Algeria Pharma Market

HEALTHCARE
HEALTHCARE
PHARMACEUTICALS:
LIFE
&
SCIENCES
LIFE SCIENCES
REVIEW
REVIEW
CARVING OUT A MEDICAL CONVERGENCE IN ACTION:
SHAKING UP THE SYSTEM DEVICE MARKET CASE STUDY: SILANES FOCUS ON DIABETES
PHARMACEUTICALS:
THE HYPERACTIVE CARVING OUT A
MARKET MEDICAL
ENTRY CONVERGENCE IN ACTION:
PAGE 21
PHARMACEUTICALS: CARVING OUT A PAGETIPS
56
MEDICAL INTERVIEW
PAGEWITH KARE SCHULTZ,
70 CONVERGENCE INPRESIDENT
PAGE 82
ACTION:
SHAKING UP THE SYSTEM DEVICE MARKET CASE STUDY: SILANES FOCUS ON DIABETES
STATE
SHAKING UP THE SYSTEM FROM THEMARKET
DEVICE EXPERTS ABDELMALEK
CASE BOUDIAF,
STUDY: SILANES & FOCUS
COO OFON
NOVO NORDISK:
DIABETES
PAGE 21 PAGE 56 PAGE 70 PAGE 82
PAGE21
PAGE 11 PAGE5624
PAGE MINISTER OF HEALTH
PAGE 70 THE STRATEGIC RELEVANCE
PAGE 82
PAGE 38 OF ALGERIAN PHARMA.
PAGE 48
MEXICO 2013
MEXICO 2013
COFEPRIS Revamped
COFEPRIS Revamped
Mikel Arriola, the man who changed an institution and an industry PAGE 18
A REGIONAL CHAMPION COMING OF AGE

published in association with
WHY THE ALGERIAN HEALTHCARE SYSTEM IS UNIQUE ACROSS THE MAGHREB PAGE 8
ALGERIA
2013 Brought to you by

2013
2013
December 2014
2
Minister of Health of Algeria

Algiers, 16th of July, 2014
As Minister of Health, I am proud to introduce this first and one-off report on the Algerian
pharmaceutical and healthcare sector. This affords a unique opportunity and effective
communication platform to demonstrate the capabilities of the industry and its actors here
in Algeria.
Over the last decade, Algeria, which now represents the fourth largest economy in Africa
and the second largest pharmaceuticals market on the continent, has been building up its
pharmaceutical industry and has stimulated dramatic developments to improve its healthcare
system to the benefit of its citizens.
2014 represents an exciting period in the history of our country with our government having
articulated an Algeria 2020 vision in which healthcare and innovation lies at the forefront
of our development and investment strategy. As a result, in June 2014, Algeria signed a
strategic partnership to host, by 2020, a biotechnology cluster for the African and Middle
Eastern regions.
Meanwhile our government has reaffirmed its commitment to renovate 320 new health
facilities, and to build more than 1500 new ones, with 45 especially for cancer and diabetes.
Algeria therefore is demonstrating its commitment to ensure better access t healthcare.
With this special report on the industry, I invite all members of the pharmaceutical and
healthcare communities to take a closer look to Algeria’s dynamism and what it has to offer.
Sincerely yours,
M. Abdelmalek Boudiaf
Minister of Health
ALGERIA DECEMBER 2014

3
Acknowledgements
PharmaBoardroom would like to thank
Minister Abdelmalek Boudiaf, Minister of Health and Hospital

Reforms,
Dr. Hamou Hafed, Director General at the MOH
Dr. Djaouad Bourkaib, Director General of Social Security,
Minister of Labour and Social Security
M’hamed Ayad, Director General of PCH,
Slim Belkessam, head of communication at MOH
Reda El Baki, Director General of the Algerian-French Chamber
of Commerce (CCIAF)
Ismael Chikhoune & Amel Benaissa,
President of US-ABC,
Karim Azaiz & Sabrina Abdelatif, Deputy Director General &
Project Director of the Algerian-German Chamber
of Commerce (AKH)
Lazhar Bounafa, Director General of AREES
Farid Benhamdine, President of the Societe Algerienne de
Pharmacie
Kamel Bouzid, President of the
Algerian Society of Oncology
as well as all the companies we have met for their support,

assistance and enthusiasm.

4
CONTENTS
Introducing Algeria’s Parastatal and regulatory actors 5
Evolution of the Algerian Pharmaceutical and Healthcare System 6
A regional Champion coming of Age 8
Dreams, drama and disruption 9
Cultural Idiosyncracies, local adaptations 11
The Hyperactive State 11
The Visible Hand 13
Putting out the Welcome Mat 15
Growth Spots and Uncovered Niches 15
The Janssen approach to tackling Algeria’s changing disease profile 18
Protecting One’s Own 19
Raging against the machine 20
Algeria: next clinical trial destination of choice? 22
Picking Winners 24
Tips for market entrants 24
The Human Resourcing Conundrum 25
Opening the Gates to a Southern Corridor 28
Leadership Prowess 28
Export Shyness 29
Betting on biotech 30
Rethinking hospital Provision 31
A National Plan for tackling cancer 33
Introducing the Mammobile 34
Changing Diabetes in Algeria 35
League Table for the Algerian Pharma Market 36
The Middle Eastern Connection 37
Reforming Healthcare from the top down 38
Lifting the lid of Algeria’s unique Social Security system 40
Voice from the frontline 42
Rise of the regulators 44
Reconfiguring hospital procurement 46
The strategic relevance of Algerian Pharma 48
An unorthodox approach to local pharmaceutical manufacturing 50
Albeit belated, clinical research finally takes off 52
This report was prepared by Pharmaboardroom.com

Project Director: Chiraz Bensemmane Editorial Coordinator: Louis Haynes
Report Publisher: Diana Viola Julie Avena
To read exclusive interviews and more info, please log onto www.pharmaboardroom.com or write to contact@focusreports.net
Copyright
All rights reserved. No part of this publication maybe reproduced in any form or by any means, whether electronic, mechanical or otherwise including
photocopying, recording or any information storage or retrieval system without prior written consent of Focus Reports.
While every attempt is made to ensure the accuracy of the information contained in this report, neither Focus Reports nor the authors accept any
liabilities for errors and omissions. Opinions expressed in this report are not necessarily those of the authors.
5
INTRODUCING ALGERIA’S PARASTATAL

AND REGULATORY ACTORS:
Algeria’s youthful pharmaceutical landscape includes an array of state-controlled entities
of an industrial or commercial nature alongside more conventional regulatory apparatus.
.....................................................................
The National Agency for Healthcare Equipment and Management of Health Infrastructures (AREES)
Delegate project manager to manage, on behalf of the state, transactions or services contributing to the realiza-
tion of health sector investment projects, and secondly, to supervise provision of health equipment based on a
list established by the Ministry of Health.
.....................................................................
l’Institut Pasteur d’Algérie (IPA)

The IPA enjoys exclusive import and distribution rights for serums and vaccines. It plays a critical role in epidemi-
ological surveillance: acting as the national reference point for the identification of infectious and parasitic
disease and tasked with the development of tools and training schemes to counter these disease categories.
.....................................................................
Saidal
The national pharmaceutical company is run as private enterprise enjoying full managerial autonomy despite
being 80% state-owned. Its dual mission comprises: consolidating its lead position as local generic manufacturer
and furthering the cause of national drug policy implemented by the government as controlling shareholder.
.....................................................................
Laboratoire National de Contrôle des Produits Pharmaceutiques (LNCPP)

Algeria’s national pharmaceutical regulator undertakes quality control and evaluation duties alongside research
and training functions. It also enjoys World Health Organisation (WHO) status as an Africa and the Middle East
–wide reference laboratory.
.....................................................................
Pharmacie Centrale Des Hôpitaux (PCH)

The PCH is responsible for the acquisition, stockage management, regulation and supply of pharmaceuticals to
the country’s public health institutions. It is also charged with maintaining strategic and contingency stocks and
itself engages in local production.

6
EVOLUTION OF THE ALGERIAN

PHARMACEUTICAL AND HEALTHCARE
SYSTEM

7

8 pharmaboardroom.com
Special SponSored Section
algeria report
Credit: Mustapha Raith, mustapha@raith.fr

AlgeRiA:
A Regional Champion Coming of Age
N
N
ewcomers to Algeria’s fledgling For many pharma companies, of
ewcomers to Algeria’s growth rate and a GDP per capita mand on both
This sponsored fronts. Combined,
supplement
but increasingly vibrant pharma- course, the true appeal in Africa lies not
fledgling but increasingly projection of USD 5,694, and the they are forecast to account for
was produced by Focus Reports.
ceuticals sector are immediately so much in its size per se – the continent
vibrant pharmaceuticals investment worthiness of Algeria’s an incredible 42 percent of a 100
struck by the sense of liveliness accounts for just three percent of the glob-
sector are immediately healthcare and life sciences sector million strongChiraz
Project Director: populous by 2020.
Bensemmane
pervading the industry. Indeed, as growth al economy – but rather in the dynam-
struck by the sense of liveliness becomes starkly apparent. This is Coordinator:
Editorial further Louiscompounded
Haynes by
patterns in developed markets continue to ics that drive sustained growth and the
pervading the industry. Indeed, as For many pharma companies, of a Report
shift Publisher:
in epidemiological
Diana Viola profile
flatten, and the protagonists of ‘big phar- mounting demand for novel treatments.
growth patterns in developed mar- course, the true appeal in Africa lies from infectiousJulie disease
Avena to chronic,
ma’ pivot towards securing new revenue For Algeria, though, the signs look
kets continue to flatten, and the not so much in its size per se – the non-transmissible ‘lifestyle’ illness,
sources in emergent economies, Algeria promising. This is because the Maghreb
protagonists of ‘big pharma’ piv- continent accounts for just three requiring
For exclusiveever more
interviews andcomplex and
more info, please
must surely constitute one of the more ex- remains locked in the midst of a demo-
ot towards securing new revenue percent of the global economy – but costly
log onto www.pharmaboardroom.com the
treatments. “Algeria is
citing African prospects on offer. graphic transition in which the propor-
sources in emergent economies, rather in the dynamics that drive sleeping
or write togiant of a North African
contact@focusreports.net
What may formerly have been con- tion of adolescent and elderly populations
Algeria must surely constitute one sustained growth and the mounting region that is slowly awakening,”
sidered a healthcare backwater today are increasing simultaneously, heralding
of the more exciting African pros- demand for novel treatments. observes Professor Farid Chaoui
ranks as the second largest pharma- escalating healthcare demand on both giant of a North African region that is
pects on offer. For Algeria, though, the signs of the Euro-Mediterranean think-
ceuticals market on the continent, fronts. Combined, they are forecast to ac- slowly awakening,” observes Professor
What may formerly have been look promising. This is because tank, IPEMED.
worth some USD 3 billion. Add to that count for an incredible 42 percent of a 100 Farid Chaoui of the Euro-Mediterranean
considered a healthcare backwater the Maghreb remains locked in Even when compared to its il-
a population of 38 million, a double- million strong populous by 2020. This is think-tank, IPEMED.
today ranks as the second largest the midst of a demographic tran- lustrious North African peers, the
digit sectoral growth rate and a GDP further compounded by a shift in epide- Even when compared to its illustri-
pharmaceuticals market on the sition in which the proportion of Algerian market would seem to
per capita projection of USD 5,694, miological profile from infectious disease ous North African peers, the Algerian
continent, worth some USD 3 bil- adolescent and elderly populations enjoy a decisive edge. As neigh-
and the investment worthiness of Al- to chronic, non-transmissible ‘lifestyle’ market would seem to enjoy a decisive
lion. Add to that a population of are increasing simultaneously, her- boring healthcare systems con-
geria’s healthcare and life sciences sec- illness, requiring ever more complex and edge. As neighboring healthcare sys-
38 million, a doubledigit sectoral alding escalating healthcare de- front a future characterized by
tor becomes starkly apparent. costly treatments. “Algeria is the sleeping tems confront a future characterized by
ALGERIA DECEMBER 2014 deceMBer 2014 FOCUS REPORTS S2

pharmaboardroom.com 9
algeria report
fragmented health coverage, runaway costs and overburdened

