
    Meanwhile, the next round of mergers has already begun, with Novartis               21.   Eisai
prepared to take on ophthalmology specialist Alcon (this year’s number 38),             22.   Merck KGaA
bringing the Swiss giant to the $40 billion Rx revenue range, and giving the            23.   Gilead Sciences
company additional reach into a growing field. And Teva (number 16) contin-             24.   Baxter International
ues to merge its way up the list. This year’s target was Germany’s Ratiopharm           25.   Mylan
(42, after an abysmal year). Look for the world’s largest generics company to           26.   Servier
close in on a top-ten spot within the next year or two.                                 27.   Chugai
    Look, too, for the largest pharma companies to hit a new revenue bench-             28.   Genzyme
mark. It’s not quite visible in this year’s figures, but once the impact of mergers     29.   Mitsubishi Tanabe
is taken into consideration, five of the top six pharma companies have revenues         30.   UCB
hovering around $40 billion, with Pfizer leaping ahead to more than $60 bil-            31.   CSL
lion. Ten years ago, the smallest companies on the 50 had revenues in the $500          32.   Allergan
million range. Today, all but four brought in $2 billion or more. Revenue rank-         33.   Forest
ings will also be influenced by the success of some companies in large biologi-         34.   Menarini
cals, which appear set to replace small molecule drugs like Lipitor as top sellers      35.   Nycomed
within the next few years.                                                              36.   Biogen Idec
    Finally, look for companies to respond aggressively to the most important           37.   Shire
piece of pharma news in recent years: Sales in emerging markets, which have             38.   Alcon
been growing at a faster rate than sales in established markets, have finally           39.   Apotex
caught up. According to IMS Health, over the next five years the “pharmerg-             40.   Lundbeck
ing” markets will generate as many new dollars in pharma sales as the tradi-            41.   Celgene
tional markets. Though there’s considerable variation, pharma companies have            42.   Ratiopharm
been investing in emerging markets for several years—not just in the “BRIC”             43.   Cephalon
countries (Brazil, Russia, India, China), but in an expanded roster of countries        44.   Dainippon Sumitomo
including Saudi Arabia, Vietnam, Chile, Venezuela, Malaysia, Thailand, Tur-             45.   Hospira
key and Mexico. These countries present many challenges, including getting              46.   Watson
drugs approved, building distribution systems, protecting intellectual prop-            47.   Actavis
erty, and pricing. But given the sharp trend toward further cost containment in         48.   Shionogi
the US, Japan and Europe, it is hard to turn away from such an opportunity,             49.   Kyowa Hakko Kirin
no matter what the difficulty.                                                          50.   Meda
70   PHARMACEUTICAL EXECUTIVE                                                                                                MAY 2010 www.pharmexec.com




                 The Pharm Exec 50
      Rank          Company & Headquarters [website]              2009Rx Sales (Billions        2009 R&D spend             2009 Top-Selling Drugs
      [2009 Rank]                                                 of USD) [change from 2008]    (Millions of USD)          [Billions of USD]
                                                                                                                           Lipitor [11.4]
                    Pfizer
      1 [1]         New York, New York [pfizer.com]
                                                                      $45.4       [2.7%]               $7845               Lyrica [2.8]
                                                                                                                           Celebrex [2.4]
                                                                                                                           Lantus [4.4]
                    Sanofi -Aventis
      2 [3]         Paris, France [sanofi -aventis.com]
                                                                      $42.0       [8.5%]               $6567               Lovenox [4.4]
                                                                                                                           Plavix [3.8]
                                                                                                                           Diovan/Co-Diovan [6.0]
                    Novartis
      3 [4]         Basel, Switzerland [novartis.com]
                                                                      $38.4       [6.7%]               $6308               Gleevec/Glivec [3.9]
                                                                                                                           Zometa [1.5]
                                                                                                                           Seretide/Advair [7.9]
                    GlaxoSmithKline
      4 [2]         Brentford, England [gsk.com]
                                                                     $37.8       [26.1%]               $6286               Valtrex [2.1]
                                                                                                                           Pandemic flu vaccine [1.4]
                                                                                                                           Avastin [6.0]
                    Roche
      5 [8]         Basel, Switzerland [roche.com]
                                                                     $37.6       [78.9%]               $8570               MabThera/Rituxan [5.9]
                                                                                                                           Herceptin [5.1]
                                                                                                                           Nexium [5.0]
                    AstraZeneca
      6 [6]         London, England [astrazeneca.com]
                                                                      $32.8       [3.8%]               $4409               Seroquel [4.9]
                                                                                                                           Crestor [4.5]

                    Merck                                                                                                  Singulair [4.7]
      7 [7]         Whitehouse Station, New Jersey
                    [merck.com]
                                                                      $25.2       [6.9%]               $5845               Corzaar/Hyzaar [3.6]
                                                                                                                           Januvia [1.9]
                                                                                                                           Remicade [4.3]
                    Johnson & Johnson
      8 [6]         New Brunswick, New Jersey [jnj.com]
                                                                      $22.5      [-8.5%]               $4591               Procrit/Eprex [2.2]
                                                                                                                           Levaquin/Floxin [1.6]
                                                                                                                           Zyprexa [4.9]
                    Eli Lilly
      9 [9]         Indianapolis, Indiana [lilly.com]
                                                                      $21.2       [9.7%]               $4300               Cymbalta [3.1]
                                                                                                                           Humalog [2.0]
                                                                                                                           Plavix [6.1]
                    Bristol-Myers Squibb
      10 [11]       New York [bms.com]
                                                                      $18.8       [6.3%]               $3647               Abilify [2.6]
                                                                                                                           Reyataz [1.4]


