The Pharmaceutical Industry in Figures
Key Data2023

www.efpia.eu

EFPIAKey Data | 2023

THE PHARMACEUTICAL INDUSTRY:A KEY ASSET TO SCIENTIFIC AND MEDICAL PROGRESS
Thanks to advances in science and technology, theresearch-based pharmaceutical industry is entering
an exciting new era in medicines development.
Research methods are evolving and we have many
promising prospects on the horizon, with groundbreaking cell and gene therapies being increasingly
available*. The innovative pharmaceutical industry
is driven by, and drives, medical progress. It aims
to turn fundamental research into innovative
treatments that are widely available and accessible
to patients.

targeted treatments. European citizens can expect
not only to live longer, but to live better quality lives.
Yet major hurdles remain, including Alzheimer’s,
multiple sclerosis, many cancers, and rare diseases.

Already, the industry has contributed to significant
improvements in patient well-being. Today’s
European citizens can expect to live up to 30 years
longer than they did a century ago. Some major
steps in biopharmaceutical research, complemented
by many smaller steps, have allowed for reductions
in mortality, for instance from HIV/AIDS-relatedcauses and several cancers. High blood pressure
and cardiovascular diseases can be controlledwith antihypertensive and cholesterol-lowering
medicines; knee or hip replacements prevent
patients from immobility; and some cancers can becontrolled – or even cured – with the help of new

TOTAL NUMBER OF DEATHS AMONG AIDS CASES IN EUROPE (TOTAL EU/EEA)

2500
2154

2123

2000

1895
1660

1669

1500

1522

1488

1335

1000
654

500
0

2012

2013

2014

2015

2016

2017

2018

2019

2020

*https://www.efpia.eu/media/676661/iqvia_efpia-pipeline-review_final-report_public-final.pdf

2

558

2021

Source: HIV/AIDS surveillancein Europe 2022
(2021 data), WHO
Regional Office forEurope & European
Centre for Disease
Prevention andControl (ECDC), 30
November 2022

THE PHARMACEUTICAL INDUSTRY:A KEY ASSET TO THE EUROPEAN ECONOMY
As well as driving medical progress by researching,developing and bringing new medicines that improvehealth and quality of life for patients around theworld, the research-based pharmaceutical industry
is a key asset of the European economy. It is one ofEurope’s top performing high-technology sectors.

INDUSTRY (EFPIA total)

2000

2010

2020

2021

2022

Production

127,504

199,730

290,309

323,950

340,000 (e)Exports (1) (2)90,935276,357

509,828

567,009670,000 (e)Imports

68,841

204,824

347,124395,250455,000 (e)Trade balance

22,09471,533

162,704

171,759

215,000 (e)R&D expenditure

17,84927,92039,442

42,53344,500 (e)Employment (units)556,506

701,059

845,770859,607865,000 (e)R&D employment (units)

88,397116,253

121,717

126,959

130,000 (e)Total pharmaceutical market
value at ex-factory prices

89,449153,685

236,459

254,267

275,000 (e)Payment for pharmaceuticals
by statutory health insurance
systems (ambulatory care only)

76,909129,464

145,428

156,140

170,000 (e)Values in € million unless otherwise stated(1) D ata relate to EU-27, Norway, Switzerland and United Kingdom since 2005 (EU-15 before 2005); Croatia and Serbia included
since 2010; Turkey included since 2011; Russia included since 2013
(2) Data relating to total exports and total imports include EU-27 intra-trade (double counting in some cases)
Source: EFPIA member associations (official figures) - (e): EFPIA estimate; Eurostat (EU-27 trade data 2000-2022)

3

EFPIAKey Data | 2023

MAIN TRENDS
The research-based pharmaceutical industry can playa critical role in restoring economic growth in Europe
and ensuring future competitiveness in an advancing
global economy. In 2022 it invested an estimated€44,500 million in R&D in Europe. It directly employssome 865,000 people and generates about threetimes more employment indirectly – upstream anddownstream – than it does directly (PwC, Economic
and societal footprint of the pharmaceutical industryin Europe, June 2019). However, the sector faces real
challenges. Besides the additional regulatory hurdles
and escalating R&D costs, the sector has been
severely hit by the impact of fiscal austerity measures
introduced by governments across much of Europe
since 2010.
There is rapid growth in the market and research
environment in emerging economies such as
Brazil, China and India, leading to a gradualmigration of economic and research activities
from Europe to these fast-growing markets.

During the period 2017-2022 the Brazilian,
Chinese and Indian markets grew by 13.0%, 5.3%
and 11.0% respectively compared to an average
market growth of 6.6% for the top 5 European
Union markets and 7.1% for the US market(source: IQVIA MIDAS, May 2023).
In 2022 North America accounted for 52.3%
of world pharmaceutical sales compared with
22.4% for Europe. According to IQVIA (MIDAS
May 2023), 64.4% of sales of new medicines
launched during the period 2017-2022 were on
the US market, compared with 16.4% on the European market (top 5 markets).
The fragmentation of the EU pharmaceuticalmarket has resulted in a lucrative parallel trade.
This benefits neither social security nor patientsand deprives the industry of additional resources
to fund R&D. Parallel trade was estimated toamount to €6,280 million (value at ex-factory
prices) in 2021.