infrastructure, the Algerian model, with its unique brand
of state reimbursement, guaranteed patient coverage of over
85 percent, bulging state coffers from hydrocarbon rent and
wholesome public infrastructure expenditure offers an alto-
gether more robust proposition. “It’s a growing market with a
large purchasing power unlike its neighbors,” explains Saleh
Daghbooshe, general manager of Dar Al Dawa. “Tunisia is
far smaller in terms of population and Morocco does not have
anything like the same customer purchase capability.”
“Right now is a momentous juncture for Algerian health-
care,” agrees Varian’s vice president for Africa, Burt Lang. “The
government is showing real drive to confront chronic disease
head on and that makes it an exceptional time for a multina- Minister of Health, Abdelmalek Boudiaf, with the American
ambassador in Algeria and GE executives at the signing of
tionals like us. The business opportunity, the need and the com- the MoU with GE
mitment from all sides coincide. It’s not like we’re building the
stadium and hoping that people will turn up. We already have perspective of the pharmaceutical provider. “It is amazing that
the game!” even chronic conditions such as cancer are fully reimbursed by
the state. This is a real luxury that translates to guaranteed
Dreams, Drama anD Disruption sales for the pharma companies. Even across the wealthy Gulf
states, it is rare to come across an equivalent,” opines Farghaly.
At heart, Algerian pharma represents a frontier industry in “When you consider the comprehensive social security system
which the adventurous will encounter their fair share of risk you have here, you might even say Algerian healthcare is more
and reward. Pfizer, which enjoys the distinction of being the first akin to that of a South European economy,” affirms Sandoz
multinational to take the plunge into local manufacturing, has Algeria Country Head, Cherif Benguerba.
first-hand experience of this. “We are talking about a market Tempering these selling points, though, lies an equally bewil-
that is undoubtedly full of promise, but also one that is com- dering array of characteristics that many an investor would re-
monly regarded as one of the toughest to master,” explains coun- gard as inconvenient, if not downright disruptive. For instance,
try manager, Amina Hamoutene. As might be expected of what “one of the eccentricities of the Algerian pharmaceutical sector
she terms a “still relatively immature” market, there are plenty of has been the woeful lack of a centralized distribution,” observes
quirks and unusual features. On the one hand, there is a whole Deloitte Algeria’s partner, Arnaud de Rincquesen. “Unlike many
array of opportunities that investors would find hard pressed to countries where cooperatives have been established to fulfil this
identify elsewhere in the region. “In the Middle East, you gener- function, the producers of medicines find themselves forced to
ally find pure branding markets. The main difference with Alge- shoulder the logistical burden of distributing to thousands of
ria is that it is both semi-branding and semi-commercial,” notes pharmacies, many of which are sluggish in paying for what they
Essam Farouk, the CEO of Saudi-Jordianian owned local outfit have purchased,” he explains.
El Kendi. “This is extremely exciting for a company like us be- Also troublesome is the lack of market
cause it allows us to be bold in two different directions – both on data on which to base sound decision mak-
the marketing side and the manufacturing side,” Farouk adds. ing. Algeria is still in the starting blocks
Yasser Farghaly, country manager of Janssen, makes a simi- with regard to data collection at hospital
larly upbeat analysis. “Algerian healthcare presents unparalleled level,” remarks IMS Health’s country man-
market opportunities both on the retail side and for the hospital ager, Hocine Mahdi. “There are currently
business,” he declares. “We’re seeing double digit growth virtually approximately 100 private wholesalers
everywhere and the physicians are increasingly brand conscious. who are operational in retail market and
Hocine Mahdi, our panel is representing more than 70
On top of that, local manufacturing is performing well, now that
country manager,
it is highly backed by the government. It’s a unique combination.” IMS Health Algeria percent of the market thus allowing us
Perhaps the most attractive draw of all, however, is a dis- to offer a strong retail audit. Acquiring
tinctive healthcare system of near-universal coverage free-at- hospital data is more complex due to the monopoly of the PCH
the-point-of-delivery treatment in which ‘solidarity’ and ‘ac- which means we require an official approval from the Ministry
cessibility’ are the watchwords. Not only does this contrast of Health. We are confident, though, that we can build a strong
strongly with the out-of-pocket expenses systems typical across partnership with the health authorities in which strong collab-
the MENA region, but it brings considerable rewards from the orative relations with the PCH form the first step,” he asserts.
S3 FOCUS REPORTS deceMBer 2014 ALGERIA DECEMBER 2014

10

algeria report
A seriously disjointed market is another hallmark, with a a one-size-fits-all

plethora of different actors, many of which are small family- approach over here
run outfits with limited managerial and business development simply won’t work,”
awareness. “It’s the sort of splintered marketplace where you’ll affirms Roche’s head
encounter a high volume of one or two-man start-ups such as of North West Af-
the pharmacist who’s set up a tiny distribution entity just to en- rica, Ralf Halbach,
sure a steady supply to his store,” points out one industry insider. “awareness of lo-
“There is certainly a general unwillingness on the part of this cal sensitivities and
multitude of family firms to consolidate the market to a level adjusting your me- From left: Ralf Halbach, North & West Africa
where suitable size investments in R&D can be made,” agrees dium, message and general manager, Roche; Peter Ulvskjold,
Algeria general manager, Novo Nordisk
de Rincquesen. entire marketing ap-
proach to fit the indigenous culture is of paramount importance
Cultural iDiosynCrasies, if you strive to be successful.”
loCal aDaptations Danish healthcare company Novo Nordisk is one foreign
incomer that has won plaudits for actively leveraging local cul-
Then there are the bountiful cultural and social endowments that ture to improve treatment of a chronic disease. “We have been
render Algerian pharma a fairly unique marketplace for doing collaborating with the Ministry of Religious Affairs and suc-
business and, more often than not, call for the adoption of im- cessfully enlisting the imams in the mosques to promote diabe-
provised and non-conventional solutions. “Trying to transplant tes prevention and raise awareness of the dangers of diabetics
The hyperactive state

After years of anemic spending in the health domain, the gov-
ernment is now pulling out all the stops to revolutionize na-
tional healthcare and kick-start the development of domestic
pharmaceutical industry capable of leading North Africa.
Ramping up Spending
 Heavy investment in healthcare to the tune of 619 billion
dinars (USD 7.09 billion) under the five-year plan currently
From left: Pr. Bouslimane Mohamed Mansouri, director general,
in force. Laboratoire National de Controle des Produits Phamaceutiques
 Government health expenditure projections for 2014 are (LNCPP, National Laboratory for Control of Pharmaceutical
USD 10.49 billion for healthcare and USD 3.75 billion for Products); M’hamed Ayad, director general, Pharmacie Centrale
pharmaceuticals. des Hopitaux (PCH); Pr. Kamal Kezzal, head manager, Pasteur
Institute of Algeria
Activist Industrial Strategy
 Target of 70 percent of national pharmaceutical consump- Regulatory and State Apparatus
tion to be manufactured domestically.  “The World Health Organization has invited us to join an
 Ban on importation of pharmaceuticals that can be pro- ‘Expert Advisory Panel on the International Pharmacopoeia
duced domestically.
and Pharmaceutical Preparations,’ further demonstrating
 49/51 joint venture rules whereby Algerian nationals must
the increasingly influential role played by Algeria in health-
possess the controlling stake.
care at the regional and international levels.” - Bouslimane
National Cancer Plan
Mansouri, General Manager of the Laboratoire National de
 An eight-point National Cancer Plan mandates the con-
Contrôle des Produits Pharmaceutiques (LNCPP).
struction of 19 anti-cancer centers (ACCs), five functional
 “Algeria’s PCH is embarking on a modernization of its man-
radiotherapy centers and five privately run cancer clinics.
The budget allocation for each ACC is 4.5 billion dinars agement systems in partnership with Telecom Algeria. The
(USD 53.60 million). soon-to-be installed enterprise resource planning (ERP)
Massive Infrastructural Projects mechanism is set to considerably improve efficiency of
control of stock, supply and distribution.”- Ayad M’Hamed,
 The newly established National Agency for Health
Equipment and Management of Health Infrastructure Director General, Pharmacie Centrale des Hôpitaux.
(AREES) “has been tasked with supervising the roll out  “Work is underway for the development of new produc-
of ten brand new university hospital centers (CHUs) by tion techniques and cell cultures allowing us to evolve our
2019, bringing the overall total number of CHUs to 24.” vaccines and to produce tomorrow what we import today”
- Lazhar Bounafa, Director General of AREES - Kamal Kezzal, Head Manager, Institute Pasteur Algeria.

12

algeria report
dramatically changing eating patterns taboo,” proudly remarks the company’s

during the holy month of Ramadan,” general manager, Amor Habes.
recalls general manager, Peter Ulvskjold. “The fields of gynecology and obstet-
Likewise, AstraZeneca is demon- rics require a certain degree of cultural
strating effectiveness in harnessing lo- sensitivity in Algeria, such as ensuring
cal customs to realize positive healthcare that female patients are being seen by
outcomes with its plans to mobilize all- women practitioners, but demand is abso-
women ambassadorial teams to widen un- lutely booming with a spate of new private
derstanding of woman-centric illness such From left: Dr. Hamou Hafed, director general fertility clinics opening their doors in the
as breast cancer. “We understood that by of pharmacy and medical equipment, last couple of years,” notes Ferring gen-
Ministry of Health; Djaouad Brahim
far the best approach would be to work Bourkaib, director general of social security, eral manager, Mohamed El Hadi Bena-
with the local culture on the ground. It Ministry of Labour & Social Security mar. “Right now there are more than 14
was obvious to us, that women themselves specialized fertility clinics in the country
would be the appropriate messengers for ible complement to the traditional distri- and more are on the way,” he discloses.
transmitting this knowledge,” explains bution channels. “We were actually the One rather common pitfall for new
general manager, Habib Bennaceur. very first company to start to communi- entrants, however, is to arrive in the mar-
Para-pharmaceutical manufacturer cate ‘femcare’ products. Massive promo- ketplace with misconceived or outdated
Faderco, meanwhile, has made inroads tion across diverse media helped us to perceptions about Algerian society. “Al-
into overcoming the taboo of elderly in- break the psychological barrier within geria’s business environment isn’t widely
continence by smart product placement consumers. Nowadays consumers are known, though there are often erroneous
of its adult nappies in local supermarkets more open-minded and the purchase of perceptions. Generally, German firms
and corner shop groceries as a highly vis- femcare products no longer considered come to Algeria with a question mark in
their minds. They wonder whether the
country is more West African or East Af-
rican in terms of work style. First-timers
then are often very pleasantly impressed
when they discover that doing business in
Innovation is about Algeria isn’t that far removed from oper-
ating in Morocco or Tunisia,” recounts
taking new perspectives Karim Azaiz of the Deutsch-Algerische
Industrie-und Handelskammer (AHK).
Karim Achaibou, North Africa area
manager of Innotech, is even more forth-
Deloitte is not just a provider right. “Algerian culture is actually not half
of multidisciplinary services in Algeria. as conservative as it might appear at first
It is also an innovative professional services glance. It is a complete misconception that
leader with a presence in Africa for more issues such as contraception are taboo. In
than thirty years.
fact, when you compare the Algerian con-
With our sectorial expertise, combining sumer to their peers in neighboring coun-
the quality of our local resources and the tries like Morocco, where superstition and
competencies of Deloitte’s network, we
non-conventional tribal therapies are rife,
provide both economic and institutional
players with tailor-made solutions, whether you will notice a stark difference. By con-
they are private or public. trast, the Algerian public tends to be well
informed about treatments, brand con-
Innovation shapes our solutions.
scious, and extremely respectful of a doc-
Deloitte Algeria Deloitte Algeria
tor’s counsel,” he reveals.
Algeria Business Center Tower Business
Algeria - Pins Maritimes
Center Tower - Pins Maritimes - 16130 Alger
16130 Alger - Mohammadia - Algérie - Algérie - Tel. : + 213 21 89 12 50
Mohammadia
Tel. : + 213 21 89 12 50
Visit us at www.deloitte.dz
the Visible hanD
Visit us at www.deloitte.dz
Copyright
Copyright 2014 Deloitte Algérie 2014 Deloitte Algérie One distinguishing trait of Algerian
health and life sciences is the relentless
presence of the state that permeates the

