Q209 sees Belarus added to BMI's Pharmaceuticals & Healthcare quarterly reports for the first time, bringing the total coverage universe up to 71 markets. Of these countries, Belarus occupies 59th position in our Business Environment Rankings, highlighting its status as a true emerging pharmaceutical market. On a regional scale, Belarus places 18th in Central and Eastern Europe (CEE), ahead only of Commonwealth of Independent States (CIS) counterparts Moldova and Uzbekistan. Belarus' pharmaceutical market has undergone a period of robust growth in recent years, a trend we believe will prevail. Over the next five years, sales of pharmaceuticals, which include prescription drugs and over-the-counter medicines, will increase from US$0.62bn to US$1.28bn, representing a compound annual growth rate (CAGR) of 15.5%, among the highest in CEE. Nevertheless, growth from a low per capita spending base means that access to innovative therapies will remain limited. This trend is reinforced by nationalistic government policies which promote the local state owned industry and limited or no reimbursement for products not covered by the essential drugs list. Despite this recent data from the Association of International Pharmaceutical Manufacturers in Russia (AIPM) and Group of Companies Remedium shows a slight decline in the market share of leading domestic producers. Belarus' domestic pharmaceutical output showed continued progression in 2008. According to the National Statistical Committee, production output rose 12.1% year-on-year (y-o-y) to 402.5bn (US$146mn). While this is by no means a blistering pace, BMI views growth as positive for the industry, as many plants only received Good Manufacturing Practice (GMP) certification during 2008. Nevertheless it appears that widespread demand for more sophisticated, if not patented drugs, is resulting in local firms losing ground. The regulatory environment has progressed significantly over five years. Widespread bioequivalence testing is now presence for all government tendered pharmaceuticals. Nevertheless, enforcement of intellectual property remains a challenge and despite claims that counterfeits are not an issue, it is unlikely that Belarus is free of fake products. Despite a somewhat outdated model for healthcare, the ministry of health is making efforts to improve the situation. The 2009 budget approved a 34.7% increase in public healthcare expenditure. This, combined with ongoing improvement projects should help lower the country's hefty disease burden. BMI's Burden of Disease Database (BoDD) predicts that DALYs lost to non-communicable diseases should fall every year between 2009 and 2030. Nevertheless a high rate of infectious disease shows not only poor access to basic healthcare in rural areas. In a sign of developing standards in urban areas, 2009 should see the country's first heart transplantation.
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