GEOGRAPHICAL BREAKDOWN (BY MAIN MARKETS) OF SALES OF
NEW MEDICINES LAUNCHED DURING THE PERIOD 2017-2022
Note:
New medicines cover all new
active ingredients marketed
for the first time on the world
market during the period
2017-2022

64.4%

16.4 %USA

Europe(Top 5)

5.5%
Japan

10.2%

Rest ofthe World

3.5%

Pharmerging

Europe (Top 5) comprises
France, Germany, Italy, Spainand United Kingdom
Pharmerging comprises 21
countries ranked by IQVIA as
high-growth pharmaceuticalmarkets (Algeria, Argentina,
Bangladesh, Brazil, Colombia,
Chile, China, Egypt, India,
Indonesia, Kazakhstan, Mexico,
Nigeria, Pakistan, Philippines,
Poland, Russia, Saudi Arabia,
South Africa, Turkey andVietnam)
Source: IQVIA (MIDAS May 2023)

4

PHARMACEUTICAL R&D EXPENDITURE IN EUROPE, USA, JAPAN AND CHINA(€ MILLION, 2020 CONSTANT EXCHANGE RATE*), 1990-2021
90,00080,00063,397

69,69970,00060,000

0,000

1990

2000

2010

2020

11,968

11,478

9,964

1,557

10,84635,623
10,472

245**

6,124

17,8494,236

10,000

5,956

7,766

20,00018,70427,92030,00039,44240,00042,53350,0002021* Note: USA: 1€ = 1,1422 $; Japan: 1€ = 121,85 ¥; China : 1€ = 7,8747 Yuan (**2001 year)
Source: EFPIA member associations, PhRMA, JPMA, China Statistical Yearbook

Europe

USA

Japan

China

SHARE OF PARALLEL IMPORTS IN PHARMACY MARKET SALES (%) – 2021
36
34
32
30
28
26
24
22
20
18
16
14
12
10
8
6
4
2
0

30.4

14.0
12.4
9.9
7.0
3.9

Austria

6.2

4.1
2.7

Belgium

Denmark

Finland1.8

Germany

Ireland Netherlands

PolandSwedenU.K.

Note: U
 .K.: in % of pharmacy market sales at reimbursement prices; Ireland: 2020 data
Source: EFPIA member associations (estimate)

5

EFPIAKey Data | 2023

PHARMACEUTICAL INDUSTRY RESEARCH
AND DEVELOPMENT IN EUROPE
All new medicines introduced into the market are
the result of lengthy, costly and risky research anddevelopment (R&D) conducted by pharmaceuticalcompanies:

The cost of researching and developing a newchemical or biological entity was estimatedat €1,926 million ($2,558 million in year 2013
dollars) in 2014 (DiMasi et al, Journal of Health
Economics, January 2016);

By the time a medicinal product reaches themarket, an average of 12-13 years will have elapsed
since the first synthesis of the new active substance;

On average, only one to two of every 10,000
substances synthesised in laboratories will
successfully pass all stages of development
required to become a marketable medicine.

PHASES OF THE RESEARCH AND DEVELOPMENT PROCESS

n

io
at

lic

p
ap

l
ica ent
lin–c opme
Pr velde

Screening (10,000 molecules)

ity
xic
nt
y
to
te
a
e
og
ty
P
ut
ol
ici
ac
Ac
ox
t
m
r
c
a
ni
Ph
ro
Ch
eI
as
Ph

ls

ria

lt

ca
ni

n

i

Cl

io
at

is
or

th

g

e
as

Ph

II

on

/M

ar

au

k

t
i
e
at
en
nc
m
str
ila
se
gi
g
r
i
e
e
R
ic
bu cov
Pr eim
a
m
R
ar
Ph

se

a
Ph

III

in
et

1 medicinal product0

10 years of R&D

6

5 years

10 years

15 years

2 to 3 years ofadministrative procedures

20 years
patent expiry

25 years
SPC (supplementary protection
certificate) max. + 5 years

PHARMACEUTICAL INDUSTRY RESEARCH AND DEVELOPMENT IN EUROPE

EFPIA 2021		

€ million€ million

Austria283

Latvian.aBelgium

5,196

Lithuania

n.aBulgaria			

95

Malta

n.a

Croatia40

Netherlands

900

Cyprus85

Norway126

Czech Rep.

75

Poland321

Denmark

1,114

Portugal

121

Estonian.aRomania72

Finland234

Russia706

France4,451

Slovakia

35

Germany

8,540

Slovenia

230

Greece

95

Spain

1,267

Hungary

298

Sweden1,104

Icelandn.a

Switzerland

8,232

Ireland305

Turkey

71

Italy

1,680

U.K.

6,857

TOTAL 									42,533
Note:
The figures relate to the R&D carried out in each country.
Hungary, Poland, Russia, Slovakia, Slovenia, Turkey: 2020 data; France: 2017 data; Norway, Sweden: 2015 data; Cyprus, Ireland:
2013 data; Croatia, Netherlands: 2011 data
Belgium, Croatia, Denmark, France, Greece, Ireland, Italy, Netherlands, Norway (LMI members), Poland, Romania, Slovenia,
Sweden (LIF members), Switzerland (Interpharma members), Turkey: estimate
Source: EFPIA member associations (official figures)

7

EFPIAKey Data | 2023

Allocation of R&D investments by function (%)
ALLOCATION OF R&D INVESTMENTS BY FUNCTION (%)

14.7 Pre-human/
Pre-clinical

9.0

Phase I

11.5 Phase II
49.2 Clinical Trials

Clinical Trials

28.7 Phase III

4.9

Approval

12.9 Pharmacovigilance(Phase IV)

Source: PhRMA, Annual Membership
Survey 2022 (percentages calculated from2021 data; total values may be affected byrounding)