3x117_475
magenta
cyanmm Flash_1-1.pgs 11.17.2014 20:39
yellow
black ADVANSTAR_PDF/X-1a
14 pharmaboardroom.com
algeria report
entire spectrum of activities. This is mani- tion are necessary measures so as to be

fested both in the healthcare arena, where able to release sufficient funding to pay
an avalanche of state sponsored initiatives for the treatment plans of “each and every
are underway to significantly raise the citizen”.
quality of provision, and in the pharma- The state’s reference price mechanism
ceutical sector, which is directed from on comes into play for all reimbursed prod-
high as a strategic industry of considerable ucts. “We inform the custodian laborato-
national interest. ries that they must decrease their product
For his part, Algerian Health Minister From left: Dr. Abdelouahed Kerrar, president, prices so as to end up with a preferential
Abdelmalek Boudiaf has been explicit in National Union of Pharmaceutical Operators price in Algeria compared to the price in
(UNOP); Mohamed El Hadi Benamar, general
outlining his intent to “steer the system” manager, Ferring the home country,” explains Bourkaib.
to achieve positive social outcomes. “We “The rationale for this approach is very
are putting into action a coherent policy that will not only en- simple: the laboratories are well aware that the Algerian state
able our pharmaceutical industry to meet the nation’s needs, but doesn’t possess the same means as some OECD countries, but
ultimately to conquer outside markets as well. Algeria will not is able to ensure sales volumes once it grants reimbursement.
remain an eternal importer. We have the means and the opportu- This assured volume offers laboratories enough leeway to
nities at our disposal to determine the industry’s future and will comfortably make some concessions by revising their prices
deploy them,” he declares. downwards.”
“Our priorities, apart from sustained growth of the drug Some multinationals, however, suggest that the end-effects
market, revolve around the sorts of political lines that charac- can actually be far from comfortable. “We’ve experienced in-
terize any sensible pharmaceuticals policy: enhanced availability stances where Algerian prices for some of our products have
of and access to medication and championing the development been hammered well below their equivalents in Tunisia and
of a strong home-grown pharmaceutical industry,” concurs the Morocco, all because of an unexpected price plummet back
ministry’s director general of pharmacy and medical equipment,
Hamou Hafed.
“In addition to a youthful, but increasingly meddlesome
regulatory framework, state orchestration of the pharmaceuti-
cal market generally takes place through two main power levers:
The drug reimbursement/reference price systems and protection-
People Come First
ism of local manufacturing against a tidal wave of foreign im-
ported medicines,” notes Abdelouahed Kerrar, president of the
National Union of Pharmaceutical Operators (UNOP).
Pharmaceutical companies trying to sell retail products are
more or less compelled to strive for reimbursement. Failure to
secure it effectively kills their product since a slice of the market
will be unable to afford the costed medicine while the rest will
prove unwilling, because the consumer is already in the habit of
expecting the state to pay for his medication.
“Algeria has been vigorously promoting generic products
wherever they exist because it is less expensive” admits the
government’s director general of social security, Djaouad
Bourkaib, “because, providing they conform to the requi- Headquartered in Switzerland, Ferring Pharmaceuticals is a research-driven,
site quality standards, they offer the same therapeutic ben- specialty biopharmaceutical group active in global markets. The company identifies,
develops and markets innovative products in the areas of reproductive health,
efits as the originator drugs, but for a mere fraction of the
urology, gastroenterology and endocrinology.
price.” “Some actors are very critical with regard to the re- Ferring has its own operating subsidiaries in 45 countries and markets its products in
imbursement committee comments, but we have no choice: more than 70 countries. To learn more about Ferring or its products please visit
www.ferring.com
the growth of drug reimbursement expenditure in Algeria has
been in double digits for the last 5 years (between 15 and
20%). It is simply not economically feasible to reimburse the
totality of products available on the market,” He explains.
The government rationale is therefore that state enouraged
MEDICINE ON THE BODY’S OWN TERMS
import-substitution, local production and generic consump-

pharmaboardroom.com
15
algeria report
in France,” explains the Guillaume Seillier, country projects that generate positive health outcomes.
manager of French company Servier. “Regardless of whatever specific incentives the
state might offer to multinationals to invest at a
putting out the WelCome mat single point in time, the Algerian government has
a long track record of encouraging the overall
Whatever inconveniences an MNC can expect to en- growth of the sector. The intent on the part of
counter as a result of state institutions tinkering with the state is clear for all to see. The government is
the market, there can be absolutely no doubt that for- firmly ‘with the industry’ so to speak; this mat-
eign investment is welcomed and highly sought after Abdelmalek Boudiaf, ters a great deal to us,” explains El Kendi’s Es-
by government and local private enterprise alike. FDI Minister of Health sam Farouk.
inflows currently stand at USD 1.5 billion, 65 percent
of which represents investment in industrial sectors such as phar-
maceuticals and infrastructure.
According to Health Minister Boudiaf, the government has Growth spots and uncovered niches
deliberately set about creating an enabling ecosystem in which Cardio therapies become big business as other market
pharmaceutical investment can flourish. “We have gone out of segments are left behind.
our way to foster an investment friendly environment unique to Algeria’s patterns of medicament consumption have
the region – a secure and solvent context, concessions, five year been shifting dramatically. Among the top ten products
tax exemptions, land zoning systems and much else – because we sold nationwide, three currently constitute cardiovascular
understand that the collaboration of our foreign partners is an es- products: the sale of anti-cholesterol and anti-hypertension
sential component to the realization of our vision,” he points out. medications is thus a lucrative business in Algeria. Tubercu-
Many multinationals testify to the reality of the state’s losis, meanwhile, represents the only remaining infectious
disease of note with a prevalence rate of 55.9 cases per
efforts to entice investment and to back foreign-initiated
every 100,000 habitants.
The repercussions of this trans-
formation have been far-reaching for
public health policy and the pharma
industry alike. Former Health Minister
Messaoud Zitouni recalls how “fight-
ing infectious disease in the 1980s
was all about delivering treatment,”
contrasting strongly with today’s con-
text, where “the battle against chronic
illness entails much greater attentive- Messaoud Zitouni,
ness to resource management, pre- head of Algeria’s
vention and early diagnosis.” Cancer Plan
In the midst of this hubbub, cer-
tain therapeutic areas that are expe-
riencing rising demand have remained
surprisingly quiet. The reason why
dermatology remains “a little bit out
of the picture” is because diseases
such as psoriasis are “all too often
wrongly categorized as cosmetic and
aesthetic issues rather than strictly
medical problems, thus ineligible for
state reimbursement,” reveals Nawal Nawal Baba-Hamed,
general manager,
Baba-Hamed, Pierre Fabre’s general Pierre Fabre
manager. What’s more, exceptionally
high rates of counterfeiting (up to 40
percent of all skincare products sold are fake) also take
their toll by eroding profit margins. For that reason Baba-
Hamed has been appealing for the “establishment of an
autonomous national cosmeto-vigilance agency.”
insert serviermagenta
cyan
yellow
QP.tff 11.22.2014 06:24 ADVANSTAR_PDF/X-1a
black
S9 FOCUS REPORTS deceMBer 2014
16

algeria report
“The government’s action dine Ioutichene. “This is an im-

is stimulating the private mar- mensely positive step enabling
ket and this is precisely why we both foreign private enterprise
have come,” agrees Varian’s Burt and the host country to blossom
Lang. “If your business project and flourish.”
benefits the nation you can rest One example of this new ap-
assured that the ministry will proach has been the multi-mil-
prove willing to throw its weight lion dollar contract awarded to
behind it,” confirms Pierre Lab- From left: Noureddine Ioutichene, executive dir. managing Varian for the supply of linear
bé, CEO of Sanofi. director algeria, MSD; Pierre Labbé, CEO, Sanofi Aventis Algeria; accelerators and radiography
Essam Farouk, CEO, El Kendi
What is perhaps most inter- equipment to the new ACCs
esting, however, is the Health cially since government incentives are being established across the
Ministry’s redrawing of the rules of en- highly advantageous to investors,” clari- country. “The ministry was very clear
gagement and manner in which it wishes fies Hamou Hafed. that they were not looking for the type of
foreign firms to participate in the market. “For several years now, the health au- company that sells equipment and then
Foreign firms are now strongly incentiv- thorities have been preparing the ground disappears, but rather a firm that would
ized to launch into local manufacturing for pharmaceutical companies to not only commit to establishing a local entity of-
and other forms of activity that maxi- ‘do business’ but also, to entrench them- fering after-sales service in the sense of
mize the opportunity for technology selves within Algeria and actively contrib- training clinicians and supporting the
transfer. “We do not expect that interna- ute to the evolution of different facets of long-term operation and maintenance. In
tional companies place their entire prod- the industry such as the risk prevention- short, a genuine partner properly vested
uct lines in Algeria, but it is legitimate to side, continuous education and clini- within the country,” explains Burt Lang.
request transfer of technologies in order cal research,” confirms MSD Algeria’s The same can be said of tenders for
to develop the domestic industry, espe- executive managing director, Noured- the new CHUs that have been contracted

pharmaboardroom.com
18Special SponSored Section
algeria report
out to leaders in hospital construction

and management. “We have been en-
listed as real collaborators to provide The Janssen approach to tackling Algeria’s evolving disease profile
a real turnkey solution that will be all
ready to ‘plug-in-and-play’ when we Janssen Algeria, part of the Janssen Pharmaceutical Companies
hand over the keys,” explain Nicho- of Johnson & Johnson, focuses on some of the most devastat-
las de Roquefeuil and Thomas Hin- ing and complex medical challenges afflicting the country, offer-
terleitner of the Bouygues Batiment ing therapies across five areas: Oncology, Cardiovascular and
Metabolism, Immunology, Infectious Disease and Neuroscience.
International-VAMED-APHP Con-
Its operations started back in 1996 and today comprise two
sortium, recently awarded the con-
separate legal entities: Janssen Pharmaceuticals Liaison bureau
tract for the construction of a brand
(tasked with conducting medical education and promotion ac-
new CHU in Constantine. “This is tivities) and Janssen-Cilag SPA (for our local manufacturing and
about a foreign management support- Yasser Farghaly,
product commercialization). Mobilizing a dynamic and ambitious
ed hospital. We categorically don’t country manager
Algeria, Janssen team of more than 70 talented Algerians, they work both within
see ourselves as the private operator. and beyond their communities to bring innovative treatments to
Instead we are the guys who deliver some of the country’s more serious unmet medical needs.
the international expertise to a local They understand their core mission as “undertaking extraordinary efforts to en-
management team so as to eventually able people to enjoy ordinary moments.” Aware that Algeria is in the midst of an
enable them to take full charge of the epidemiological transition whereby patients are facing ever more complex medical
day-to-day operations.” challenges, they strive to stretch beyond their own four walls in the search for new
Such an approach also stands to medicines. Their approach is, therefore, to look towards the entire world as their lab,
benefit many of the old-timers in the seeking innovative ideas wherever they occur and pooling their own capabilities with
market who have for many years been those of the most creative minds in every field.
endeavoring to align their in-country
magenta
cyan
yellow HP_Janssen_1-1.pgs 11.22.2014 07:04 deceMBer 2014 FOCUS REPORTS
ADVANSTAR_PDF/X-1a S12
black
pharmaboardroom.com
19
algeria report
proteCting one’s oWn