        Note about the listings: Companies         ed in 2009. For most American and                        US dollars, we have converted their
     in the Pharm Exec 50 are ranked ac-           European pharmaceutical companies,                       numbers using the average interbank
     cording to global human prescription          that means the year ending December                      rate for the last day of the fi scal year.
     drug sales. As far as company docu-           31, 2009; for most Japanese compa-                       Some charts that appear in this arti-
     mentation allows, generics and vac-           nies, it means the year ending March                     cle are based on numbers from IMS.
     cines are included; over-the-counter          31, 2009. In the case of private compa-                  These are calculated differently from
     products, royalties, and contract man-        nies that do not report results, we have                 our sales figures. Percentage growth
     ufacturing are not. In most cases, num-       relied on outside estimates, including                   figures should be treated with caution,
     bers are taken from annual reports or         IMS reports. For companies that re-                      as they can be affected by fluctuating
     SEC fi lings for the fi scal year that end-   port revenue in currencies other than                    exchange rates.
     *Estimate                                      About the Authors: Patrick Clinton is marketing director, Health & Life Sciences, Oliver Wyman. He can be
                                                    reached at patrick.clinton@oliverwyman.com. Mark Mozeson is partner, Health & Life Sciences, Oliver
                                                    Wyman. He can be reached at mark.mozeson@oliverwyman.com
72   PHARMACEUTICAL EXECUTIVE                                                                                                            MAY 2010 www.pharmexec.com




                      Abbott
      11 [12]         Abbott Park, Illinois [abbott.com]
                                                                           $15.6     [-6.7%]              $2744                       Humira [5.5]

                      Bayer                                                                                                           Yaz/Yasmin/Yasminelle
      12 [13]         Leverkusen, Germany [bayer.com]
                                                                           $15.0     [-0.7%]              $2253                       [1.8]

                      Boehringer Ingelheim
      13 [16]         Ingelheim, Germany
                      [boehringer-ingelheim.com]
                                                                           $14.4    [12.3%]               $3010                       Spiriva [3.4]


                      Amgen
      14 [14]         Thousand Oaks, California
                      [amgen.com]
                                                                           $14.4     [-2.4%]              $2864                       Neulasta/Neupogen [4.6]


                      Takeda
      15 [17]         Osaka, Japan [takeda.com]
                                                                           $14.2     [16.6%]              $4657                       Pioglitazone [4.0]




      GLOBAL PHARMACEUTICAL SALES BY REGION, 2009




                                                                                                                                                                      SOURCE: IMS Health
      Percent of Global Sales       Market                  2009 Sales (US$B)                                % Growth from 2008
                                    North America                                          $323.8                   1.9%
                                    Europe                                            $263.9                                   7.0%
                                    Asia/Africa/Australia                 $106.6                                                               15%
                                    Japan                                $95.0                                      2.1%
                                    Latin America                $47.8                                                                    12.7%
                         30.6
          39.8
                       12.7
                   11.2
             5.7

                                                            TOP 15 U.S. PHARMACEUTICAL PRODUCTS BY SALES
      US Prescription sales                                 Total US Prescription Market
                                                            1     Lipitor
                                                                                               US$ in Billions
                                                                                                                                                              7.5

                 grew by                                    2
                                                            3
                                                            4
                                                                  Nexium
                                                                  Plavix
                                                                  Advair Diskus                                                          4.7
                                                                                                                                                  5.6
                                                                                                                                                        6.3



      5.1 percent                                           5
                                                            6
                                                            7
                                                                  Seroquel
                                                                  Abilify
                                                                  Singulair                                                   3.7
                                                                                                                                   4.2
                                                                                                                                 4.0

         to approximately                                   8     Actos                                                 3.4




                                                                                                                                                                      SOURCE: IMS Health
                                                            9     Enbrel                                               3.3

      $300 billion                                          10
                                                            11
                                                            12
                                                            13
                                                                  Epogen
                                                                  Remicade
                                                                  Crestor
                                                                  Avastin
                                                                                                                  3.0
                                                                                                                  3.0
                                                                                                                     3.2
                                                                                                                     3.2


                                                            14    Neulasta                                        3.0
                                                            15    Oxycontin                                      2.9




                      Teva
      16 [18]         Petach Tikva, Israel [tevapharm.com]
                                                                           $13.9    [25.2%]                $802                       Copaxone [2.8]

                      Novo Nordisk
      17 [22]         Bagsvaerd, Norway [novonordisk.com]
                                                                            $9.8    [14.4%]               $1521                       Insulin analogs [4.1]

                      Astellas
      18 [20]         Tokyo, Japan [astellas.com]
                                                                             $9.8   [1.4%]                $1635                       Prograf [2.1]

                      Daiichi Sankyo
      19 [21]         Tokyo, Japan [daiichisankyo.com]
                                                                             $8.1   [-7.5%]               $1897                       Olmesartan [2.2]

                      Otsuka
      20 [25]         Tokyo, Japan [otsuka-global.com]
                                                                            $7.9    [21.1%]                 N/A                       N/A
74   PHARMACEUTICAL EXECUTIVE                                                                                                                                      MAY 2010 www.pharmexec.com




                                            Eisai
      21 [24]                               Tokyo, Japan [eisai.co.jp]
                                                                                                $7.8       [8.7%]                         $1605                 Aricept [3.2]

                                            Merck KGaA
      22 [23]                               Darmstadt, Germany [merck.de]
                                                                                                $7.7       [0.8%]                         $1724                 Rebif [2.2]

                                            Gilead Sciences
      23 [28]                               Foster City, California [gilead.com]
                                                                                               $6.5       [26.8%]                         $940                  Truvada [2.5]

                                            Baxter International
      24 [26]                               Deerfield, Illinois [baxter.com]
                                                                                               $5.6        [5.2%]                         $917                  Advate [1.5]

                                            Mylan
      25 [29]                               Canonsburg, Pennsylvania [mylan.com]
                                                                                              $4.8        [11.4%]    *
                                                                                                                                          $275                  Generics [N/A]


                                                                                                                                                                Mergers have been a clear
     TOP GLOBAL THERAPEUTIC CLASSES, 2009                                                                                                                       part of the growth strategy
     Therapeutic Class                                   2009 Sales (US$M)                                                         % Growth from 2008           of the top ten pharmas.
     Oncologics                                                                                                 $52,372                         8.8             Easily visible in the chart
     Lipid Regulators                                                                     $35,281                                         4.9
     Respiratory Agents                                                                 $33,596                                                  11.0           below are Pfizer’s merg-
     Antidiabetics                                                                  $30,406                                                       13.4          ers with Warner Lambert
     Anti-ulcerants                                                                $29,610                                          0.6
     Antiotensin II Antagonists                                               $25,209                                                            11.5
                                                                                                                                                                (completed in 2000, with
     Antipsychotics                                                         $23,248                                                       4.6                   results appearing in the
     Antidepressants                                                   $19,416                                              -1.3                                2001 Pharm Exec 50) and