18.2 Uncategorized

NUMBER OF NEW CHEMICAL AND BIOLOGICAL ENTITIES (2003-2022)
EuropeUSA

Japan

Others

China
159

160
140
120

100

100

77

80

66

74

65

60

55
48

40

30

26
20

50

46
39

35

17

15 15

0
2003-2007

2008-20122013-2017

Source: CITELINE May 2023 & SCRIP – EFPIA calculations (according to nationality of mother company)
Note: Up to 2017 China is included under ‘Others’

8

2018-2022

2,600

2,558

2,500

IMPORTANCE OF
PHARMACEUTICAL R&D

2,400

2,300
2,200

In 2021 the pharmaceutical industry invested morethan €42,500 million in R&D in Europe. A decadeof strong US market dominance led to a significant
shift of economic and research activity towards the
US during the period 1995-2005, a trend that has
been exacerbating since 2015. Additionally, Europe
is now facing increasing competition from emerging
economies: rapid growth in the market and research
environments in countries such as China and Korea arecontributing to the move of economic and research
activities to non-European markets. In 2022 China
nearly equalled Europe as originator of new active
substances launched for the first time on the world
market, with respectively 16 and 17 new substances,
far behind the US leading with 24 on a total of 73. After
having lost its crown as the top innovation region in theworld in 2000, Europe moved to the third place on the
podium in 2020, being overtaken by China and others.
The geographical balance of the pharmaceuticalmarket – and ultimately the R&D base – is likely to shift
gradually towards fast-growing emerging economies.
ESTIMATED FULL COST OF BRINGING A NEW
CHEMICAL OR BIOLOGICAL ENTITY TO MARKET($ MILLION - YEAR 2013 $)

2,100

2,000

1,900

1,800
1,700

1,600
1,500

1,400

1,300

1,200

1,100

1,044

1,000
900

800

700
600
500

413
400
300

179

200

Source: Joseph. A. DiMasi, Henry G. Grabowski, Ronald W.Hansen,
Innovation in the pharmaceutical industry: New estimates of R&D
costs, Journal of Health Economics, 47 (2016), 20-33

100

01970 early 1980s

1980 early 1990s

1990 mid 2000s

2000s mid 2010s

PHARMACEUTICAL R&D EXPENDITURE ANNUAL GROWTH RATE (%)
40

35.1

35

Europe

30
25
20
10
5
0

15.6

13.6

15

9.4

8.4
2.6

0.8

2008-2012

USA

3.2

4.6

2013-20172018-2022

China

Note: USA, China: data relating to period 2018-2021
Source: EFPIA, PhRMA, China Statistical Yearbook 2002-2022

9

EFPIAKey Data | 2023

RANKING OF INDUSTRIAL SECTORS BY OVERALL SECTOR R&D INTENSITY(R&D AS PERCENTAGE OF NET SALES – 2021)

Health Industries

12.4%
9.3%

ICT services

7.0%

ICT products
Automobiles & other transports

4.9%

Total

4.7%
3.9%

Aerospace & defence
Financial

2.7%

Others2.6%

Industrials

2.5%

Chemicals

2.4%

Construction

2.3%
0.5%

Energy
0

2

4

6

8

10

12

14

16

Note:
Data relate to the top 2,500 companies with registered offices in the EU-27 (361), Japan (233), the US (822), China (679) and the Restof the World (405), ranked by total worldwide R&D investment (with investment in R&D above €48.5 million).
Companies are distributed by main sector according to the International Classification Benchmark (ICB); health industries include
biotechnology, health providers, medical equipment, medical supplies and pharmaceuticals.
Source: The 2022 EU Industrial R&D Investment Scoreboard, European Commission - Joint Research Centre

According to EUROSTAT data, the pharmaceuticalindustry is the high technology sector with the highest
added value per person employed, significantly higher
than the average value for high-tech and manufacturingindustries. The pharmaceutical industry is also the sector
with the highest ratio of R&D investment to net sales.

10

According to the 2022 EU Industrial R&D Investment
Scoreboard, health industries invested about €235.3
billion in R&D in 2021, accounting for 21.5% of totalbusiness R&D expenditure worldwide.

PHARMACEUTICAL PRODUCTIONEFPIA 2021		

€ million€ million

Austria

1,387

Latvia321

Belgium

43,300Lithuania

n.aBulgaria

291

Malta

307

Croatia

451

Netherlands

6,180

Cyprus253

Norway1,432

Czech Rep.

950

Poland2,515

Denmark

16,819Portugal

1,734

Estonian.aRomania

655

Finland

1,851

Russia6,459

France23,557

Slovakia

356

Germany

34,579Slovenia

3,402

Greece

1,585

Spain

17,457

Hungary

3,607

Sweden9,616

Iceland89

Switzerland

59,823

Ireland

19,305

Turkey

3,497

Italy

34,400U.K.

27,772TOTAL 								323,950Note:
All data based on SITC 54
Austria, Croatia, France, Norway, Russia, Spain, Turkey, U.K.: 2020 data; Cyprus: 2018 data; Slovakia: 2017 data; Iceland: 2016 data;
Bulgaria: 2015 data; Ireland: 2014 data; Romania: 2013 data; Netherlands: 2010 data
Croatia, Denmark, France, Ireland, Italy, Netherlands, Norway, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland: estimate
Bulgaria, Croatia, Cyprus, France, Hungary, Ireland, Latvia, Norway, Poland, Portugal, Romania, Slovenia: veterinary products
excluded
Source: EFPIA member associations (official figures)

Graph 13 - à remplir

PHAR

Efpia 2 013

11

EFPIAKey Data | 2023

EMPLOYMENT IN THE PHARMACEUTICAL INDUSTRYEFPIA 2021

 		

Units

Units

Austria

16,381

Latvia2,232

Belgium

42,062

Lithuania

1,220

Bulgaria

15,500

Malta

1,033

Croatia

6,041

Netherlands

20,000Cyprus

1,755

Norway4,500

Czech Rep.