Any foreign investor seeking to engage in a joint venture with a
local entity is obliged to abide by Algeria’s notorious 49/51 rul-
ing, which limits the participation of a foreign investor in a local
company to a maximum shareholding of 49 percent. First imple-
mented in 2006 for the hydrocarbons industry, the regulation
From left: Dr. Karim Bendhaou, President for North & West Africa, was expanded in 2009 to cover investments in all sectors of the
Merck; Reda El Baki, general manager, CCIAF; Burt Lang, senior economy, thus impacting the pharmaceutical community. Despite
managing director, Varian its initial controversy and fears that the measure would dampen
investor confidence, the volume of foreign firms engaging in local
strategies with the government’s policy agenda and to distinguish partnerships nonetheless continues to increase unimpeded.
themselves from superficially integrated competitors that set up On an intellectual level, if you follow the logic of a foreign in-
a ‘bureau de liaison’ to flaunt their products and then repatriate vestor, this is of course looks terribly out of kilter with the norms
the profits without making any kind of tangible investment. “We of globalization, but appearances can be deceptive as Karim
endeavor to marry with the local strategy of the authorities and Bendhaou, Merck Serono’s President for North and West Africa,
respond to whatever the government is trying to put in motion,” explains: “The 49/51 percent ownership requirement could be
reveals Pfizer’s Amina Hamoutene. “The gusto with which we a matter of concern for a foreign investor out of fear of losing
have embraced local manufacturing demonstrates this. We are control over business. Nevertheless, contracts still permit to in-
keen to impress upon the government that we are the real deal, fluence the structuring of the factories and the fabrication units,
an authentic partner.” so in this regard Algerian law does allow for a certain degree of
flexibility and permissiveness between pact partners.”
“Indeed, the rule stipulates that, in any joint venture, the Al-
gerian partner must necessarily be an Algerian incorporated en-
tity owned 51 percent by Algerian nationals who are at the same
time Algerian residents. It does not say the partnership has to be
necessarily structured as a 49/51 percent joint venture so that in
itself allows for workarounds such as the subcontracting of local
content by foreign bidders,” explains Samir Sayah, lead partner
at CMS Law firm. “Besides, any foreign investment in partner-
ship which contributes to the transfer of know-how towards Al-
geria, automatically benefits from tax and tax-like benefits so
there are ample financial incentives to offset concerns about the
rule itself.”
“It is certainly the case that Algerian pharma is the kind of
market where companies fall on their feet; there’s something in it
for everyone,” muses the general manager of the French-Algerian
Chamber of Commerce (CCIAF), Reda El Baki. “None of our
members have quit the market over JV rules. They’re all too busy
making a profit. With return on investment generally of the or-
der of 10 to 12 percent out here, the mood is buoyant; so much
so that our members have felt fairly insulated from the global
economic downturn.”
Others, however, disagree and claim that the inflexible joint
venture rules create what Deloitte’s Arnaud de Rincquesen terms
a “lopsided and distorted market” in which an entire strata of
international SMEs is absent. “While big pharma can lever-
age their influence in other ways, the very SMEs usually tasked
with pioneering innovation find themselves unable to relinquish
that amount of control so are effectively locked out of the mar-
ket,” he says. In his analysis, it would be unwise to overlook the

pharmaboardroom.com
20
algeria report
importance of these SMEs because it’s “precisely “We want to improve our ranking
those companies that are dynamos to growth, not but ultimately there are entrenched
the giants.” hurdles that are hampering our prog-
Meanwhile, Karim Azaiz of AHK argues ress – essentially the long timeframes
that he has himself witnessed this very trend for getting new products registered
amongst the chamber’s members with “techno- and the unpredictable and opaque
logically innovative family-run German enter- regulatory and legal frameworks.
prises dissuaded from entering into fully fledged Pfizer is essentially an R&D com-
joint-ventures and opting just for distribution From left: Arnaud de Rincquesen, partner, pany. The mainstay of our business
agreements instead.” Deloitte Algeria; Amina Hamoutene, should therefore be introducing new
country manager, Pfizer Algeria
molecules that are too difficult to
raging against the maChine manufacture on the ground in Algeria” laments Pfizer Algeria’s
Amina Hamoutene.
In many respects, it is not the rules themselves that stakeholders “Product registration procedures are long and there is or-
have a problem with, but more the manner in which they are dinarily a lag time of several years between the introduction
applied and the regularity with which they are amended. Com- of a new molecule in Europe and its arrival in Algeria,” ex-
pared with developed countries, Algerian tax codes and fiscal plains Chiesi Algeria’s country manager, Karima Sadok. “All
burden can be described as neither complex nor onerous, but too often, Algerian doctors misinterpret this and think that
they can be faulted for a lack of stability. References to the “bu- international firms are reserving their latest generation prod-
reaucratic black box” and “revolving door of health ministers” ucts for their home markets. This is far from the case. We are
(no fewer than seven in the last ten years, each with their own trying our very best, but battling the bureaucratic machine is
entourages and ideas) are commonly voiced. heavy going.”
Sandoz Leader mondial de l’Anti-infectieux1

12 Centres de Recherche et Développement1
Médicaments de haute qualité1
1er fabricant de génériques Européen dans le monde1

Présence mondiale dans 130 pays1
Leader mondial des biosimilaires1
1. Document Sandoz France ( PARTAGEZNOTREVISION) - PPR 0660310/1 - Avril 2010: 02 - 24
magenta
cyan
yellow
black Sandoz HP_1-1.pgs 11.17.2014 20:38 ADVANSTAR_PDF/X-1a
deceMBer 2014 FOCUS REPORTS S14

21

22Special SponSored Section pharmaboardroom.com
algeria report
The government, for its part, is sympathetic to these concerns fects, effectiveness of active ingredients, the risk-benefit balance
and realizes that the bureaucracy still has much to do to optimize and cost-benefit ratio,” he reaffirms.
its standard operating procedures so as to speed up registration Though she jokes that “Algeria must have inherited its bloat-
times. Director General of Social Security Djaouad Bourkaib is ed bureaucracy from France,” Nadia Oka-Bousbia, bioMéri-
nonetheless keen to assure all stakeholders that the registration eux’s country manager, is not so much concerned by the tur-
and reimbursement processes are clearly defined and conducted pitude of the system, which she sees as “gradually improving,”
in a highly scientific manner. “Every decision taken is grounded as the fact that the rules of the game can change at a moment’s
in scientific fact taking into account therapeutic value, side-ef- notice. “Laws are so fluid and subject to amendment that it is
Algeria: Next clinical trial destination of choice?

Long regarded by the scientific community as somewhat percent of global clinical trials. This basically means that
of a laggard in clinical research, Algeria would finally drugs sold here have never been tested on our popula-
seem to be making amends, and in a pretty big way too. tion despite the increasingly important role that genetics
There was a time when clinical trials in Algeria essen- play in therapeutic efficacy,” he declares.
tially meant observational, Phase IV “post-marketing” “What is also particularly pertinent when consider-
studies, but that is now changing, according ing Algeria’s genuine potential as a preferred
to Cellia Habita, CEO of the American CRO Ari- clinical trials destination is the fact that the
anne. “Algeria has a tremendous potential for country possesses a predominantly Caucasian
conducting all types of clinical trials, particular- population,” highlights Habita. “Genetically,
ly interventional studies within a global setting. Algerians are much closer to the Western civi-
The country has a well-educated workforce, lizations, thus there is a real opening for in-
especially when it comes to investigators and tegrating the data without risking the sorts of
their staff. Algeria’s hospitals in the regions are differences that could ultimately compromise
also comparable with those in Southern and the performance of the product when sold on
Eastern European countries, so the appropriate Western markets,” she explains.
Jean-Paul Digy, vice In other aspects too, Algeria would appear
infrastructure is definitely there. Algeria repre- president for Africa,
sents a real competitive alternative.” to be highly competitive as a clinical trial pros-
Novo Nordisk
Currently, Novo Nordisk is the company run- pect: the country has surprisingly attractive
timelines for regulatory approval (a mere three
ning the highest number of clinical trials in
months) and a centralized system of ethical
the country, with a minimum rate of five or six
committees that also significantly speeds up
Phase IIIa and IIIb trials per year. Recently Novo
the final approval process.
Nordisk made the headlines for becoming the
“Good clinical research is contingent upon
first firm to explore the clinical effects of taking the availability of skilled physicians, well-fund-
base insulin when the daily routine of eating is ed universities, a fully functioning and effective
disrupted. The study, which aimed at enquiring healthcare network, experienced CROs, and
into the implications of diabetics’ observation the goodwill of the authorities. AstraZeneca
of Ramadan, represents a landmark moment in Cellia Habita, CEO, has identified the presence of all of these in-
Algeria’s short clinical research history because Arianne gredients in Algeria which is why we have been
the trial will subsequently be exported and rep- strengthening our in-country presence,” re-
licated elsewhere. marks the company’s general manager, Habib
“Taking full ownership of the clinical trial pro- Bennaceur.
cess is actually one of the hallmarks of Novo What remains now is for the various stake-
Nordisk in Algeria. We believe it affords us a holders to grasp this opportunity. “The clini-
unique opportunity to really familiarize ourselves cians and investigators are showing great
with our end customers and also enables us to willingness: they aspire to participate in inter-
control the safety and efficacy of a drug at each national studies, not just Phase IV observa-
different stage of its development,” explains tions. The ball is now firmly in the court of the
Jean-Paul Digy, the vice president for Africa. pharmaceutical industry, to come to the author-
Salah Eddine Sahraoui, CEO of Clinica Group, Salah Eddine ities with programs that meet national needs,”
wholeheartedly agrees with this approach. “To- Sahraoui, CEO, concludes Amel Daoudi, general manager of
Clinica Group
day’s emerging countries participate in only two Bayer Algeria.

23
Merck.
LiveabetterLife.
THE FORMULA FOR A BETTER LIFE

WE’RE WORKING ON IT – EVERY DAY!
www.merckgroup.com

pharmaboardroom.com
24
algeria report
tremendously difficult to formulate a development strategy that

you can actually stick to,” she sighs.
For some, the “chopping and changing” is symptomatic of
a lack of direction. “What we really need is a dialogue involv-
ing all stakeholders so we can debate frankly what sort of in-
dustry and healthcare system would be optimal for Algerians
as a nation instead of attempting to copy all sorts of existing
models, not well adapted to our country,” suggests the general
manager of GSK Algeria, Mohamed Benali Khoudja. From left: Pr. Farid Chaoui, project manager, IPEMED (Institut
For others, it is because power is dispersed across the bu- de Prospective Economique du Monde Mediterraneen, Euro-
Mediterranean Think Thank); Boumediene Derkaoui, CEO, Saidal;
reaucratic apparatus, leaving no single agency fully in control. Farid Benhamdine, president, Algerian Society for Pharmacy
“There is an ideological choice to make: between a ‘supermar-
ket’ healthcare system, where the individual gets treatment scale of this achievement. In contrast with other Maghreb
based on what he can afford, and a system that makes the case markets that are dominated by foreign firms, 80 percent of Al-
for solidarity and equity. Algeria has yet to settle the question, geria’s medicine manufacturing capabilities are owned by Al-
because there is a clear discrepancy between the official politi- gerian nationals, with many having proved more than capable
cal discourse, which advocates for solidarity, and administra- of holding their own against incoming foreign competition.
tive reality that seems to favor the haves,” remarks IPEMED’s Boumediene Derkaoui, CEO of Saidal, Algeria’s state-
Farid Chaoui. owned pharmaceutical company, urges people not to under-
estimate the feat of growing an industry like this from scratch
piCking Winners? in such a short space of time. Saidal was created in the so-
called ‘dark years’ of the 1990s, essentially to kick-start the
One area where Algeria has scored notable successes has been government’s agenda of pharmaceutical import-substitution
in developing a homegrown pharmaceutical manufacturing and even today, continues to cast its influence, signing pro-
base, even if the government’s ambitious target of 70 percent duction agreements with foreign multinationals at a rate of
local production still remains some way off. A cursory com- roughly five per year. “We are proud of what we have built
parison with neighboring Morocco and Tunisia reveals the and Saidal’s own specific contribution to the task,” affirms
Derkaoui. “Nowadays our laboratory is also regularly used as
a reference price for calculating reimbursement.”
Tips for new market entrants Farid Benhamdine, president of the Algerian Society for
Pharmacy, agrees that the local pharma industry is a “source
Insights from existing players on what to expect and how of great national pride” and a great example of the country
to succeed.
“The key to being successful is to be direct and forth-
right with the Algerians themselves. Trust in them and they
will certainly trust in you.” – Essam Farouk, CEO, El Kendi.
“The pace of doing business is very different from in
Europe - as the saying goes, ‘gently in the morning and not
too fast in the evening.’ A measure of patience and perse-
verance is helpful.” – Fatima Zohra Mostefaoui, general
manager, Medicalliance.
“Don’t fall prey to misconceptions and outdated stereo-
types. Go in with your eyes wide open and see the Alge-
rians as they really are. You will really like what you see.”
– Karim Achaibou, North Africa area manager, Innotech.
“Never lose heart. This is a fine market where there’s
something in it for everyone.” – Reda El Baki, general
manager, CCIAF.
“Algerians are audacious people renowned for making
things happen… look beyond the administrative inconve-
niences and understand that this industry is approaching
its heyday, this is very much the moment for you to be
here!” – Cherif Benguerba, Algeria Country Head, Sandoz
Novo Nordisk’s manufacturing facility in Tizi Ouzou
deceMBer 2014 FOCUS REPORTS S18

pharmaboardroom.com
Special SponSored Section 25
algeria report
“pulling itself up by its bootstraps and needs, there was a massive overcapac- indigenous producer Laboratoires
learning the right lessons.” He shares ity of 70 percent for paste forms, oint- Biocare “The problem stems from the
concerns of many, however, when he ments and syrups, representing an ad- fact that everyone does the same and pro-
notes that “too much emphasis is being vance of 20 years on the market’s need! duces identical products, especially when
placed on volume and not enough on Meanwhile injectable forms only met a it comes to generics. We need to devel-
scaling the production value chain.” mere 16 percent of consumption needs op new molecules, expand the product
Indeed, a comprehensive study con- and other areas such as hormone pro- lines. Algerian companies need to stop
ducted in 2012 uncovered significant duction none at all. How to explain this mutual infringement and copying.”
imbalances in the manufacturing base market failure? For Salim Habes, CEO of another of
in terms of responding to market de- “This issue has nothing to do with Algeria’s more successful pharma man-
mand. While dry and suspension forms our production capacity nor means” of- ufacturers, INPHA-MédiS, the reason
catered to 81 percent of consumption fers Mohamed Habbes, CEO of iconic is primarily down to an “asymmetry of
The human resourcing conundrum

