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CHILE: A BRIEF LANDSCAPE OF COUNTRY ECONOMY AND HEALTHCARE MARKET
CHILE: A BRIEF LANDSCAPE OF COUNTRY ECONOMY AND HEALTHCARE MARKET
Edson Luis de Brito, Pharm.D. – Executive Consultant in Korea Heath Industry Development Institute, KHIDI
- 글 Edson Luis De Brito
- KHIDI 해외제약전문가
From a troubled economic and political environment at the end of the 20th century to a growing market economy and with social indicators above the Latin American standard, Chile has been prominent in several economic sectors. Although it is still a small country with a compelling geography, the country seems to be a promise of prosperity and human development at the beginning of the twenty-first century.
Still few recognized as a prominent player in the global drug market, Chile presents potential opportunities that are still far from being explored, but which can lead to a pleasant surprise once they are fully known. This article tries to show a little of the current market of medicines in Chile and provide some insights in order to put the market in an interesting perspective for the pharmaceutical business in Latin America. During the last decades,
Chile has improved significant the quality of life of its citizens. However the growth stagnated once the commodities boom ended cousins. In the short term, solid economic fundamentals, improvement of international perspectives for trade and exports of raw materials, and a fiscal and monetary policy expansive are helping to achieve a gradual recovery. Increase social spending and education, in particular through the current educational reform will reinforce inclusive growth with the pass of the time. However, increasing productivity would increase the income of all Chileans and contribute to finance high quality public education, health and services. Too many adults have poor basic skills, time that excessive dependence on self-employment and of short-term contracts, as well as the inefficient system of training, hinder the growth of productivity and wellness.
The economy of Chile is the sixth largest economy in Latin America in terms of nominal gross domestic product (GDP), and also in terms of GDP at purchasing power parity prices (GDP PPP). Chile has the highest per capita income in Latin America (USD 26,864 per capita GDP PPP and USD 18,592 GDP per capita at nominal prices) and belongs to the category of high income countries according to the World Bank.
The Chilean economy has remarkable index in terms of competitiveness, economic freedom, financial development, and is considered the most dynamic economy in Latin America. It also has the rating of the continent's most favorable external debt.
Regarding foreign investment, in 2012, Chile attracted almost 18% of investments in Latin America with USD 30,332 million, while in terms of foreign investment of Chilean companies, it attracted almost 50% in the same year. USD 21.09 billion, becoming the second economy in receipt and export of capital and the first in relation to its GDP in Latin America.
Its main economic sector is services with 63.9% of GDP, followed by mining, which generated in 2012 14.2% of GDP and 57% of exports with USD 48 827 million. Chile is the world's largest producer of copper, lithium, iodine, and other products such as fresh grapes, blueberries, plums, dehydrated apples, salmon, trout and lithium carbonate
Chile has been succeeding to create improvements for their people. The quality of life of Chileans has improved significantly in the last decades, backed by the stability of the macroeconomic framework, the implementation of deep structural reforms in areas such as trade liberalization and investment, and prosperous sectors of natural resources. The quality of life is close to OECD average in some dimensions of well-being - in particular what is refers to employment and income, life-work balance, health and subjective well-being. Convergence in terms of GDP per capita and the reduction of inequalities has been among the fastest in the OECD in recent decades. However, progress has slowed down recently and the ratio between the highest income proportion and the lowest income proportion is among the most pronounced of the OECD, despite being lower than in other countries of Latin America.
Additionally to the good results, Chilean economy also presents an attractive healthcare market, despite being small currently; the potential is not plenty developed.
With a population reaching 18 million inhabitants, Chile has a Healthcare System capable to cover significantly the needs of country population, mainly those located in the urban areas. The Infant Mortality rate (7.8 / 1000 inhabitants) is low, being compared to countries with high level of human development. The birth rate is 13.8 per 1.000 inhabitants, what configures an increment in Chile population of 240,000 children per year approximately. Also, life expectation in Chile is very interesting compared with other countries in Latin America Region, reaching the average of 80 years, being 83 for women and 77 for men.
These characteristics lead Chile to face several situations in terms of public health, and with the social contrasts it is clear that the Chilean State needed to develop a Health System able to cover the necessities of the population.
In general the Health System follows the structure below:
Public health Insurance (70.4% of population)
The supplying is reached by sales through public system – ordered by the Chilean Government and Chilean Provinces.
Medicine purchase model is Public tenders.
Quality, price, trust records are the main pre-requisites aimed by the tenders
Private health Insurance (16.4% population)
Sales through private pharmacies
Purchase model: B2B reached by Health Management Organizations such as BanMedica, Fonasa, MasVida and others.
Brands recognition, physician prescriptions are the practices.
National health policies (Explicit Health Guarantees) (13.2% population)
Provided for 69 catastrophic diseases (including treatment & pharmaceuticals)
Purchase model: B2B for private, public tender for public system
Medicine supply through public or private system
Based on the structure above it is realized that Chile can move the Pharmaceutical Market with volumes interesting but below of the potential, maybe due to significant financial transitory imbalances and social inequities.
Total market Pharmaceutical Market in Chile is about US$ 1.553 Billion, being ethical market about US$ 1.050 Billion. In other hand, Institutional market is about US$ 850 Mio.
Chile has around 80 pharmaceutical companies able to supply the market, for this reason the Chilean market is dominated by national companies being the coverage in volumes the relation 80% for national companies versus 20% to the global pharma companies, and in terms of values the relation is 60% for Chilean companies versus 40% of values reached by global companies.
Differently of other countries in Latin America, Chile has no price regulation and the country respect patent protection since 1995.
However, 95% of private market is concentrated in 3 pharmacy chains with own generics brands. Those are: Cruz Verde; Ahumada and SB.
Chile has a regulatory environment that matches with many others regulatory agencies in the world and complies with ICH (International Council of Harmonization) in most of cases.
The registration process of a pharmaceutical in Chile has a timeline more affordable than Brazil, taking around 8 to 12 months to complete the registration submission. However, for a registration of a generic formulation, the ISP (Institut de Salud Publica) requires the fulfilment of results obtained in Bioequivalence and Pharma-equivalence tests. So far, Chile accepts those tests made by the manufacturer in case of finished dosage formulations imported by overseas, or performed for an independent laboratory for domestic products. However, regulations are a matter that tends to be more aggressive becoming tougher with time. The possibility of this change in long term therefore, exists
Chile has a vibrant and successful economy reached in the last 15 years due control of public costs and investments in the local industry of commodities.
In other hand, Chile is just beginning the transformation in their healthcare market, because the access for most of their population is not fully achieved.
Taking into account that Chilean pharmaceutical market is hugely concentrated in few companies’ wholesale, retail, importers, manufacturers and distributors, to be inserted and know how the process of promotion, sales and distribution work in Chile really matter for the success in business with this country.
Culturally, Latins are too much careful to make a decision, Chileans are not different. However, they have a good growth potential in the middle and long term and an economy in development always attracts people and create more opportunity in the country. This is the chance to be inserted through high new health technology and new products that more advanced nations, such as Korea, can provide in short and middle terms.
1. Estudios Económicos de la OCDE – Chile, Feb 2018
2. Registro de medicamentos en Chile: de la opacidad a la transparencia, DNM, March, 2013
3. A practical overview of requirements for drug registration in Latin America, Regulatory Rapporteur, September 2013
4. www.ispch.ch, Regulaciones de ISP, Chile
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