                                                                                                                                                                                                SOURCE: IMS Health
     AutoImmune agents                                             $17,961                                                                               18.0
     Platelet Aggr. Inhibitors                                    $14,604                                                                       9.0             Pharmacia (with revenue
     HIV Antivirals                                             $13,758                                                                               14.9      jumping up in 2005).
     Anti-epileptics                                           $12,995                            -19.8                                                         Other key mergers during
     Narcotic analgesics                                      $11,235                                                                       8.6
     Non-narcotic analgesics                                $11,174                                                                        7.3                  the period include Sanofi
     Eythropoietins                                         $10,806                                                  -4.1                                       Synthelabo with Aventis,
                                                                                                                                                                Novartis with Chiron, Glaxo
                                                                                                                                                                Wellcome with SmithKline
                                                                                                                                                                Beecham, and Roche with
                                       TEN YEARS OF THE 2010 TOP 10                                                                                             Genentech.
                                       50
                                       45
           Prescription drug revenue




                                       40
               in billions of USD




                                       35
                                       30
                                       25
                                       20
                                       15
                                       10
                                        5
                                        0
                                            Pfizer     Aventis     Novartis     GSK          Roche           AstraZeneca       Merck             J&J            Lilly       BMS


                                            Servier
      26 [27]                               Neuilly-sur-Seine [servier.com]
                                                                                             $4.6     [-10.9%]       *
                                                                                                                                           N/A                  N/A

                                            Chugai
      27 [35]                               Tokyo, Japan [chugai-pharm.co.jp]
                                                                                               $4.3       [23.1%]                         $599                  Tamiflu [0.8]

                                            Genzyme
      28 [31]                               Cambridge, Massachusetts
                                            [genzyme.com]
                                                                                               $4.1        [-2.9%]                        $856                  Cerezyme [0.8]


                                            Mitsubishi Tanabe
      29 [34]                               Osaka, Japan [mt-pharma.co.jp]
                                                                                               $3.9        [9.1%]                         $751                  Remicade [0.4]

                                            UCB
      30 [30]                               Brussels. Belgium [ucb.com]
                                                                                              $3.8        [-10.6%]                        $966                  Keppra [1.3]
76   PHARMACEUTICAL EXECUTIVE                                                                                       MAY 2010 www.pharmexec.com




                          CSL
      31 [38]             Victoria, Australia [csl.com.au]
                                                                         $3.7    [9.4%]             $251           Gardasil [0.1]

                          Allergan
      32 [36]             Irvine, California [allergan.com]
                                                                         $3.7    [5.3%]             $706           Botox [1.3]

                          Forest
      33 [37]             New York, New York [frx.com]
                                                                         $3.6    [3.9%]            $661            Lexapro [2.3]

                          Menarini
      34 [41]             Florence, Italy [menarini.com]
                                                                       $3.6     [16.1%]    *
                                                                                                     N/A           N/A

                          Nycomed
      35 [40]             Zurich, Switzerland
                                                                         $3.5    [0.9%]            $285            Pantaprazole [N/A]




     THE TOP TEN POST-MERGER
              Pfizer + Wyeth



              Sanofi-Aventis
                                                                                                  Major mergers are reshaping the top ten.
                                                                                                  This chart shows the impact recent and
            Novartis + Alcon
                                                                                                  recently announced mergers would have had
                                                                                                  on the top ten if they’d taken place January
                   Merck +
            Schering-Plough                                                                       1, 2008. Pfizer leaps forward, Merck jumps
                                                                                                  from seventh place to fourth. Roche (which
          GlaxoSmithKline +                                                                       reported a full year of Genentech revenue)
                    Stiefel
                                                                                                  moves from eighth place in 2009 to sixth.
                                                                                                  (This chart omits several minor mergers.)
         Roche + Genentech                                                                        Even without additional mergers, Pharma’s
                                                                                                  Top Six should all have revenues of $40 bil-
                AstraZeneca                                                                       lion and up.


         Johnson & Johnson




                                                                                                                                                 SOURCE: Oliver Wyman
                     Eli LIlly
                                                                                                  2009 pro forma
                                                                                                  2009 actuals
        Bristol-Myers Squibb


                                 0.0   10.0   20.0      30.0   40.0   50.0     60.0        70.0




                          Biogen Idec
      36 [42]             Cambridge, Massachusetts
                          [biogenidec.com]
                                                                        $3.2    [12.6%]           $1283            Avonex [2.3]


                          Shire
      37 [43]             Dublin, Ireland [shire.com]
                                                                         $2.7    [-3.8%]           $638            Adderall [0.6]

                          Alcon
      38 [44]             Hünenberg, Switzerland [alcon.com]
                                                                         $2.7    [3.0%]            $665            Glaucoma products [1.1]

                          Apotex
      39                  North York, Ontario [apotex.com]
                                                                       $2.6     [74.3%]    *
                                                                                                     N/A           Generics [N/A]

                          Lundbeck
      40 [45]             Copenhagen, Denmark [lundbeck.com]
                                                                        $2.6    [23.5%]            $615            Cipralex/Lexapro [1.5]
78   PHARMACEUTICAL EXECUTIVE                                                                                    MAY 2010 www.pharmexec.com