One longstanding challenge that Algeria function effectively and meet the needs
continually grapples with is a chronic of the industrial base, the state will
shortfall of skilled clinicians and medi- need to revise the academic curricu-
cal specialists. Despite close to 10,000 lum. The bottom line is that Algeria has
students currently studying medicine- a well educated population of working
related disciplines and strong student age, but there will need to be chang-
demand for careers in healthcare and es to convert that resource base into
pharmacy, both the industry and hospi- something that is more fit-for-purpose.”
tal apparatus frequently report difficulty Training for paramedical catego-
sourcing and retaining high-end labor. Senator Louisa ries also tends to be inadequate to Mohamed
Chachoua, president Benali Khoudja,
“Throughout the 1960s and 1970s, of the Health, social the extent that companies like Bayer head strategy
Algeria simply didn’t possess enough affaires, labor and resort to providing their own (product- development North
doctors to care for the population,” re- national solidariy centric) workshops and training pro- Africa, VP and
calls Senator Louisa Chachoua, presi- commission, the grams to the practitioner community. general manager
Council of the Algeria - GSK
dent of the Health Commission in the Nation “Because we understand the critical
Council of the Nation. “During the sub- role that paramedics play in enabling
sequent decades we responded to this multiple sclerosis patients and he-
problem with a radical reform of the edu- mophiliacs to receive home-care and
cation system that allowed us to train up auto-manage their conditions, we
many more practitioners. The issue we take it upon ourselves to support the
then experienced, however, was a brain community with professional training
drain, with these newly trained person- schemes orientated towards those
nel choosing to emigrate abroad to pur- therapeutic areas,” explains gen-
sue their careers.” eral manager of Bayer Algeria, Amel
Professor Aïcha Ladjouze-Rezig of the Daoudi.
Professor Aïcha Amel Daoudi,
Ben Aknoun CHU identifies a secondary Ladjouze-Rezig, chief Ferring’s Mohamed El Hadi Benamar general manager of
problem stemming from the kneejerk of rhumatology, notices that levels of expertise across Bayer Algeria
reaction to boost the numbers of medi- University Hospital the local industry are gradually improv-
Center of Ben
cal students. “University standards for Aknoun ing as a result of the private sector’s efforts. “If we consider
medical disciplines have been steadily the last ten years, pharmaceutical skills are emerging in the
declining” she asserts. “Students have less class time and country in a large part thanks to the training programs of mul-
the curricula discourage critical analysis.” The end result is tinationals. Algeria is now beginning to reap the fruits of that
that “Algeria possesses a glut of generalists, and deficit of first informal cycle of knowledge transfer,” he says.
specialists.” In short, what the universities are churning out is “Ferring has itself been contributing to this process
mismatched to the demands of the market. though its educational schemes with the medical asso-
“With 1.3 million students per year, the country should ciations and doctor’s symposiums for the development of
have more than adequate human resources,” confirms GSK new protocols for therapeutic areas such as obstetrics
Algeria’s Mohamed Benali Khoudja. “However, for them to and gynecology.”

26

27
pharmaboardroom.com
algeria report
information.” “Entrepreneurs setting move was just as significant as the 2008

out in the market gravitate towards the regulation prohibiting the import of any
easiest forms of production with little molecule already produced locally. It
information as to what competitors are may have boosted local manufacturing
doing and end up engaging in duplica- in the short-term, but has damaged its
tion and market skimming.” “The re- quality in the long-term and stymied its
sponsibility therefore lies squarely with potential for value advancement.”
the government to impose some form of What seems likely is that government
corporate strategy externally,” he sug- From left: Sofiane Achi, head of prescription and the local business community alike
gests. medicine North French West Africa, are banking on joint ventures and tech-
Boehringer Ingelheim; Malik Ait Said,
“What is actually required,” argues general manager, Propharmal nology transfers to help liberate local
Benhamdine, “is an independent and manufacturing from the doldrums and
autonomous National Agency for Phar- and systemic lack of quality standards. propel it to the next level. Fortunately,
maceuticals to carry out this function “This all stems back to a landmark foreign multinationals appear more than
by centralizing the technical and ad- decision taken by the authorities to ready to answer the call. “Many local
ministrative validation activities. This promote local production at the ex- plants are not operating to full capacity
is because current responsibility is split pense of imports,” explains Prophar- and their business processes may be be-
across the Ministries of Health, Indus- mal’s general manager, Malik Ait Said. low par, and this is precisely where inter-
try and Labor, which leads to the pre- “Basically, the state decided to exempt national companies like BI can be of real
vailing inaction and impasse.” local manufacturing from the sorts of assistance, by leveraging and sharing our
Others diagnose the root problem bioequivalence studies that imported globally validated expertise,” proposes
as being more to do with a widespread generics are subjected to. To me this the Boehringer Ingelheim’s Sofiane Achi.

S21 magenta
FOCUS REPORTS
cyan
yellow
black deceMBer 2014 Faderco Insert Half-page_1-1.pgs 11.17.2014 20:38 ADVANSTAR_PDF/X-1a
28 Company focus pharmaboardroom.com
algeria report
perspective, the high

Opening the gates to a southern corridor volume of multi-
national pharma
As Algeria’s youthful pharmaceutical
companies opting to
manufacturing base seeks impetus
from abroad, south-south cooperation base their regional
is seen as an attractive solution. headquarters in Al-
Laboratoires Biocare, may today geria is demonstra-
be viewed as one of the great success tive of the strategic
stories of domestic pharmaceutical importance attrib- From left: Habib Bennaceur, country
manufacturing, but, when the compa- uted to the country manager, AstraZeneca; Amor Habes,
general manager, Faderco
ny started out in 1998, its owners had and market. Astra-
little prior experience of the industry. Mohamed Redha Zeneca, the latest entity to follow the trend by converting its
Habbes, CEO, Biocare
“We adopted an incremental growth Algerian operations into a hub for francophone Africa, took
strategy starting out with packaging the decision because “the right geo-strategic fundamentals
and then, over time, progressing to were judged to be in place from favorable fiscal concessions to
real manufacturing. Limited capital geographical positioning to political stability,” according to
essentially compelled us to grow the country manager, Habib Bennaceur. Indeed, what makes Al-
business this way, but with hindsight
geria an almost irresistible choice in the eyes of Faderco’s Amor
it was very beneficial for us because it
Habes, is “its physical location right at the gates of the African
enabled us to build solid foundations
continent and the proximity to both positive demographics and
and develop in-house mastery of each
production category as we mounted a blossoming industrial base.”
the value chain,” recalls CEO, Mo- Dr. Mohamed In terms of market size and value, the Algerian pharma-
hamed Habbes. Salim Habes, CEO, ceutical sector would also appear to be well out in pole posi-
INPHA-Médis tion relative to the rest of the region. “The Algerian mar-
“Local production is not something
that can just be parachuted in from ket is one of the biggest in Africa and
afar. Growing your own industrial base is actually part of a continually growing with a good social
maturation process that involves shifts in mentality and if it security coverage compared to many
is short-circuited could risk compromising the quality of the other countries in Africa. Hypertension,
product being manufactured,” he explains. “The advantage Diabetes, Heart Failure or tumours are
with many south-south collaborations is a local firm can becoming very substantial diseases and
gain accelerated access to technologies while still retaining a key proportion of the Servier portfo-
ownership of its processes, because of the more equitable lio is well adapted to treating patients,
nature of the relation,” he affirms. who suffer from these conditions, more
One highly successful south-south partnership has been Guillaume Seillier,
effectively. announces Servier’s country country manager,
the joint venture between the local Algerian manufacturer
manager for Algeria, Guillaume Seillier. Servier
INPHA and Tunisian outfit Médis. “Linking up made a lot
In Algeria, an impressive governmental
of sense for both parties: Médis had benefited from high
hospital development programme is in process and this is an
exposure to foreign technology and was FDA accredited by
virtue of the more open Tunisian market while, we could of- opportunity for Servier to increase its cooperation with key
fer a much more extensive potential client base” explains actors from the hospitals for the mutual benefit of the pa-
INPHA-MédiS’s Salim Habes. tients. “Algeria has already turned the corner and matured
into a great country,” asserts Boehringer Ingleheim’s Sofiane
Achi. “It can be described as a healthcare locomotive for the
“Private enterprise has the potential to play a very active Maghreb, maybe even for Africa.”
role in the development of Algeria’s pharmaceutical industry When asked about the pre-eminence of the ‘Made in Al-
in terms of training, technology and know-how transfer, such geria’ brand, however, opinions are much more divided. “I
as good manufacturing practices, quality assurance and phar- honestly don’t think there’s that much consumer conscious-
macovigilance,” says Merck’s Karim Bendhaou. ness of locally branded medicines,” reflects Jamal Salem,
deputy managing director of Salem Laboratories, “industry
leaDership proWess insiders are aware that the quality of certain domestically
produced pharmaceuticals is now very high indeed, but the
To what extent, then, can Algeria realistically be considered a Algerian public tend to remain fixated on European brands.”
regional pharmaceutical leader? From a business development “It will take quite some time before ‘Made in Algeria’

pharmaboardroom.com
Special SponSored Section 29
algeria report
achieves the recognition it deserves,”

Market Algeria Morocco Tunisia Libya Mauritania Spain
agrees INPHA-MédiS’s Salim Habes.
“We’re still trying hard to bolster the Population (Millions) 35.4 32 10.4 6.3 3.4 46
image of domestically produced phar- Life Expectancy (M/F) 72.5 73 75 72.5 58.5 82
maceuticals on the home market, let Density of Doctors per 12.1 6.2 11.9 19 1.3 39.6
10,000 of population
alone regionally.
Density of Pharmacies 2.4 2.7 2 3.6 0.4 8.4
export shyness per 10,000 of population
Out of pocket charges 20.9 53.5 39.8 31.2 44.3 20.7
(% of health spending)
If there is one factor impeding Algeria
Credit: IPEMED
from assuming the title of North Af-
rican pharmaceutical giant, then it is mac facility in France, had been export- ufacturing involving living organisms
undoubtedly the curious absence of the ing as far back as 2007, but abandoned if we don’t see an easy way of export-
export-side of industry. Stories abound the strategy in recent years to refocus ing what we produce. The local market
of pharmaceutical entrepreneurs and on the much more lucrative home mar- would simply not be big enough to justi-
multinationals striving to export Al- ket. Sandoz meanwhile, despite enjoy- fy the investments that we would have to
gerian manufactured medicines to the ing a global positioning at the forefront make for these types of manufacturing
surrounding region, but giving up be- of bio-similar production, is refraining techniques,” explains Cherif Benguerba.
cause of the administrative complexi- from introducing that technology to Al- Nadir Abderrahim, general manag-
ties involved. geria because of the difficulties associ- er of Industries Médico-Chirurgicales
Laboratoires Salem, a local entity ated with export. “We cannot produce (IMC), which supplies medico-surgical
famed for having bought up BMS’s Mey- bio-similars in Algeria or engage in man- devices to markets as diverse as Russia
Promoting Health Improving Life
Science For A Better Life
There are approximately 30,000 different

diseases known today. A satisfactory form of
therapy is only available for one-third of
them.
Bayer HealthCare, a subgroup of Bayer AG,
develops innovative products to improve
health and quality of life for both humans and
animals. In addition to activities in the fields
of Animal Health, Consumer Care and Di-
abetes Care, the company also focuses on
specialty pharmaceuticals. Bayer HealthCare
is an international leader in this sector.
A strong community for a healthy future.
magenta
cyan
yellow
black Bayer AW_rev_1-1.pgs 11.22.2014 07:04 ADVANSTAR_PDF/X-1a