18,000Poland25,868Denmark

27,868

Portugal

9,000

Estonia380

Romania

33,230Finland

6,061

Russian.aFrance99,310Slovakia

2,287

Germany

121,245

Slovenia

12,583

Greece28,800Spain

49,200Hungary

34,800Sweden13,156

Iceland500

Switzerland

46,800

Ireland40,204

Turkey42,291

Italy

67,300U.K.

70,000TOTAL 								859,607

Note:
France, Netherlands, Romania, Spain, Sweden, Turkey: 2020 data; Cyprus, Latvia, Malta: 2018 data; Slovakia: 2017 data;
Estonia: 2016 data; Lithuania: 2013 data
Belgium, Bulgaria, Croatia, Estonia, France, Ireland, Italy, Netherlands, Norway, Poland, Portugal, Romania, Slovenia, Sweden,
Switzerland, Turkey, United Kingdom: estimate
Source: EFPIA member associations (official figures)

The research-based pharmaceutical industry is
one of Europe’s major high-technology industrial
employers. Recent studies in some countries
showed that the research-based pharmaceuticalindustry generates about three times more
employment indirectly – upstream and downstream– than it does directly (PwC, Economic and societal

12

footprint of the pharmaceutical industry in Europe,
June 2019). Furthermore, a significant proportionof these are valuable skilled jobs, for instance in thefields of academia or clinical science, which can help
maintain a high-level knowledge base and prevent a
European “brain drain”.

EMPLOYMENT IN THE PHARMACEUTICAL INDUSTRY (1990-2022)

2022

865,000 (e)2021

859,6072020

845,770

2015

747,3932010

701,059

2005

636,684

2000

556,506

1995

499,482

1990

500,8790

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

900,000

Note:
Data includes Iceland (since 2017), Croatia, Lithuania and Turkey (since 2010), Bulgaria, Estonia and Hungary (since 2009), Czech
Republic (since 2008), Cyprus (since 2007), Latvia, Romania & Slovakia (since 2005), Malta, Poland and Slovenia (since 2004)
Source: EFPIA member associations (official figures) - (e): EFPIA estimate

EMPLOYMENT IN PHARMACEUTICAL R&D (1990-2022)

2022

130,000 (e)2021

126,9592020

121,7172015

113,1632010

116,253

2005

100,636

2000

88,397

1995

82,618

1990

76,1260

20,00040,00060,00080,000100,000

120,000

140,000

Note:
Data includes Iceland (since 2017), Greece & Lithuania (since 2013), Bulgaria and Turkey (since 2012), Poland (since 2010), Czech
Republic, Estonia and Hungary (since 2009), Romania (since 2005) and Slovenia (since 2004)
Croatia, Cyprus, Latvia, Malta, Russia, Serbia, Slovakia: data not available
Source: EFPIA member associations - (e): EFPIA estimate

13

EFPIAKey Data | 2023

PHARMACEUTICAL SALES
The world pharmaceutical (prescription) market was worth an estimated €1,222,921 million ($1,287,736 million) at
ex-factory prices in 2022. The North American market (USA & Canada) remained the world’s largest market with a
52.3% share, well ahead of Europe, China and Japan.
BREAKDOWN OF THE WORLD PHARMACEUTICAL MARKET – 2022 SALES

EuropeNorth America(USA, Canada)

22.4 %

52.3%

China

8.1%

Latin
America

Japan

4.9%

Source: IQVIA (MIDAS)
Q4 2022 MAT, May 2023;
data relate to the 2022
global retail and hospital
pharmaceutical market(prescription only) at
ex-factory prices.

Africa, Asia*& Australia

4.1%

Note:
Europe includes Belarus,
Turkey, Russia andUkraine; percentages
might not add up to
100% due to rounding

8.3%* Excluding China & Japan

PRICE STRUCTURE
Distribution margins, which are generally fixed by governments, and VAT rates differ significantly fromcountry to country in Europe. On average, approximately one third of the retail price of a medicine reverts todistributors (pharmacists and wholesalers) and the State.
BREAKDOWN OF THE RETAIL PRICE OF A MEDICINE, 2021 (%)

Manufacturer

66.8%
14

Wholesaler

5.2%

Pharmacist

17.4%

State (VAT and other taxes)

10.6%

Note:
Non-weighted averagefor Europe (average
estimate for 25
countries)
Source: EFPIA member
associations

PHARMACEUTICAL MARKET VALUE(at ex–factory prices)
EFPIA 2021		

€ million€ million

Austria

5,247

Lithuania

586

Belgium

6,728

Luxembourg

322

Bulgaria

1,570

Malta

196

Croatia

1,231

Netherlands

7,073

Cyprus177

Norway3,055

Czech Rep.

3,474

Poland7,817

Denmark

3,350

Portugal

3,783

Estonia409

Romania

4,946

Finland

2,846

Russia18,398

France32,077

Serbia867

Germany

47,588

Slovakia

1,669

Greece5,468

Slovenia

792

Hungary

2,668

Spain

18,442

Iceland215

Sweden4,872

Ireland

2,553

Switzerland

Italy

24,143

TurkeyLatvia271

U.K.