     The Top 10: The Year In Review
     Pfizer Acquired Wyeth in $68 billion Roche Completed $47 billion acquisi- Johnson & Johnson                               Acquired
     deal, giving company entrée to the vac-        tion of Genentech. Fifty-nine new molec-       Elan’s rights and assets in the Al-
     cines and (again) consumer products            ular entities in clinical testing, including   zheimer’s Immunotherapy Program, a
     markets. Launched Toviaz for overactive        eight in Phase III/registration. Actemra/      joint venture with Wyeth, Completed
     bladder in the US. Prevnar 13 approved         RoActemra for rheumatoid arthritis ap-         acquisition of Cougar, a biotech with
     in 40 countries. 133 R&D programs,             proved in EU (and in January 2010 in           a Phase III drug for metastatic pros-
     Phase I through registration. Created          the US). Signed 51 new research/tech-          tate cancer. Launched Nucynta, a nov-
     regenerative medicine unit, and signifi-       nology deals, including a partnership          el oral drug for chronic pain, co-de-
     cantly boosted licensing partnerships.         with Tekmira Pharmaceuticals to bring          veloped with Gruenenthal. Simponi, a
                                                    Roche’s first RNA interference products        monthly, injectable anti-TNF drug for
                                                    into human testing.                            rheumatoid arthritis, approved in the
                                                                                                   US, EU, and Canada.
     Sanofi-Aventis Multiple acquisitions
     of generics companies including Medley
     (Brazil’s largest), Kendricks (Mexico),        AstraZeneca Launched Onglyza (for
     and Zentiva (Czech republic). Announced        diabetes) in the US & EU. Launched Ir-         Eli Lilly Launched translational
     purchase of Chattanooga-based OTC              essa for non-small cell lung cancer in         medicine unit and opened new biotech
     company Chattem for $1.9 billion. Ac-          the EU after having withdrawn its ap-          center in San Diego. Adcirca (with
     quired Oenobrol, French maker of nu-           plication in 2005 Divested portfolio of        the same active ingredient as Cialis—
     tritional beauty supplements. Launched         over-the-counter products. Submitted           tadalafil) approved for pulmonary ar-
     Multaq, anti-arrhythmia drug, in US, EU,       US NDA for ticagrelor (tentatively to be       terial hypertension in the US, EU, and
     and Canada.                                    known as Brilinta) an oral antiplatelet        Japan. Co-promotion deal with Kowa
                                                    treatment. Announced acquisition of            for the statin Livalo. Effient, an anti-
                                                    infection-research company Novexel             platelet agent co-developed with Dai-
                                                    and expanded anti-infective partnership        ichi-Sankyo, approved in the US.
     Novartis Joe Jimenez appointed new             with Forest.
     CEO. Approvals include Afinitor (for
     renal cell cancer), Ilaris (cryopyrin-as-
     sociated periodic syndromes), Onbrez                                                          Bristol-Myers Squibb Acquired
     Breezhaler (EU, for COPD), Valturna (hy-       Merck Merged with Schering-Plough              the shares it did not already own of
     pertension). Acquired EBEWE Pharma’s           in $41 billion deal. Announced acquisi-        Medarex, a biotech focused on fully
     specialty generics business. 145 projects      tion of Avecia, a contract manufacturer        human monoclonal antibody drugs
     in clinical development. Launched bi-          of biologics. Divested itself of its stake     for cancer, autoimmune diseases, in-
     osimilars in Japan and Canada.                 in Merial, an animal health joint ven-         flammation, and infection. Divested
                                                    ture with Sanofi-Aventis. In April, struck     holdings in Mead Johnson Nutrition,
                                                    ground-breaking, much-discussed deal           completing a transition toward pure-
                                                    with the health insurer Cigna over dia-        play pharma. Onglyza (a drug for Type
     GlaxoSmithKline Product approvals              betes drugs Januvia and Janumet, pro-          II diabetes, developed and marketed
     include Votrient, an oral medication for       viding bigger discounts to the plan for        with AstraZeneca) approved. Entered
     renal cell cancer. Launched Arzerra (for       achieving better patient results.              partnerships with ZymoGenetics, Nis-
     refractory chronic leukocytic leukemia)                                                       san Chemical Industries, Teijin Phar-
     in the US. Filings include Benlysta, poten-                                                   ma, Adler Biopharmaceuticals.
     tially the first new drug for lupus in more
     than 60 years. Acquired Stiefel, a specialty
     dermatology company with revenues of
     $900 million. With Pfizer created ViiV,
     specialty company dedicated to HIV.
80   PHARMACEUTICAL EXECUTIVE                                                                                                                                                        MAY 2010 www.pharmexec.com




     TOP 15 GLOBAL PRODUCTS, 2009
     Product
     1
     2
                                 Lipitor
                                 Plavix
                                                 2009 Sales (US$M)

                                                                                                $9,100
                                                                                                                       $13,288                             In 2009, there were                        29
     3
     4
     5
                                 Nexium
                                 Seretide
                                 Seroquel                                      $6,012
                                                                                            $8,236
                                                                                           $8,099                                                          mergers & acquisitions
     6
     7
                                 Enbrel
                                 Remicade
                                                                             $5,863
                                                                            $5,453
                                                                                                                                                           in the pharmaceutical industry
     8                           Crestor                                   $5,383




                                                                                                                                 SOURCE: IMS Health
     9
     10
     11
                                 Zyprexa
                                 Humira
                                 Avastin
                                                                           $5,357
                                                                         $5,032
                                                                         $5,015
                                                                                                                                                           worth $126.5 billion
     12
     13
                                 Singulair
                                 Mabithera
                                                                         $4,986
                                                                        $4,681                                                                                That compares with
     14
     15
                                 Abilify
                                 Lovenox
                                                                       $4,673
                                                                       $4,572
                                                                                                                                                           48 mergers & acquisitions
                                                                                                                                                       worth $51.1 billion in 2008
                                         REVENUE DISTRIBUTION, THE TOP 50
                                  50.0
                                  45.0                                                                                                                                               Revenue continues to
                                  40.0                                                                                                                                               be concentrated in the
     Prescription drug revenue




                                  35.0                                                                                                                                               largest companies. In this
         in billions of USD




                                  30.0                                                                                                                                               year’s Top 50, the Top 10




                                                                                                                                                                                                                  SOURCE: Oliver Wyman
                                  25.0                                                                                                                                               accounted for just under
                                  20.0                                                                                                                                               60 percent of revenue,
                                  15.0                                                                                                                                               while the top 20 were
                                  10.0                                                                                                                                               responsible for about 80
                                   5.0                                                                                                                                               percent of sales.
                                   0.0
                                         1   3   5   7   9   11   13   15   17   19   21   23    25   27    29   31    33   35   37                   39   41   43   45   47   49