pharmaboardroom.com
algeria report
clares Kåre Schultz, global president and temperature require a high level of
and COO of Novo Nordisk. “It is in- control and where high attentiveness to
deed a very peculiar situation when avoiding contamination is imperative”
a country renders it easier to import adds Merck Serono’s Karim Bendhaou.
than to export. Development models “It would certainly take real guts
from across the world from China to on the part of the biotech companies to
India to Mexico testify to the national manufacture biosimilars outside of their
benefits accrued from having a strong own facilities”, ventures one industry in-
From left: Kåre Schultz, president & COO, export sector”. “To be a regional sider. This is because the bulk is ordinar-
Novo Nordisk; Ismael Chikhoune, president & leader it’s imperative to have good in- ily manufactured only in one location so
CEO,US-Algeria Business Council (USABC)
teractions with other countries in the as to minimise the risk of ending up with
and Iraq, describes a daunting array region, and that means free-flowing two substantially different products.
of obstacles that prevent the execution goods, people and payments. The irony
of a smooth export strategy. “Not is that the ‘Made in Algeria’ brand has
only are there the well-known difficul- huge potential, if only the authorities
ties in doing currency exchanges and would allow other markets to familiar-
navigating products through customs, ize themselves with it.”
but on top of all of that, the Algerian
economy is so import-orientated that betting on bioteCh
there is never sufficient outward bound
container space. This means that your Testament to Algeria’s genuine ambi-
From left: Jeffrey P. Kemprecos, executive
products end up sitting at the ports for tions of regional healthcare dominance,
director Emerging Markets Public Policy,
months on end before boarding vessels, in June 2014 the authorities signed a Merck/MSD; Saleh Daghbooshe, general
resulting in a considerable increase of memorandum of understanding entitled manager, Dar Al Dawa
logistics costs.” “Algeria Vision 2020” with the mem-
“Criticism of the export environ- bers of the US association PhRMA, “We are enthusiastic about Vision
ment is legitimate, but less to do with with a view to establishing the country 2020 because this project speaks direct-
the laws per se than about the reluc- as a MENA-wide biotechnology hub by ly to our industry’s two broad goals in
tance of the bureaucracy to relinquish the end of the decade. Algeria would Algeria: to advance human health and
supervisory control over money trans- thus rank as the fourth such hub after strengthen the innovative medicines seg-
fers,” clarifies Samir Sayah of CMS Le- similar ventures in the Boston, Dublin ment,” affirms Jeffrey Kemprecos, ex-
gal. “When you export you are actu- and Singapore. ecutive director of MSD Eastern Europe,
ally exempt from taxes, so this is more Ismael Chikhoune, president of the Middle East and Africa. “While there is
about the institutional mind-set of the US Algerian Business Council (USABC), much low hanging fruit that government
bureaucracy, inherently suspicious of which assumes a role of observer and ar- and industry might agree to pick, we also
any kind of behaviour that could con- biter to the 2020 initiative, explains that appreciate that business cycles are gener-
stitute repatriation of profits,” he adds. “Algeria was selected as the optimum lo- ally 90 days while changes in policy and
“These cultural relics from the Bou- cation for a biotech cluster primarily in legislation may occur on more of a 900
mediene era that inhibit currency trans- view of its strategic position as a gateway day cycle, so we won’t despair if the pro-
fer risk clipping the potential of a sector to Africa and the Middle East, its long cess is sometimes slower or bumpier than
that holds a great deal of promise,” says track record of stability, sizable educated we’d like. The main thing is we’re head-
Dar Al Dawa general manager, Saleh population and ‘hands on’ health policy.” ing in an excellent direction,” he adds.
Daghbooshe. “In Jordan, you actually The response of the international The ministry’s director general of
have the opposite story. Over there, ev- pharmaceutical companies to this news pharmacy, Hamou Hafed, seems calm
erything is centered on a culture of ex- has been overwhelmingly positive, even and confident. “Biotechnology can be
port and you are encouraged to release if many consider the timeframes to be harnessed as an effective lever of scien-
your products on international markets unrealistic. “Algeria should go slow and tific, technological and economic devel-
from an early stage. I would very much first start with “fill-and-finish” manu- opment,” he notes. Thus, by sticking the
love to see that sort of mentality trans- facturing before setting up a biotech course with Vision 2020, “Algeria should
posed and nourished here in Algeria.” industry. That way the local industry ultimately find it possible to generate suf-
“To my mind, the Algerian govern- can gain experience by learning how to ficient critical mass to ensure substantial
ment is missing an opportunity” de- handle live products where the dosage technology transfer.”

31
Rethinking Hospital
Provision
O
ne of the more eye-catching elements of the funded health sector infrastructural interventions.
government’s public health programme, has “Previously it was up to the individual directors of
been its radical agenda for Algeria’s hospitals. health for each Wilaya, but this decentralised system
10 brand new University Hospital Centers (CHUs) are proved disjointed hence the decision on the part of
to be constructed by 2019 raising the the Ministry to intervene directly in
national total to 24 while the existing 14 are improving the quality of patient care,”
set to undergo complete overhaul bringing explains Lazhar Bounafa, its director gen-
them up to international standards. Already eral.
the contracts for four of the new CHUs have The effect of these changes has been
been awarded to consortia composed of almost immediate. “AREES has adopted
global leaders in their category. What’s a completely fresh approach, taking ini-
more, on top of these considerable mone- tiatives that had been long in the pipeline
tary investments, Minister Boudiaf has also and reconfiguring them as ambitious
spoken of his steadfast intent to “spark a design-build-operate turnkey projects,”
veritable revolution in healthcare provision Thomas Hinterleitner, explains Thomas Hinterleitner, regional
by transforming the manner in which it is member of the director for Africa and the Middle East of
delivered.” management board VAMED, part of the consortium awarded
Central to this strategy has been the - regional director the contract for the new CHU in Constan-
Africa & Middle East,
establishment in 2013 of a National Agency Vamed Group tine. “What they are in effect doing is
for Healthcare Equipment and Management taking what are normally considered to
of Health Infrastructures (AREES) specifically tasked be thoroughly different segments and blending them
with centrally coordinating and optimizing publically into a single holistic project for contracting out. This
Architectural design for a new CHU in Alger to be constructed by a consortium fronted by Italian firm, Rizzani de Eccher

32
brings the significant advantage of being able to marry obsolete,” he points out. “What is really ground-
efficiency of design with efficiency of hospital man- breaking for this project is that all the key stake-
agement,” he attests. holders are sitting around the table from the incep-
Another of the selec ted contr ac tor s who tion phase – from architect to equipment providers
applauds the wisdom of this bold approach is Nich- to operator to medical practitioner to client – each
olas de Roquefeuil, Bouygues’ Director for Devel- delivering inputs right from the concept-idea
opment in the Maghreb. “If you design a hospital stage. This enables us to generate huge efficiency
just based on today’s equipment then there is gains and end up with a very well rounded end
always the risk that your building will become unfit- product that will be efficient over the entire lifes-
for-purpose once those technologies become pan,” he declares.
Credits: Chiraz Bensemmane

33
A National Plan for

Tackling Cancer
The combat proud. “C ancer is existing machines that we are
against cancer certainly not the dis- selling to the Algerian state,”
represents yet ease that kills the explains Varian’s Burt Lang. “We
a n ot h e r b a t t l e - most, but it is one have ad ditio nally agree d to
ground now con- that causes the most establish a Center of Excellence
s i d e re d s e r io u s dis tres s, and thus to serve as an anti-cancer train-
enough to warrant c alls for a special ing hub for the region,” he adds.
being dealt with response on the part Not ever yone agrees that a
centrally. With an of t h e s t ate,” h e special plan for combatting can-
estimated 30,000 asserts. cer outside of the normal health
new cases arising Already the gov- system is necessarily the right
each year, a spe- er nment has com- approach. Professor Kamel Bou-
cial commis sion mitted to increasing zid, president of the AlgerianSo-
reporting directly the number of Anti- ciety for Oncology questions why
t o P r e s i d e n t Pr. Messaoud Zitouni Cancer Centers oncology products are not reim-
Bouteflika and (CACs) from 13 to 29 bursable through the social secu-
spearheaded by b y 2 018 a n d h a s rity system like other treatments
former Health signed a landmark for chronic disease. “Because it
Minis ter Zitouni deal with American is only the Ministry of Health and
has been assem- firm, Varian for the not the Social Security system
bled tasked with p r ov i s io ni n g of 6 that pays for anti-cancer treat-
formulating a cancer treatment ment, many oncology products
National Anti-can- centers with US$51 are simply not available in phar-
cer Plan for the million wor th of macies and patients have to buy
period 2015-2019. advanced radiother- them in Fr ance ins tead,” he
According to apy and r adiosur- lament s. “It also means that
Professor Zitouni, gery technology. In patie nt s force d to t r avel to
cancer has ke e p i n g w i t h t h e Algiers for treatment from remote
become a major gover nment ’s new wilayas in the south cannot be
public health at tentiveness to r e i m b u r s e d f o r t h e i r t r av e l
worry because of Pr. Kamel Bouzid, President, “s m a r t p r o c u r e - expenses which can be consider-
the way it “tran- Algerian Society for Oncology ment” the equip - able,” he points out.
scends purely ment has been cho- What he does agree with,
medical concerns casting a heavy s e n f o r i t s l o n g - t e r m c o s t however, is the broad thrust of
burden on both the social and ef fec tiveness, and technology Professor Zitouni’s soon-to-be-
political spheres” – impacting transfer requirements have been published recommendations that
not just the patient, but entire included in the contractual terms. emphasize “improving patient-
communities and threatening the “Upgrade paths have been built centric palliative care alongside
economic viability of the free-at- into the technology so that, as infrastructural investments and a
the-point-of-delivery healthcare new innovations are developed, renewed focus on prevention and
system of which Algeria is so they can be deployed using the early-detection.”

34
Introducing the Mammobile

It was a project that was two years screening facilities closer to the Algeria.
in the making, but finally saw the doorstep of women in a country in “In Algiers today, it is quite easy
light of day in February 2013 when which roughly 3500 of every 10,000 for a woman to go to a doctor and
a triumvirate of collaborators – sufferers diagnosed with breast can- have a mammogram, but in far-flung
patient advocacy group El Amel, cer, die. “Algeria is the biggest desert areas access to diagnostics
Algerian mobile communications country in Africa. Towns in the inte- is much more limited. That is why we
operator Mobilis, and the world’s rior area are far away from each co-sponsored the concept of what
largest cancer medicine producer, other with sparse populations and is essentially a bus that drives to
Roche – launched Algeria’s first ever this made it difficult for the health secluded villages to give women
mobile breast cancer screening authorities build the necessary access to mammography diagnos-
facility. healthcare infrastructure to properly tics there and get their results on the
Dubbed the ‘Mammobile’ the fight cancer,” explains Nora Bouz- spot,” agrees Roche’s head of
unit aims to bring breast cancer ida, Roche’s Media Manager in North West Africa, Ralf Halbach.
Launch of the Mammobile

35
Changing Diabetes in
Algeria
Novo Nordisk operates two legal Digy, the vice president for Africa. remote regions spreading the word
entities in Algeria: a bureau de liai- The mainstay of the company’s and offering on-the-spot diabetes
son dealing primarily with product operations in Algeria relate to diagnosis.
registration, promotion and clinical spearheading the charge against “We are proud to announce
trials, and a local company called diabetes. “When, in the late 2000s, that, to date, Novo has received
Aldaph SPA which enables them to Novo first started collaborating more than 100 000 visitors to its
simultaneously conduct manufac- with the government on this front, Changing Diabetes® mobile clinic
turing from a flagship facility based it became quickly apparent that and conducted more than 13 000
out in Tizi-Ouzou. “Back in 2005, we much more had to be done to cor- screenings during stops in 10 cities.
constituted approximately 50 rect the deficit in information and What’s more, over 14 000 diabetics
employees and maintained sales of to offer earlier diagnosis,” explains have received a free of charge com-
around 12 million euros. Nowadays Digy. Their first solution, in collabo- prehensive evaluation of their dia-
we possess a workforce of 450 peo- ration with the authorities and betes-related health complications
ple and our sales have increased patient associations, was thus to which is a unique achievement
more than tenfold to 150 million establish a Changing Diabetes® worldwide,” declares Digy.
euros which is indicative of how far mobile clinic, which was launched Then, in 2013, the company
we have come,” proclaims Jean-Paul in November 2011 traveling around enhanced its mobile clinic by rolling
Novo Nordisk’s Algerian labs