TOTAL 								Graph 176,127

Breakdown of the world ph

6,496

28,811
North America(USA, Canada)

254,267
44.5%

Note:
Medicinal products as defined by Directive 2001/83/EC
Cyprus, Denmark, Finland, Iceland, Latvia, Lithuania, Norway, Russia, Slovenia, Sweden: pharmaceutical market value at pharmacy
purchasing prices
Latin
America
Belgium, France, Germany, Greece, Ireland, Italy, Norway, Spain, United Kingdom: estimate
Source:EFPIA member associations (official figures); Latvia, Lithuania, Serbia: IQVIA; Russia: 2020 data; Cyprus, Malta: 2019 data

4.7%

The figures above are for pharmaceutical sales, at ex-factory prices, through all distribution channels (pharmacies, hospitals,
dispensing doctors, supermarkets, etc.), whether dispensed on prescription or at the patient’s request. Sales of veterinary medicines
are excluded.

Graph 18

Breakdow

15

EFPIAKey Data | 2023

VAT RATES APPLICABLE TO MEDICINES
The table below shows the VAT rates applied to medicines in European countries as of 1 January 2023.

CountryStandard VAT rate (%)
VAT rates applied to medicines		 Prescription (%)
OTC (%)
Austria
Belgium
Bulgaria
Croatia
CyprusCzech Rep.
Denmark
Estonia
FinlandFrance (1)Germany
GreeceHungary
Iceland
Ireland (2)Italy
LatviaLithuania (3)Luxembourg
Malta
Netherlands
NorwayPolandPortugal
Romania
RussiaSerbiaSlovakia
Slovenia
Spain
SwedenSwitzerland
TurkeyU.K. (4)

20,0
21,0
20,0
25,0
19,0
21,0
25,0
20,0
24,0
20,0
19,0
24,0
27,0
24,0
23,0
22,0
21,0
21,0
16,0
18,0
21,0
25,0
23,0
23,0
19,0
20,0
20,0
20,0
22,0
21,0
25,0
7,7
18,0
20,0

10,0
6,0
20,0
5,0
5,0
10,0
25,0
9,0
10,0
2,1
19,0
6,0
5,0
24,0
0-23,0
10,0
12,0
5,0
3,0
0,0
9,0
25,0
8,0
6,0
9,0
10,0
10,0
10,0
9,5
4,0
0,0
2,5
8,0
0-20,0

10,0
6,0
20,0
5,0
5,0
10,0
25,0
9,0
10,0
10,0
19,0
6,0-13,05,024,00-23,0
10,0
12,0
21,0
3,0
0,0
9,0
25,0
8,0
6,0
19,0
10,0
10,0
20,0
9,5
4,0
25,0
2,5
8,0
20,0

(1) France: reimbursable medicines 2.1%; non-reimbursable medicines 10.0% (2) Ireland: oral medication 0%; other medication 23%(3) Lithuania: reimbursable medicines 5.0%; non-reimbursable medicines 21.0% (4) U.K.: 0% for prescription medicines dispensed in
the Community; 20% for prescription medicines consumed in the hospital setting

16

GENERICS AND BIOSIMILARS
Generics and biosimilars are usually produced
by a manufacturer who is not the inventor of theoriginal chemical or biological substance. They canbe marketed after expiry of the intellectual property

16.4
29.5

Bulgaria

35.0

Croatia

27.0

Czech Republic

Note:
Bulgaria, Croatia, Czech Republic, Denmark,Estonia, Finland, Ireland, Hungary, Slovenia,
U.K.: share of generics and biosimilars inpharmacy market sales

31.9

Denmark

20.2

Estonia
Finland18.0

France18.5

Austria, Belgium, France, Germany, Greece,
Italy, Luxembourg, Netherlands, Portugal,
Spain: share of generics and biosimilars inreimbursable pharmacy market sales

21.8

Germany

27.9

Greece36.8

Hungary
Ireland

SHARE (ESTIMATE IN %)ACCOUNTED FOR BY GENERICS AND
BIOSIMILARS IN PHARMACEUTICAL
MARKET SALES VALUE(AT EX-FACTORY PRICES), 2021

48.0

Austria
Belgiumprotection rights of the innovative product.
Data might not be strictly comparable acrosscountries due to differences in procurement andreimbursement practices.

Latvia, Lithuania, Norway, Poland, Romania,
Russia, Serbia, Slovakia, Sweden, Switzerland,
Turkey: share of generics and biosimilars intotal market sales

17.2
21.0

Italy

44.0

LatviaIreland, Latvia, Lithuania, Russia: 2020 data;
Cyprus, Iceland, Malta: data not available

24.0

Lithuania

France: data relate only to those active
substances listed on the official list of
medicines

Luxembourg 3.6
Netherlands 13.0

27.5

Norway22.8

Portugal
Romania

Source: EFPIA member associations

55.8

Poland18.9

Russia31.6

Serbia30.7

Slovakia

21.4

Slovenia

21.9

Spain

22.2

Sweden22.7

Switzerland 13.9
Turkey

29.0

U.K.