                                                                                                Ranking


                                             Celgene
            41                               Summit, New Jersey [celgene.com]
                                                                                                           $2.6       [20.1%]                                   $471                Revlimid [1.7]

                                             Ratiopharm
            42 [33]                          Ulm, Germany [ratiopharm.com]
                                                                                                           $2.4       [-35.4%]                                   N/A                Generics [N/A]

                                             Cephalon
            43 [47]                          Frazer, Pennsylvania [cephalon.com]
                                                                                                           $2.2       [13.2%]                                   $395                Provigil [1.0]

                                             Dainippon Sumitomo
            44 [46]                          Osaka, Japan [ds-pharma.co.jp]
                                                                                                           $2.1       [1.2%]                                    $543                Amlodin [0.6]

                                             Hospira
            45 [48]                          Lake Forest, Illinois [hospira.com]
                                                                                                           $2.1       [15.2%]                                   $241                N/A

                                             Watson
            46 [49]                          Corona, California [watson.com]
                                                                                                           $2.0       [13.1%]                                   $197                CNS generics [0.8]

                                             Actavis
            47 [50]                          Hafnarfjörður, Iceland [actavis.com]
                                                                                                           $1.8       [0.9%] *                                   N/A                Generics [N/A]

                                             Shionogi
            48                               Osaka, Japan [shionogi.co.jp]
                                                                                                           $1.8       [-0.7%]                                   $543                Crestor [0.2]

                                             Kyowa Hakko Kirin
            49                               Tokyo, Japan [kyowa-kirin.com.jp]
                                                                                                           $1.7       [55.7%]                                   $497                Espo/Nesp [0.4]

                                             Meda
            50                               Solna, Sweden [meda.se]
                                                                                                           $1.7       [34.3%]                                    N/A                Astelin [0.2]

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World Top 50 Pharmaceutical Companies 2009