36 Company spotlight
Novo Nordisk’s Tizi Ouzou manfacturing facility
out ‘30 diabetes barometers cen- New initiatives are also afoot killer, but is easily preventable
ters’ across the country, with a view with the company partnering State through healthy lifestyle. Digy thus
to compiling, processing and shar- entity Saidal for the local manufac- speaks of his ideas for co-opting
ing data on diabetes. The hope is turing of human insulin in a move the local food and drink industry in
that these centres of excellence in that will significantly improve the schemes to curb excessive sugar
diabetes care management will country’s security of insulin supply. and fat consumption and foster
form the cornerstone of future Nor will there be any let up in the healthy living. In short, despite the
efforts to improve the livelihoods drive to spread awareness about a very real progress, there is still
of Algerian diabetics. disease that represents a silent much to do.
League Table for the Algerian Pharmaceutical Market

2012 2013
Rank Company 2012 US$ 2013 US$
growth growth
1 SANOFI 409,122,056 +19% 480,832,847 +18%
2 GLAXOSMITHKLINE 188,191,668 +9% 221,587,912 +18%
3 HIKMA PHARMA 198,077,693 +10% 213,350,230 +8%
4 NOVO NORDISK 191,970,101 +17% 209,000,403 +9%
5 EL KENDI 134,772,249 +49% 173,504,995 +29%
6 PFIZER 167,790,858 +4% 163,768,841 -2%
7 SAIDAL 140,699,096 -10% 144,303,822 +3%
8 NOVARTIS 102,737,968 -29% 111,764,584 +9%
9 MSD 86,116,456 +12% 96,717,270 +12%
10 ROCHE DIAGNOSTICS 106,434,224 +27% 89,339,931 -16%
Courtesy of: IMS HEALTH

37
The Middle Eastern Connection

Middle Eastern investors have manager of Hikma, a Jordanian out- home markets are more branding
proved to be amongst some of the fit that has subsequently estab- orientated and also in its scope as
most eager and enduring partici- lished itself as the leader in the local a stepping stone into the neigh-
pants in Algerian pharma. Indeed, sale and production of antibiotics. bouring African continent. “For us
one distinguishing fea- He puts this initial faith the Algerian market now ranks as
ture of the local land- placed in the market
the third most important market in
scape is the presence of down not only to strate-
the MENA. Saudi Arabia leads the
high-performing Mid- gic foresight, but also to
dle Eastern-backed “close cultural proxim- way, followed closely by Jordan and
companies, some of ity and common under- then it’s Algeria,” declares Dagh-
which are now deeply standing.” Saleh Dagh- booshe. “Our strategy is about
embedded in the mar- booshe of another spreading our wings on the manu-
ket. Two such compa- Jordanian entity, Dar Al facturing side and harnessing our
nies, Hikma Pharmaceu- Dawa, recounts a very base in Algeria as a springboard for
ticals and El Kendi, similar s tor y. “ We penetrating the rest of the conti-
today rank 3rd and 5th arrived in 1993 spotting nent,” he confirms. Hikma’s Kabech
in terms of overall mar- market niches vacated agrees that Algeria provides a fan-
ket share and have A b d e l k r i m K a b e c h, by European firms that tastic opportunity for local produc-
been registering year General Manager, Hikma were pulling out and for
tion. “We have really adopted Alge-
on year growth rates of a time we were the only
ria, embraced local industry and
8 and 29 percent respectively. generics company in the whole of
“This year we celebrate 20 years the country,” he remembers. invested accordingly,” he says. “A
in Algeria. We settled in 1994 in the For many Middle Eastern firms, full 70 percent of the products we
middle of the ‘black decade’ when the great appeal of Algerian pharma place on the market are locally man-
virtually everyone else was leaving,” today lies in its potential as a pro- ufactured and this will rise to 80 per-
recalls Abdelkrim Kabech, general duction platform when many of the cent next year.”

38 Interview
Reforming healthcare
from the top down
PharmaBoardroom: You took up your PB: Another aspect of the reform you
position in September 2013, and imme- are spearheading is the overhaul of the
diately determined that the health sec- CHIFA health smartcard. Could you
tor was in great need of reform. Can you clarify the intent behind this measure
share with us your assessments and and precisely what you aspire to
describe the first steps that your minis- achieve?
try has taken? ABDELMALEK BOUDIAF: Indeed, the
ABDELMALEK BOUDIAF: The subject health card needed a rethink. Previously,
of public health is a vast topic to discuss, the system was fraught with irregularities
especially when considering its reforma- and redundancy: each visit of a patient
tion. Our central executives from the Min- to a doctor could result in a new prescrip-
istry of Health have conducted an audit, tion and fresh tests to run cumulative to
according to a one-month monitoring the previous ones and all at the expense
outline. This has enabled us to ensure of state coffers. The solution to this lies
clear view of the situation in the health- in better organization and greater scope
care system and in all of our hospital facil- for physician referrals.
ities (university hospitals, clinics, health As things stand at present, the role of
centers, etc.). Thus we have defined a general practitioner is not influential
roadmap outlining the government’s pri- enough, when he should really be the
orities. One of these priorities was to backbone of the system. Through the new
steer the system to a return to good prac- health smart card, “health districts” will
tices. provide necessary reorganization and
Health is indeed a very sensitive sector, enable us to better understand the needs
hence the need to focus on education, sup- of the patient. This in turn will enable us to
port and increased awareness of the oper- implement effective human and material
ators, in order to achieve positive out- resource allocation. The most important
comes and put our priorities in motion. Our thing is to provide efficient health coverage
key set of priorities comprise: organization, to meet the needs of the Algerian patient.
management, training, access to medicines
PB: The Algerian government spends
as well as vaccines and, last but not least,
around US$ 3 billion merely to cover
major investment projects in the private
and the public sector.
pharmaceuticals expenditure. How do
When looking at public health invest- you assess the effectiveness of this cru-
ments, 18.400 additional beds are coming cial expense?
on-stream following the decision of Presi- ABDELMALEK BOUDIAF: Algerian leg-
dent Bouteflika and this will include the islation includes three core elements in
establishment of 10 new university hospi- terms of health issues: free, universal and
tals. Five of them are already under con- accessible care. A closer look at the main
struction. Moreover, we have opened the recorded pathologies reveals that they
sector to private players so they can estab- are similar to those encountered in devel-
lish hospitals, a landmark in Algerian history. oped countries, and their incidence rate
Minister Abdelmalek Boudiaf, MINISTRY OF HEALTH

39
mirrors that of Europe. Treatments offered to try’s needs, but also to conquer other mar-
Algerian patients are also similar to those kets. We will not remain eternal importers.
offered in such countries. This expense can, We have the means and the opportunities at
of course, be judged considerable, yet these our disposal.
figures reflect the global increase in drug Algeria is now a secure homeland and a sol-
costs, and also include veterinary products. vent country that can offer many more oppor-
tunities than other countries in the region.
PB: How would you assess the current These elements encourage partners to come
structure of your department and its effec- and invest. On top of that, do not forget that
tiveness in achieving its mandate? no other country in the world offers what Alge-
ABDELMALEK BOUDIAF: The central ria offers today to investors. They enjoy exclu-
issue relates to matters of management, sive benefits, first of which concession, but also
and medium and long term perspectives. five-year exemption from taxes, zoning system,
Using the example of drug shortages that etc. The latest major international group that
occurred in 2013, it should be emphasized joined us in strategic partnership is Variant,
which is establishing a training center for the
that nothing analogous has happened
entire Africa and Middle East region.
within the last 10 months. The Central Hos-
pital Pharmacy (PCH) assumes stockpile PB: In June 2014, Algeria signed a partner-
management and appropriate distribution ship with the United States, as part of
in accordance with the resources at its dis- “Algeria 2020 vision” with a view to creat-
posal. We addressed this issue and current ing a biotechnology hub for Africa and the
results give us satisfaction. Middle East. What makes Algeria the ideal
Furthermore, we are revisiting the overarch-
host for this project?
ing health law so as to provide health staff with
ABDELMALEK BOUDIAF: Its location: situated
legal framework that would allow them more
on the sea, gateway to Africa, and with the Mid-
flexibility in terms of management. It will also
dle East being only three hours away. In addi-
allow us to best meet the needs of modern
tion to Algerian surroundings and context, the
Algeria. Our national legislation and regulation
university offers a huge labor pool that is tal-
must adapt and we need to combine our efforts
ented, but cheaper than in the West. Also our
to this effect.
country is solvent. This combination of ele-
PB: Algeria envisions to domestically pro- ments has motivated international investors to
duce 70% of the pharmaceuticals con- join us. Algeria is a secure country, and the
Americans are well aware of this. We have excel-
sumed in the country, and also foresees
lent relationships with them, especially in the
expenditure decreases while enhancing
field of health products.
patient access at the same time. How does
International investors are welcome, our
Algeria intend to achieve these objectives?
nation is warm and hospitable, and our people
ABDELMALEK BOUDIAF: Algeria already are extraordinary. Algeria is like a small conti-
has the assets that could lead to national pro- nent, with each of the four seasons in every
duction increase: labor, space, expertise, pro- corner of the country. We will encourage and
fessionals (nearly 5.000 pharmacists in train- favor the inflow of foreign capital into Algeria.
ing), and a growing number of foreign My desire is that the Algerian patient receives
laboratories that come and settle. To achieve the best care out there, and in this regard, our
such results, it is clear that we will need our active search for new partnerships is para-
foreign partners. No country can claim to self- mount.
sufficiency in this regard. In the long term, I
focus on the establishment of a coherent pol-
icy that will allow not only to meet the coun-

40 Interview
Lifting the lid on

Algeria’s unique Social
Security system
PharmaBoardroom: Can you please the advent of the CHIFA or electronic
start by introducing the social secu- smart card for social security in 2007,
rity system in Algeria, highlighting there are now more than 10.4 million fam-
those features that make it unique ilies enrolled which translates to around
across the region? 34 million beneficiaries. This card enables
direct third party payment from the social
DJAOUAD BRAHAM BOURKAIB: The
security system to pharmacies awarded
Algerian social security system is based
the Social Security Agreement. Over
on the principle of solidarity and sharing.
10,000 pharmacies are par t of this
It is mandatory for all workers, whether
scheme and citizens enrolled in the
employed or self-employed, and covers
CHIFA can go to any of them to collect
specific categories such as students,
his or her medication, irrespective of his
retired workers, and the disabled who are
or her place of work or residence.
unable to work. In this way, over 85% of
Sufferers of chronic illness enjoy access
the population is today guaranteed social
to third party billing, with no caps, for their
security coverage. This system further
prescriptions except in instances of abuse,
includes all branches of social security duplication or fraud, which can be identi-
provided for within the Conventions of fied by adequate control mechanisms in
the International Labor Organization place. Insured persons without chronic ill-
(ILO). ness, meanwhile, are subject to a ceiling
The system is effectively financed of two prescriptions worth 3,000 dinars
through contributions from the country’s per person per quarter (which is roughly
workforce and is supplemented by a con- 77 USD per person per quarter) for their
tribution from the state which subsidizes direct third party billing. Once this thresh-
the most vulnerable groups, or those who old is exceeded, which is rare for those
have no fixed income. Any insured per- without chronic ailments, then the stan-
son who contributes provides coverage dard reimbursement system kicks in.
to his or her immediate family, whether
that entails dependent children, depen- PB: What is the breakdown between
dent parents, or spouses. The system is the financing based on labor income
therefore considerable in terms of cover- contributions, and the share of state
age. Currently a full 26 chronic illnesses funding?
are eligible for full coverage. DJAOUAD BRAHAM BOURKAIB: At
present, workplace contributions finance
PB: Algeria enjoys an exceptional the bulk of Algeria’s national health insur-
level of medicament accessibility. ance. Although the unemployment rate
How is this achieved? has been steadily declining and a greater
DJAOUAD BRAHAM BOURKAIB: Since portion of the population are contribut-
Djaouad Braham Bourkaib, DIRECTOR GENERAL OF SOCIAL SECURITY