29.0

0%

10%

20%

30%

40%

50%

60%

70%

80%

17

EFPIAKey Data | 2023

PHARMACEUTICAL EXPORTS€ million€ million

Austria			

12,545

Latvia				 591

Belgium 			

84,251

Lithuania				 912

EFPIA 2021

Bulgaria				 1,024

Luxembourg			

Croatia			

Malta				 434

1,008

163

Cyprus				 354

Netherlands		

Czech Republic

3,375

Norway				 608

18,472

Poland				 4,682

Estonia				 104

Portugal				 1,382

Finland				 1,045

Romania				 983

France			33,899Slovakia				 536

Germany 		

101,152

Slovenia				 8,214

		Denmark		

45,090

Greece				 2,888

Spain			Hungary				 6,686

Sweden		

9,873

Iceland				Switzerland		

89,886

6

18,244

Ireland			62,632Turkey				 1,436

Italy			32,486

United Kingdom		

TOTAL 								22,048567,009

Note: All data based on SITC 54
Source: Eurostat (COMEXT database – May 2023)
Iceland: OECD; Norway: LMI; Switzerland: Swiss Federal Customs Administration; Turkey: Turkish Statistical Institute18

PHARMACEUTICAL IMPORTS
EFPIA 2021

€ million€ million

Austria

11,995

Latvia803

Belgium

62,138

Lithuania

1,362

Bulgaria

1,799

Luxembourg

603

Croatia

1,580

Malta

332

CyprusNetherlands

32,865

Czech Republic

6,278

357

Norway2,505Denmark

5,780

Poland8,895

Estonia

669

Portugal

3,362

Finland2,293

Romania

4,150

France31,149Slovakia

2,272

Germany

68,216

Slovenia

5,604

Greece

3,721

Spain

21,783

Hungary

5,636

Sweden5,130

Iceland

202

Switzerland

36,189Ireland9,811

Turkey

5,994

Italy

28,985

United Kingdom

22,792TOTAL 								395,250

Note: All data based on SITC 54
Source: Eurostat (COMEXT database – May 2023)
Iceland: OECD; Norway: LMI; Switzerland: Swiss Federal Customs Administration; Turkey: Turkish Statistical Institute19

EFPIAKey Data | 2023

PHARMACEUTICAL TRADE BALANCEEFPIA 2021

€ million€ million

Austria

550

Latvia-212

Belgium

22,113

Lithuania-450

Bulgaria-775

Luxembourg-440

Croatia

-572

Malta

102

CyprusNetherlands

12,225

Czech Republic-2,903

Norway-1,897

Denmark

12,692

PolandEstonia-565

Portugal

Finland-1,248

Romania

France2,750

Slovakia

Germany
Greece-332,936-833

Graph 24

-4,213-1,980EU -28 trade-3,167 balance-1,73660,000Slovenia
Spain-3,53940,000Hungary

1,050

SwedenIceland-196

Switzerland

Ireland52,821

Turkey

Italy

3,501

United Kingdom

2,610

55,33750,00033,611

4,743

30,00053,69720,00018,13-4,55810,000-744

0TOTAL 								-10,000

2,980

171,759-20,000
Note: All data based on SITC 54-30,000

Source: Eurostat (COMEXT database – May 2023)-40,000
Iceland: OECD; Norway: LMI; Switzerland: Swiss Federal Customs Administration; Turkey:
Turkish Statistical Institute-45,320-50,000-44,497-60,000

Graph 25

20

The European Union’s

EU-27 TRADE BALANCE - HIGH TECHNOLOGY SECTORS (€ MILLION) - 2022
200,000
180,000 175,143
160,000
140,000
120,000
SITC 54 Medicinal and pharmaceutical products

100,000
80,000

SITC 71 Power generating machinery and equipment

60,000
SITC 75 Office machines and automatic data processing machines

40,00020,00019,08910,573SITC 76 Telecommunications, sound-recording andreproducing apparatus and equipment

0

SITC 77 Electrical machinery, apparatus and appliances-20,000-40,000-60,000

SITC 87 Professional, scientific and controlling instruments
and apparatus-56,084-72,423-74,386-80,000

Source: Eurostat, COMEXT database, April 2023

-100,000

THE EUROPEAN UNION’S TOP 5 PHARMACEUTICAL TRADING PARTNERS - 2022
USA

Switzerland

U.K.