  • 1. 68 PHARMACEUTICAL EXECUTIVE Megamergers shook up the industry in 2009, shuffling the deck of pharma’s top companies. Find out which companies emerged on top, who might be next, and how those best positioned to weather a challenging business environment are poised to rip the rankings apart over the next few years By Patrick Clinton and Mark Mozeson
  • 2. MAY 2010 www.pharmexec.com 69 The PHARM EXEC 50 T he Pharm Exec 50 ranks the world’s largest pharmaceutical companies by global sales of prescription drugs. The most striking theme in this year’s list 1. Pfizer is the continued pace of sector consolidation: many companies have disap- 2. Sanofi -Aventis peared from the list as a result of mergers over the course of 2009. And not just 3. Novartis smaller companies: Wyeth, last year’s number 10, is now part of Pfizer, providing 4. GlaxoSmithKline our almost perennial number one company with a solid entrée into biologics and 5. Roche vaccines as well as a return to OTC medicines. Schering-Plough (last year’s num- 6. AstraZeneca ber 15) has been combined in a reverse merger with Merck, creating a company 7. Merck that should rise to the number-four slot next year, with Rx revenues of about 8. Johnson & Johnson $40 billion. Genentech (19) was acquired by Roche, and Solvay (32) by Abbott, 9. Eli Lilly while Procter & Gamble’s pharmaceutical unit (39) has become part of Warner- 10. Bristol-Myers Squibb Chilcott, an Irish firm that has never appeared on the 50 before—but will jump 11. Abbott to the middle of the list next year thanks to P&G’s Avonex business. 12. Bayer Growth by acquisition is not always a sign of strength, of course, and it 13. Boehringer Ingelheim doesn’t always feed into continued organic growth. The track record of the in- 14. Amgen dustry is mixed when it comes to mergers, but in the current climate, with new 15. Takeda drug approvals slowing to a trickle, the merger wave is far from over. Where in 16. Teva recent years, Pharma M&A has been dominated by mid-size deals and “bolt- 17. Novo Nordisk on” acquisitions, the transformational deals of the past year seem likely to 18. Astellas inspire renewed interest in mega-mergers. “Big Pharma” is getting bigger, and 19. Daiichi Sankyo the question is whether it makes sense to try to keep up. 20. Otsuka Meanwhile, the next round of mergers has already begun, with Novartis 21. Eisai prepared to take on ophthalmology specialist Alcon (this year’s number 38), 22. Merck KGaA bringing the Swiss giant to the $40 billion Rx revenue range, and giving the 23. Gilead Sciences company additional reach into a growing field. And Teva (number 16) contin- 24. Baxter International ues to merge its way up the list. This year’s target was Germany’s Ratiopharm 25. Mylan (42, after an abysmal year). Look for the world’s largest generics company to 26. Servier close in on a top-ten spot within the next year or two. 27. Chugai Look, too, for the largest pharma companies to hit a new revenue bench- 28. Genzyme mark. It’s not quite visible in this year’s figures, but once the impact of mergers 29. Mitsubishi Tanabe is taken into consideration, five of the top six pharma companies have revenues 30. UCB hovering around $40 billion, with Pfizer leaping ahead to more than $60 bil- 31. CSL lion. Ten years ago, the smallest companies on the 50 had revenues in the $500 32. Allergan million range. Today, all but four brought in $2 billion or more. Revenue rank- 33. Forest ings will also be influenced by the success of some companies in large biologi- 34. Menarini cals, which appear set to replace small molecule drugs like Lipitor as top sellers 35. Nycomed within the next few years. 36. Biogen Idec Finally, look for companies to respond aggressively to the most important 37. Shire piece of pharma news in recent years: Sales in emerging markets, which have 38. Alcon been growing at a faster rate than sales in established markets, have finally 39. Apotex caught up. According to IMS Health, over the next five years the “pharmerg- 40. Lundbeck ing” markets will generate as many new dollars in pharma sales as the tradi- 41. Celgene tional markets. Though there’s considerable variation, pharma companies have 42. Ratiopharm been investing in emerging markets for several years—not just in the “BRIC” 43. Cephalon countries (Brazil, Russia, India, China), but in an expanded roster of countries 44. Dainippon Sumitomo including Saudi Arabia, Vietnam, Chile, Venezuela, Malaysia, Thailand, Tur- 45. Hospira key and Mexico. These countries present many challenges, including getting 46. Watson drugs approved, building distribution systems, protecting intellectual prop- 47. Actavis erty, and pricing. But given the sharp trend toward further cost containment in 48. Shionogi the US, Japan and Europe, it is hard to turn away from such an opportunity, 49. Kyowa Hakko Kirin no matter what the difficulty. 50. Meda
  • 3. 70 PHARMACEUTICAL EXECUTIVE MAY 2010 www.pharmexec.com The Pharm Exec 50 Rank Company & Headquarters [website] 2009Rx Sales (Billions 2009 R&D spend 2009 Top-Selling Drugs [2009 Rank] of USD) [change from 2008] (Millions of USD) [Billions of USD] Lipitor [11.4] Pfizer 1 [1] New York, New York [pfizer.com] $45.4 [2.7%] $7845 Lyrica [2.8] Celebrex [2.4] Lantus [4.4] Sanofi -Aventis 2 [3] Paris, France [sanofi -aventis.com] $42.0 [8.5%] $6567 Lovenox [4.4] Plavix [3.8] Diovan/Co-Diovan [6.0] Novartis 3 [4] Basel, Switzerland [novartis.com] $38.4 [6.7%] $6308 Gleevec/Glivec [3.9] Zometa [1.5] Seretide/Advair [7.9] GlaxoSmithKline 4 [2] Brentford, England [gsk.com] $37.8 [26.1%] $6286 Valtrex [2.1] Pandemic flu vaccine [1.4] Avastin [6.0] Roche 5 [8] Basel, Switzerland [roche.com] $37.6 [78.9%] $8570 MabThera/Rituxan [5.9] Herceptin [5.1] Nexium [5.0] AstraZeneca 6 [6] London, England [astrazeneca.com] $32.8 [3.8%] $4409 Seroquel [4.9] Crestor [4.5] Merck Singulair [4.7] 7 [7] Whitehouse Station, New Jersey [merck.com] $25.2 [6.9%] $5845 Corzaar/Hyzaar [3.6] Januvia [1.9] Remicade [4.3] Johnson & Johnson 8 [6] New Brunswick, New Jersey [jnj.com] $22.5 [-8.5%] $4591 Procrit/Eprex [2.2] Levaquin/Floxin [1.6] Zyprexa [4.9] Eli Lilly 9 [9] Indianapolis, Indiana [lilly.com] $21.2 [9.7%] $4300 Cymbalta [3.1] Humalog [2.0] Plavix [6.1] Bristol-Myers Squibb 10 [11] New York [bms.com] $18.8 [6.3%] $3647 Abilify [2.6] Reyataz [1.4] Note about the listings: Companies ed in 2009. For most American and US dollars, we have converted their in the Pharm Exec 50 are ranked ac- European pharmaceutical companies, numbers using the average interbank cording to global human prescription that means the year ending December rate for the last day of the fi scal year. drug sales. As far as company docu- 31, 2009; for most Japanese compa- Some charts that appear in this arti- mentation allows, generics and vac- nies, it means the year ending March cle are based on numbers from IMS. cines are included; over-the-counter 31, 2009. In the case of private compa- These are calculated differently from products, royalties, and contract man- nies that do not report results, we have our sales figures. Percentage growth ufacturing are not. In most cases, num- relied on outside estimates, including figures should be treated with caution, bers are taken from annual reports or IMS reports. For companies that re- as they can be affected by fluctuating SEC fi lings for the fi scal year that end- port revenue in currencies other than exchange rates. *Estimate About the Authors: Patrick Clinton is marketing director, Health & Life Sciences, Oliver Wyman. He can be reached at patrick.clinton@oliverwyman.com. Mark Mozeson is partner, Health & Life Sciences, Oliver Wyman. He can be reached at mark.mozeson@oliverwyman.com
  • 4. 72 PHARMACEUTICAL EXECUTIVE MAY 2010 www.pharmexec.com Abbott 11 [12] Abbott Park, Illinois [abbott.com] $15.6 [-6.7%] $2744 Humira [5.5] Bayer Yaz/Yasmin/Yasminelle 12 [13] Leverkusen, Germany [bayer.com] $15.0 [-0.7%] $2253 [1.8] Boehringer Ingelheim 13 [16] Ingelheim, Germany [boehringer-ingelheim.com] $14.4 [12.3%] $3010 Spiriva [3.4] Amgen 14 [14] Thousand Oaks, California [amgen.com] $14.4 [-2.4%] $2864 Neulasta/Neupogen [4.6] Takeda 15 [17] Osaka, Japan [takeda.com] $14.2 [16.6%] $4657 Pioglitazone [4.0] GLOBAL PHARMACEUTICAL SALES BY REGION, 2009 SOURCE: IMS Health Percent of Global Sales Market 2009 Sales (US$B) % Growth from 2008 North America $323.8 1.9% Europe $263.9 7.0% Asia/Africa/Australia $106.6 15% Japan $95.0 2.1% Latin America $47.8 12.7% 30.6 39.8 12.7 11.2 5.7 TOP 15 U.S. PHARMACEUTICAL PRODUCTS BY SALES US Prescription sales Total US Prescription Market 1 Lipitor US$ in Billions 7.5 grew by 2 3 4 Nexium Plavix Advair Diskus 4.7 5.6 6.3 5.1 percent 5 6 7 Seroquel Abilify Singulair 3.7 4.2 4.0 to approximately 8 Actos 3.4 SOURCE: IMS Health 9 Enbrel 3.3 $300 billion 10 11 12 13 Epogen Remicade Crestor Avastin 3.0 3.0 3.2 3.2 14 Neulasta 3.0 15 Oxycontin 2.9 Teva 16 [18] Petach Tikva, Israel [tevapharm.com] $13.9 [25.2%] $802 Copaxone [2.8] Novo Nordisk 17 [22] Bagsvaerd, Norway [novonordisk.com] $9.8 [14.4%] $1521 Insulin analogs [4.1] Astellas 18 [20] Tokyo, Japan [astellas.com] $9.8 [1.4%] $1635 Prograf [2.1] Daiichi Sankyo 19 [21] Tokyo, Japan [daiichisankyo.com] $8.1 [-7.5%] $1897 Olmesartan [2.2] Otsuka 20 [25] Tokyo, Japan [otsuka-global.com] $7.9 [21.1%] N/A N/A
  • 5. 74 PHARMACEUTICAL EXECUTIVE MAY 2010 www.pharmexec.com Eisai 21 [24] Tokyo, Japan [eisai.co.jp] $7.8 [8.7%] $1605 Aricept [3.2] Merck KGaA 22 [23] Darmstadt, Germany [merck.de] $7.7 [0.8%] $1724 Rebif [2.2] Gilead Sciences 23 [28] Foster City, California [gilead.com] $6.5 [26.8%] $940 Truvada [2.5] Baxter International 24 [26] Deerfield, Illinois [baxter.com] $5.6 [5.2%] $917 Advate [1.5] Mylan 25 [29] Canonsburg, Pennsylvania [mylan.com] $4.8 [11.4%] * $275 Generics [N/A] Mergers have been a clear TOP GLOBAL THERAPEUTIC CLASSES, 2009 part of the growth strategy Therapeutic Class 2009 Sales (US$M) % Growth from 2008 of the top ten pharmas. Oncologics $52,372 8.8 Easily visible in the chart Lipid Regulators $35,281 4.9 Respiratory Agents $33,596 11.0 below are Pfizer’s merg- Antidiabetics $30,406 13.4 ers with Warner Lambert Anti-ulcerants $29,610 0.6 Antiotensin II Antagonists $25,209 11.5 (completed in 2000, with Antipsychotics $23,248 4.6 results appearing in the Antidepressants $19,416 -1.3 2001 Pharm Exec 50) and SOURCE: IMS Health AutoImmune agents $17,961 18.0 Platelet Aggr. Inhibitors $14,604 9.0 Pharmacia (with revenue HIV Antivirals $13,758 14.9 jumping up in 2005). Anti-epileptics $12,995 -19.8 Other key mergers during Narcotic analgesics $11,235 8.6 Non-narcotic analgesics $11,174 7.3 the period include Sanofi Eythropoietins $10,806 -4.1 Synthelabo with Aventis, Novartis with Chiron, Glaxo Wellcome with SmithKline Beecham, and Roche with TEN YEARS OF THE 2010 TOP 10 Genentech. 50 45 Prescription drug revenue 40 in billions of USD 35 30 25 20 15 10 5 0 Pfizer Aventis Novartis GSK Roche AstraZeneca Merck J&J Lilly BMS Servier 26 [27] Neuilly-sur-Seine [servier.com] $4.6 [-10.9%] * N/A N/A Chugai 27 [35] Tokyo, Japan [chugai-pharm.co.jp] $4.3 [23.1%] $599 Tamiflu [0.8] Genzyme 28 [31] Cambridge, Massachusetts [genzyme.com] $4.1 [-2.9%] $856 Cerezyme [0.8] Mitsubishi Tanabe 29 [34] Osaka, Japan [mt-pharma.co.jp] $3.9 [9.1%] $751 Remicade [0.4] UCB 30 [30] Brussels. Belgium [ucb.com] $3.8 [-10.6%] $966 Keppra [1.3]
  • 6. 76 PHARMACEUTICAL EXECUTIVE MAY 2010 www.pharmexec.com CSL 31 [38] Victoria, Australia [csl.com.au] $3.7 [9.4%] $251 Gardasil [0.1] Allergan 32 [36] Irvine, California [allergan.com] $3.7 [5.3%] $706 Botox [1.3] Forest 33 [37] New York, New York [frx.com] $3.6 [3.9%] $661 Lexapro [2.3] Menarini 34 [41] Florence, Italy [menarini.com] $3.6 [16.1%] * N/A N/A Nycomed 35 [40] Zurich, Switzerland $3.5 [0.9%] $285 Pantaprazole [N/A] THE TOP TEN POST-MERGER Pfizer + Wyeth Sanofi-Aventis Major mergers are reshaping the top ten. This chart shows the impact recent and Novartis + Alcon recently announced mergers would have had on the top ten if they’d taken place January Merck + Schering-Plough 1, 2008. Pfizer leaps forward, Merck jumps from seventh place to fourth. Roche (which GlaxoSmithKline + reported a full year of Genentech revenue) Stiefel moves from eighth place in 2009 to sixth. (This chart omits several minor mergers.) Roche + Genentech Even without additional mergers, Pharma’s Top Six should all have revenues of $40 bil- AstraZeneca lion and up. Johnson & Johnson SOURCE: Oliver Wyman Eli LIlly 2009 pro forma 2009 actuals Bristol-Myers Squibb 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 Biogen Idec 36 [42] Cambridge, Massachusetts [biogenidec.com] $3.2 [12.6%] $1283 Avonex [2.3] Shire 37 [43] Dublin, Ireland [shire.com] $2.7 [-3.8%] $638 Adderall [0.6] Alcon 38 [44] Hünenberg, Switzerland [alcon.com] $2.7 [3.0%] $665 Glaucoma products [1.1] Apotex 39 North York, Ontario [apotex.com] $2.6 [74.3%] * N/A Generics [N/A] Lundbeck 40 [45] Copenhagen, Denmark [lundbeck.com] $2.6 [23.5%] $615 Cipralex/Lexapro [1.5]