China

Japan

Singapore

OthersEU exports

32.5%

12.9%

7.2%

5.9%

5.6%

-

35.9%

EU imports

35.3%

33.9%

9.1%

5.2%

-

3.9%

12.6%

EU exports

EU imports

Source: Eurostat, COMEXT database, April 2023

21

EFPIAKey Data | 2023

TOTAL SPENDING (PUBLIC AND PRIVATE) ON HEALTHCARE
AS A PERCENTAGE OF GDP AT MARKET PRICESCountry

1980

1990

2000

2010

2020

2021

Austria

7.0

7.7

9.2

10.2

11.5

12.2

Belgium

6.2

7.1

8.0

10.2

11.1

-

Czech Republic

-

3.7

5.7

6.9

9.2

-

Denmark

8.4

8.0

8.1

10.6

10.5

10.8

Estonia

-

-

5.2

6.3

7.8

7.5

Finland

5.9

7.3

7.1

9.1

9.6

-

France

6.8

8.0

9.6

11.2

12.2

12.4

Germany

8.1

8.0

9.9

11.1

12.8

12.8

Greece

-

6.1

7.2

9.6

9.5

-

Hungary

-

-

6.8

7.4

7.3

-

Iceland

5.9

7.4

8.9

8.4

9.5

9.7

Ireland

7.5

5.6

5.9

10.5

7.1

6.7

Italy

-

7.0

7.6

8.9

9.6

9.5

Latvia

-

-

5.4

6.1

7.4

-

Lithuania

-

-

6.2

6.8

7.5

7.9

Luxembourg

4.8

5.3

5.9

6.7

5.8

-

Netherlands

6.5

7.0

7.7

10.2

11.1

11.2

Norway

5.4

7.1

7.7

8.9

11.4

10.1

Poland

-

4.3

5.3

6.4

6.5

6.6

Portugal

4.8

5.5

8.6

10.0

10.5

11.2

Slovakia

-

-

5.3

7.7

7.2

-

Slovenia

-

-

7.8

8.6

9.5

9.2

Spain

5.0

6.1

6.8

9.1

10.7

-

Sweden

7.7

7.2

7.3

8.3

11.5

11.4

Switzerland

6.4

7.6

9.1

9.9

11.8

-

Turkey

2.4

2.4

4.6

5.0

4.6

-

United Kingdom

5.1

5.1

7.2

10.0

12.0

11.9

Europe

6.1

6.4

7.2

8.7

9.5

10.1

USA

8.2

11.2

12.5

16.2

18.8

17.8

Japan

6.2

5.8

7.0

9.1

11.1

Note: Europe: non-weighted average (27 countries) – EFPIA calculations
Source: OECD Health Statistics 2022, May 2023

22

PAYMENT FOR PHARMACEUTICALS BY COMPULSORYHEALTH INSURANCE SYSTEMS AND NATIONAL HEALTHSERVICES (ambulatory care only)
EFPIA 2021 		

€ million€ million

Austria

3,350

Lithuania

406

Belgium

5,588

Luxembourg

276

Bulgaria

460

Malta

123

Croatia

507

Netherlands

3,315

Cyprus108

Norway1,358

Czech Rep.

1,543

Poland2,099

Denmark

814

Portugal

1,430

Estonia176

Romania

1,590

Finland

1,771

Russia1,500

France26,378Serbia317

Germany

48,648

Slovakia

1,308

Greece2,001

Slovenia

405

Hungary

1,168

Spain

11,747

Iceland99

Sweden2,808

Ireland

2,076

Switzerland

6,090

Italy

7,505

Turkey5,802

Latvia170

U.K.

13,204TOTAL 								156,140

Note: Croatia, Netherlands, Russia: 2020 data; Latvia: 2019 data; Cyprus: 2018 data
France, Ireland, Netherlands, Norway, Sweden, U.K.: estimate
Source: EFPIA member associations (official figures)

23

EFPIAKey Data | 2023

MAIN CAUSES OF MORTALITY IN EU COUNTRIES,
2019 (OR NEAREST YEAR)
Lung

Strokes5%8%Colorectal

3%

ALL DEATHS

Ischaemic
heart
diseases

4,652,641

Diseases ofcirculatory
system11%

Cancers

Breast

26%

35%

2%

Prostate

1%Diabetes2%
Alzheimer'sand Dementia

External
Causes5%

Respiratory
diseases

5%

COVID 192020: 8%2021: 10%

COPD

8%

3%

SuicideAccidents

Pneumonia

1%

3%

2%

Note: The other causes of death not shown in this figure represent 18% of all deaths. Data refer to 2017 for France
Source: Eurostat Database, complemented with OECD Health Statistics 2022 for COVID-19 mortality, Health at a Glance: Europe
2022, OECD & European Commission, page 95.

HPV VACCINES ARE AT LEAST 94.7% EFFECTIVE INPREVENTING HPV INFECTIONS
30,000THIS MEANS THAT, EVERY YEAR, OVER
27,000 CASES AND 12,000 CERVICALCANCER-RELATED DEATHS CAN BE
PREVENTED BY HPV VACCINES

28,92525,00020,000-27,392 cases

15,00012,765

10,0005,000-12,089 cases
1,533

0
CASES
Without HPV Vaccination

24

677
DEATHSWith HPV Vaccination

1. Kjaer SK, Nygård M, Sundstrőm K, et al.
Final analysis of a 14-year long-term
follow-up study of the effectiveness andimmunogenicity of the quadrivalent humanpapillomavirus vaccine in women from four
Nordic countries. EClinicalMedicine 2020;
23:100401.
2. Fernandes A, Viveros-Carreño D, Hoegl J, et al.
Human papillomavirus-independent cervicval
cancer. International Journal of Gynecologic
Cancer 2020; 32:1-7.

THE ADDED VALUE OF
MEDICINES IN HEALTHCAREBREAKDOWN OF TOTAL HEALTH
EXPENDITURE IN EUROPE – 2020

41.1% 40.9% 18.4%

Medicines constitute the smallest part of healthcare
costs with, on average, 18.4% of total health expenditurein Europe being spent on pharmaceuticals and othermedical goods. In costly diseases such as cancer andrheumatoid arthritis, medicines account for less than 20%of the total disease costs. Medicines can also generate
additional savings, for example by substantially reducing
costs in other areas of healthcare, including hospital stays
and long-term care costs.

In-patient care (hospital)

Source: OECD Health Statistics 2022, May 2023 – EFPIA
calculations (non-weighted average for 26 EU & EFTA countries)

Outpatient care & others

Medical goods (including pharmaceuticals)

CHRONOLOGY OF HEPATITIS C TREATMENT (1999-2015)1
H epatitis C is the leading cause of liver transplants and the reason liver cancer is on the rise
+133%

63-80%
cure rate

41%
cure rate
1st generation(1999-2010)
Interferon and ribavarin
injection
48 weeks*

90%
cure rate

2nd generation(2011-2013)
Protease inhibitors w/IFN
injection
24-28 weeks*

3rd generation(2013-2014)
Polymerase inhibitors w/IFN
injection
12 weeks*

95-96%
cure rate

4th generation(2014-2015)
Oral combination
therapies
8-12 weeks*

Improved tolerance and ease of treatment* Treatment duration, INF=interferon;Source: PhRMA, ‘Prescription Medicines: International Costs in Context’ (2017)25

EFPIAKey Data | 2022

EFPIA MEMBER ASSOCIATIONS
Austria
Fachverband der Chemischen
Industrie Österreichs (FCIO)

Ireland
Irish Pharmaceutical Healthcare
Association (IPHA)

Belgium
Association Générale del’Industrie du Médicament(pharma.be)

Italy
Associazione delle Imprese delFarmaco (Farmindustria)

Denmark
Laegemiddelindustriforeningen

Netherlands
Vereniging Innovatieve
Geneesmiddelen Nederland

The Danish Association of thePharmaceutical Industry (Lif )NorwayLegemiddelindustriforenigen

Finland
Lääketeollisuus ry

Norwegian Association of
Pharmaceutical Manufacturers(LMI)

Pharma Industry Finland (PIF)
FranceLes Entreprises du Médicament(LEEM)
Germany
Verband Forschender
Arzneimittelhersteller (VfA)
GreeceHellenic Association of
Pharmaceutical Companies (SFEE)PolandEmployers Union of Innovative
Pharmaceutical Companies(Infarma)
Portugal
Associação Portuguesa daIndústria Farmacêutica (Apifarma)

RussiaAssociation of International
Pharmaceutical Manufacturers(AIPM)
Spain
Asociación Nacional Empresarial
de la Industria Farmacéutica(Farmaindustria)
SwedenLäkemedelsindustriföreningen
The Swedish Association of thePharmaceutical Industry (LIF)
Switzerland
Verband der forschenden
pharmazeutischen Firmen der
Schweiz (Interpharma)
TurkeyArastirmaci Ilac Firmalari
Dernegi (AIFD)
United Kingdom
The Association of the British
Pharmaceutical Industry (ABPI)ASSOCIATIONS WITH LIAISON STATUS
Bosnia-Herzegovina: Association of Research-based Medicine Producers (UIPL)
Bulgaria: Association of Research-based Pharmaceutical Manufacturers in Bulgaria (ARPharM)
Croatia: Innovative Pharmaceutical Initiative (iF!)
Cyprus: Cyprus Association of Pharmaceutical Companies (KEFEA)
Czech Republic: Association of Innovative Pharmaceutical Industry (AIFP)
Estonia: Association of Pharmaceutical Manufacturers in Estonia (APME)
Hungary: Association of Innovative Pharmaceutical Manufacturers (AIPM)
Iceland: Icelandic Association of the Pharmaceutical Industry (FRUMTÖK)
Latvia: Association of International Research-based Pharmaceutical Manufacturers (SIFFA)
Lithuania: The Innovative Pharmaceutical Industry Association (IFPA)
Luxembourg: Innovative Medicines for Luxembourg (IML)
Macedonia: Association of Foreign Innovative Pharmaceutical Manufacturers (HOBA)
Malta: Maltese Pharmaceutical Association (PRIMA)
Romania: Association of International Medicines Manufacturers (ARPIM)
Serbia: Innovative Drug Manufacturers’ Association (INOVIA)
Slovakia: Slovak Association of Innovative Pharmaceutical Industry (AIFP)
Slovenia: Forum of International Research and Development Pharmaceutical Industries (EIG)
Ukraine:
Association of Pharmaceutical Research and Development (APRaD)
26

MEMBER COMPANIES
Full Members
AbbVieLEO Pharma

Almirall

Lilly

Amgen

Menarini

Astellas

Merck

AstraZeneca

Merck Sharp & Dohme (MSD)

Bayer

Novartis

BiogenNovo Nordisk

Boehringer Ingelheim

PfizerBristol Myers Squibb

Pierre Fabre

ChiesiRoche

CSL Behring

Sanofi

Daiichi-Sankyo

Servier

GileadTakedaGlaxoSmithKline

Teva

Grünenthal

UCB

Ipsen

Vifor Pharma

Johnson & Johnson
Affiliate Members

Lundbeck

Bial

Otsuka

Eisai

Rovi

Jazz Pharmaceuticals

Stallergenes

Small & Medium-Sized Enterprises (SMEs)

GenfitAC Immune

Kuste Biopharma

AiCuris

Lysogene

AM Pharma

Minoryx

ByondisPolyphor

ENYO Pharma

ProQR

Idorsia

Spero Therapeutics

ImcyseTransgene
27

EFPIA (The European Federation of Pharmaceutical Industries and Associations)represents the research-based pharmaceutical industry operating in Europe.
Founded in 1978, its members comprise 37 national pharmaceutical industry associations,
40 leading pharmaceutical companies and 15 small and medium sized enterprises undertaking research,development and manufacturing of medicinal products in Europe for human use.
EFPIA aims to create an environment that enables its members to innovate, discover, develop and deliver
new therapies and vaccines for people across Europe, as well as contribute to the European economy.
EFPIA’s vision is for a healthier future for Europe. A future based on prevention, innovation, access to newtreatments and better outcomes for patients.
Through its membership, EFPIA represents the common views of about 2,000 large, medium and small
companies including the entire European research-based pharmaceutical sector whose interests also
include a significant part of the generics and biosimilars segments. Vaccines Europe (VE) is the specialised
vaccine industry group within EFPIA. It represents major innovative research-based global vaccine
companies as well as small and medium sized enterprises operating in Europe.

Further details about the Federation and its activities can be obtained from:

EFPIA
Leopold Plaza Building Rue du Trône 108
B–1050 Brussels Belgium
Tel.: +32 (0)2 626 25 55
www.efpia.eu info@efpia.eu