  • 7. 78 PHARMACEUTICAL EXECUTIVE MAY 2010 www.pharmexec.com The Top 10: The Year In Review Pfizer Acquired Wyeth in $68 billion Roche Completed $47 billion acquisi- Johnson & Johnson Acquired deal, giving company entrée to the vac- tion of Genentech. Fifty-nine new molec- Elan’s rights and assets in the Al- cines and (again) consumer products ular entities in clinical testing, including zheimer’s Immunotherapy Program, a markets. Launched Toviaz for overactive eight in Phase III/registration. Actemra/ joint venture with Wyeth, Completed bladder in the US. Prevnar 13 approved RoActemra for rheumatoid arthritis ap- acquisition of Cougar, a biotech with in 40 countries. 133 R&D programs, proved in EU (and in January 2010 in a Phase III drug for metastatic pros- Phase I through registration. Created the US). Signed 51 new research/tech- tate cancer. Launched Nucynta, a nov- regenerative medicine unit, and signifi- nology deals, including a partnership el oral drug for chronic pain, co-de- cantly boosted licensing partnerships. with Tekmira Pharmaceuticals to bring veloped with Gruenenthal. Simponi, a Roche’s first RNA interference products monthly, injectable anti-TNF drug for into human testing. rheumatoid arthritis, approved in the US, EU, and Canada. Sanofi-Aventis Multiple acquisitions of generics companies including Medley (Brazil’s largest), Kendricks (Mexico), AstraZeneca Launched Onglyza (for and Zentiva (Czech republic). Announced diabetes) in the US & EU. Launched Ir- Eli Lilly Launched translational purchase of Chattanooga-based OTC essa for non-small cell lung cancer in medicine unit and opened new biotech company Chattem for $1.9 billion. Ac- the EU after having withdrawn its ap- center in San Diego. Adcirca (with quired Oenobrol, French maker of nu- plication in 2005 Divested portfolio of the same active ingredient as Cialis— tritional beauty supplements. Launched over-the-counter products. Submitted tadalafil) approved for pulmonary ar- Multaq, anti-arrhythmia drug, in US, EU, US NDA for ticagrelor (tentatively to be terial hypertension in the US, EU, and and Canada. known as Brilinta) an oral antiplatelet Japan. Co-promotion deal with Kowa treatment. Announced acquisition of for the statin Livalo. Effient, an anti- infection-research company Novexel platelet agent co-developed with Dai- and expanded anti-infective partnership ichi-Sankyo, approved in the US. Novartis Joe Jimenez appointed new with Forest. CEO. Approvals include Afinitor (for renal cell cancer), Ilaris (cryopyrin-as- sociated periodic syndromes), Onbrez Bristol-Myers Squibb Acquired Breezhaler (EU, for COPD), Valturna (hy- Merck Merged with Schering-Plough the shares it did not already own of pertension). Acquired EBEWE Pharma’s in $41 billion deal. Announced acquisi- Medarex, a biotech focused on fully specialty generics business. 145 projects tion of Avecia, a contract manufacturer human monoclonal antibody drugs in clinical development. Launched bi- of biologics. Divested itself of its stake for cancer, autoimmune diseases, in- osimilars in Japan and Canada. in Merial, an animal health joint ven- flammation, and infection. Divested ture with Sanofi-Aventis. In April, struck holdings in Mead Johnson Nutrition, ground-breaking, much-discussed deal completing a transition toward pure- with the health insurer Cigna over dia- play pharma. Onglyza (a drug for Type GlaxoSmithKline Product approvals betes drugs Januvia and Janumet, pro- II diabetes, developed and marketed include Votrient, an oral medication for viding bigger discounts to the plan for with AstraZeneca) approved. Entered renal cell cancer. Launched Arzerra (for achieving better patient results. partnerships with ZymoGenetics, Nis- refractory chronic leukocytic leukemia) san Chemical Industries, Teijin Phar- in the US. Filings include Benlysta, poten- ma, Adler Biopharmaceuticals. tially the first new drug for lupus in more than 60 years. Acquired Stiefel, a specialty dermatology company with revenues of $900 million. With Pfizer created ViiV, specialty company dedicated to HIV.
  • 8. 80 PHARMACEUTICAL EXECUTIVE MAY 2010 www.pharmexec.com TOP 15 GLOBAL PRODUCTS, 2009 Product 1 2 Lipitor Plavix 2009 Sales (US$M) $9,100 $13,288 In 2009, there were 29 3 4 5 Nexium Seretide Seroquel $6,012 $8,236 $8,099 mergers & acquisitions 6 7 Enbrel Remicade $5,863 $5,453 in the pharmaceutical industry 8 Crestor $5,383 SOURCE: IMS Health 9 10 11 Zyprexa Humira Avastin $5,357 $5,032 $5,015 worth $126.5 billion 12 13 Singulair Mabithera $4,986 $4,681 That compares with 14 15 Abilify Lovenox $4,673 $4,572 48 mergers & acquisitions worth $51.1 billion in 2008 REVENUE DISTRIBUTION, THE TOP 50 50.0 45.0 Revenue continues to 40.0 be concentrated in the Prescription drug revenue 35.0 largest companies. In this in billions of USD 30.0 year’s Top 50, the Top 10 SOURCE: Oliver Wyman 25.0 accounted for just under 20.0 60 percent of revenue, 15.0 while the top 20 were 10.0 responsible for about 80 5.0 percent of sales. 0.0 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 Ranking Celgene 41 Summit, New Jersey [celgene.com] $2.6 [20.1%] $471 Revlimid [1.7] Ratiopharm 42 [33] Ulm, Germany [ratiopharm.com] $2.4 [-35.4%] N/A Generics [N/A] Cephalon 43 [47] Frazer, Pennsylvania [cephalon.com] $2.2 [13.2%] $395 Provigil [1.0] Dainippon Sumitomo 44 [46] Osaka, Japan [ds-pharma.co.jp] $2.1 [1.2%] $543 Amlodin [0.6] Hospira 45 [48] Lake Forest, Illinois [hospira.com] $2.1 [15.2%] $241 N/A Watson 46 [49] Corona, California [watson.com] $2.0 [13.1%] $197 CNS generics [0.8] Actavis 47 [50] Hafnarfjörður, Iceland [actavis.com] $1.8 [0.9%] * N/A Generics [N/A] Shionogi 48 Osaka, Japan [shionogi.co.jp] $1.8 [-0.7%] $543 Crestor [0.2] Kyowa Hakko Kirin 49 Tokyo, Japan [kyowa-kirin.com.jp] $1.7 [55.7%] $497 Espo/Nesp [0.4] Meda 50 Solna, Sweden [meda.se] $1.7 [34.3%] N/A Astelin [0.2]