41
ing, the pharmaceutical expenditures is ucts being awarded reimbursement should

increasing at a faster rate than revenue either be bringing a new medical benefit to
growth can match. the market or an improvement on what is
The contribution base is calculated in view already in existence. In instances where there
of the economic realities of the moment - is no demonstrated improvement in actual
notably the minimum wage, while the reim- benefit, then the Committee also considers
bursement is mainly based on the costs of the economic dimension attached to this
external production, since we import more drug. If this “me too” product is being
than we currently produce. This is precisely imported and is more expensive than equiv-
why the state is so keen to promote local alent products already in the country, then it
pharmaceutical manufacturing. The good has little chance of being awarded a positive
news is that this policy is working and the reimbursement decision (which is consistent
ratio of national production is increasing. with a 2009 directive currently in force that
Algeria has been vigorously promoting promote the domestic pharmaceutical pro-
generic products wherever they exist because duction over imported products) . If that
they can offer the same therapeutic benefits same molecule has been locally manufac-
as the originator products but for a fraction tured, then it is much more likely to interest
of the price. This, in turn, allows us to release the committee.
more funding to pay for the treatment plans If a medicine has no obvious competitor
of other citizens. Moreover, in line with the product and provides a new answer to a real
national policy, we are also committed to healthcare need, then the committee in prin-
local production and encourage balanced ciple has absolutely no objection to a request
partnerships between local and foreign pro- for reimbursement. In such instances, the
ducers, to promote the transfer of technology procedure moves to the next stage: a deci-
and know-how. A third key emphasis in work sion to accept the refund is issued and an
concerns strengthening our relationship with order confirms the decision.
the world of prescription so as to promote
good practice provides optimum benefit to PB: What steps has the ministry been
the patient. taken to ensure cost-efficient prescrib-
ing?
PB: Can you please describe to us the DJAOUAD BRAHAM BOURKAIB: We have
decision-making process of drug reim- chosen to financially encourage prescribers
bursement? (doctors and pharmacists) to promote phar-
DJAOUAD BRAHAM BOURKAIB: Once a maceutical products manufactured primarily
medicament is awarded its registration and in Algeria. The pharmacist in particular is
placed on the market, laboratories have full being awarded a 20% markup on every prod-
discretion whether or not to submit a request uct manufactured in Algeria that he dis-
a refund by filing an application with the com- penses using his right of substitution. Note
mittee. The submission is then transferred to that this incentive covers both generic and
a technical secretariat, made up of health originators, with the sole condition that they
practitioners (including a doctor, a pharma- are manufactured in Algeria and their prices
cist and a statistician). The application is are in line with the reference rate. This incen-
reviewed according to set procedures and tive costs us over 7 billion Dinars every fiscal
assessment criteria which differ depending year; however this has produced indirect sav-
on whether the product is one where there ings of 35 billion dinars, not to mention the
are no other equivalent molecules on the spate of new job creations. Pharmacies ben-
market or one where there are other drugs efiting from the incentives and markups that
available of the same class or therapeutic cat- I have just mentioned have so far hired
egory. roughly and additional 30,000 staff.
The idea is that the majority of new prod-

42 Interview
Voice from the frontline

PharmaBoardroom: Can you please Beyond the current laws, I have been
start by outlining the role of the Health using my influence as commission presi-
Commission in the Council of the dent to push for an update to the national
Nation? medical reimbursement system. This is well
SENATOR LOUISA CHACHOUA: First overdue because it dates back to the 1980s
of all, we are there to prepare, oversee when the contextual environment was very
and review legislation. At the moment, different from today’s scenario. A review of
that system is absolutely imperative if it is
we are working on several laws in the
to remain sustainable.
health domain: one relating to comple-
mentary healthcare, another on children’s PB: You happen to also be a professor
health, and also one to do with the social of ophthalmology. How important is it
security of Algerians abroad. Secondly, to have a real medical practitioner
we hold the executive branch of govern- leading the commission?
ment to account by summoning the Min-
SENATOR LOUISA CHACHOUA: I believe
isters to answer questions on health and it’s really quite an advantage. Being a fully
social welfare topics. Thirdly, we act as a functional health professional alongside my
direct link with the Algerian population role in politics, I am exposed on a daily
by going out on the ground canvassing basis to the very same challenges that most
grassroots opinions and compiling brief- medical practitioners face. Because I have
ing reports for the government on the thorough understanding of the real issues,
actual state of healthcare across the I am able to promote proper solutions. It
country. Finally we organize what are also, of course, helps to be part of the med-
known as ‘parliamentary days’ where we ical community. I have the contact net-
can raise awareness and debate the most works and know many of the key individu-
topical issues concerning the nation’s als involved. The practitioners can rest
healthcare. assured that we really represent their best
interests in the parliament.
PB: As the incumbent president of the
Commission, how would you describe PB: A National Agency for Pharmaceu-
your current priorities? ticals was theoretically founded in
SENATOR LOUISA CHACHOUA: The 2008, but ill-conceived legislation has
focus right now is really on the pieces of resulted in it never being effectively
legislation that I have referred to. Here in implemented. What, if any, changes
the Council of the Nation, we senators would you like to see to remedy this?
unfortunately do not enjoy the same powers SENATOR LOUISA CHACHOUA: We
as the deputies sitting in the People’s need to review our overarching health pol-
National Assembly or lower chamber. All we icy and determine whether it is feasible to
can do is accept or reject legislation whole- continue with universal coverage that is
sale. We have no prerogative to make free at the point of delivery. We also need
amendments to specific clauses. This means to critically analyze the workings of the
that we are currently somewhat hamstrung, social security system. At the moment the
but we are confident that the new constitu- responsibility for this domain is shared
tion, when finally enacted, will rectify this between the Ministries for Health and for
anomaly. Labour, with perhaps the consequence that
Senator Louisa Chachoua, COUNCIL OF THE NATION

43
the roles are not demarcated enough. It will a career in France. Today we have imbalances
also be essential to relook at our management in the type of medical practitioners. Essentially
of human, medical and paramedical resources we have a great many doctors, but are lacking
because Algerian healthcare can only be sus- personnel in the specialist categories. There
tainable if these assets are managed sensibly. are also imbalances in the geographical distri-
Above all, I am keen that we take another bution with a concentration of practitioners in
look at the idea of complementary activities. the north, but deficit in the south. Our special-
In my view, the current law actually prevents ists continue to emigrate, and we resort to for-
doctors from properly carrying out their func- eign experts such as Cubans or Koreans to plug
tions and committing to either the public or the the gaps.
private sector. By having doctors try and To address this problem, the solution is
assume both roles it actually exacerbates obvious: we need to better pay our doctors,
inequality of treatment and encourages abuses. and empower them in terms of equipment and
What Algeria needs is a sensible healthcare infrastructure to work properly throughout
system that encourages both private and pub- Algeria. Young graduates want to be working
lic provision and incentivizes all actors to with state-of-the art technology that they have
respect the norms. been learning about. If this is on offer in the
southern wilayas and if the pay packet is com-
PB: How beneficial is the CHIFA card? petitive, then they would surely be tempted.
SENATOR LOUISA CHACHOUA: As a starting
base, the idea is laudable. It is supposed to PB: What would you like to have seen Alge-
contribute to the better management of health- ria achieve by the end of your mandate in
care dispensation by avoiding waste, double five years’ time?
prescribing and the like. The trouble right now SENATOR LOUISA CHACHOUA: Most of all,
is it doesn’t yet have the means to be truly I’d like to see Algeria develop a dynamic and
effective. Without computerization, clear com- competitive pharmaceuticals industry. Today,
munication and proper rationalization, it is the domestic production of medicines, whether
going to be very difficult to improve patient generic or otherwise, is insufficient. Though the
monitoring and reduce the public bill for medi- state strives for 70% coverage of national needs
caments which is the real purpose of the card by the end of the year, local production can at
in the first place. At present, the card relates to best cover 40% of national demand. To com-
a range of chronic diseases such as diabetes, pensate, Algeria has to import a large volume
senility and hypertension. However it doesn’t of expensive medicines which weigh too heav-
cover everything. What about cancer? My view ily on the national pharmaceutical bill. Algeria
is that the card should actually be extended. would have done better to follow World Health
Algeria’s social welfare structures have to be Organization (WHO) policy right from the start.
more ambitious. The Ministry for Social Security Therefore I would definitely like to see some
enjoys a considerable budget and, in my opin- progress on this front. Secondly, I would love
ion, it could reimburse more therapeutic areas. for the National Agency for Medicines to finally
see the light of day.
PB: Algerian healthcare has a human
resources challenge. Even though there
are more science-orientated students
graduating from the universities than ever
before, many are choosing to seek employ-
ment abroad. What can be done?
SENATOR LOUISA CHACHOUA: I must con-
fess that I was one of them. In the early 1980s,
I took the decision to finish my studies and start

44 Interview
Rise of the regulators

PharmaBoardroom: You have been PB: The main mission of the LNCPP is
directing the LNCPP since its estab- to ensure quality control of medica-
lishment in the mid-1990s. What have ments in Algeria and to foster exper-
been your organisation’s main tise in pharmaceuticals. What are the
achievements to date? And what main challenges your organisation
would you describe as the current has faced in carrying out that man-
priorities? date? And what sorts of challenges
MOHAMED MANSOURI: The laboratory do you expect to encounter in the
was established back in 1995 with a view future?
to managing the circulation of medicines MOHAMED MANSOURI: First of all, it
within the country. We benefited from was necessary to forge consensus and
strong support on the part of the govern- gain the support of all stakeholders – with
ment because, since the opening up of private enterprise as much as with the
the Algerian pharmaceutical industry to government. Inevitably, in the beginning,
private sector participation, there had many people were resistant to the idea
been no real regulatory structure in of restrictions. This is why it was espe-
place. Initially many people were scepti- cially necessary to build up a coalition of
support so as to avoid potential bottle-
cal about the creation of the LNCPP and
necks. This has been our stance ever
its capabilities, but our workforce has
since the inception of LNCPP. We engage
been rapidly expanding to the 350 per-
in frank, open and respectful relation-
sonnel that we employ today and our
ships with all actors – the manufacturers,
expectation is that it won’t be too long
the importers, the multinational con-
before we enjoy a human capital base of
glomerates – whilst always bearing in
as many as 700 employees.
mind our core mandate of safeguarding
We are immensely proud to have built
quality.
such a comprehensive institution. Today
Ensuring quality control, for example,
the LNCPP specialises in no fewer than requires considerable human and finan-
17 different areas spanning quality con- cial resources. Because this is a matter of
trol, security and even training. We really public health, we have been tasked with
are a unique entity and that is precisely not tolerating any kind of non-adherence
why we are in the process of expanding to quality standards. We are the body
our partnerships with international labo- that, to date has successfully brought
ratories round the world. Contrary to about the withdrawal of 17 products from
what one might have thought, the issue multinational pharmaceutical companies
of financing has never been a problem because they failed to comply with the
for us in our development of the institu- country’s norms and quality standards.
tion. It’s all a question of having the right In the future, we aspire to create two
political will behind you. Beyond that, the new public laboratories, one of which will
secret to our success has been hard work. be dedicated to biotechnology which is
It’s about continuing to work day and a growth sector. That’s why we need to
night as we did in the very beginning. put in place strong structures and robust
Mohamed Mansouri, GENERAL MANAGER - LNCPP

45
preparation. Our ambition is for Algeria to not only Algerian nationals, but the peoples
become the African lead nation for health- of other developing countries.
care products and services from biotechnol- Our infrastructure is of high quality, which
ogy to hospitals. The goal is to emulate the is why we helped to build other facilities in
sort of dominance in healthcare and pharma- other countries across the African continent.
ceuticals that the US has achieved, but on a Our reputation precedes us and we feel com-
regional and continental scale. pelled to train-up African scientists here and
assist in the development of infrastructure in
PB: For the fourth consecutive time, the other African emergent countries. For many
World Health Organisation (WHO) has years, it was the French that helped build
renewed its support of the LNCPP as a laboratories around Africa. Now that task falls
reference laboratory across Africa and to Algeria.
the Middle East. What’s the rationale
behind this award? PB: Last June, a Memorandum of Under-
MOHAMED MANSOURI: From the very standing was signed between Algeria
beginning, we requested ‘collaboration cen- and the United States for the creation of
tre’ status from the WHO. We considered it the biotechnology cluster in Sidi Abdal-
very important to gain international recogni- lah (Algiers) as part of ‘Algeria Vision
tion from such a prestigious institution 2020’. In what ways is Algeria best placed
because doing so helps us raise considerable to assume this regional role?
local support and backing. Ultimately, follow- MOHAMED MANSOURI: We are extremely
ing a visit from a delegation of experts from confident in our ability to build up our exper-
the WHO, we were designated as a ‘reference tise and capabilities in the field of biotech-
laboratory’ which was well above our expec- nology. We have signed an agreement with
tations. our American partners for bi-lateral cooper-
Last year, the WHO even invited us to join ation in this sector. The Americans were firm
an ‘Expert Advisory Panel on the Interna- that they wanted to cooperate with Algeria
tional Pharmacopoeia and Pharmaceutical given our level of expertise which is probably
Preparations,’ which further demonstrates unique within the region. Only Egypt has
the increasingly influential role played by been a long term strategic partner with the
Algeria in healthcare at the regional and United States in the healthcare and pharma-
international levels. ceutical field, but the mass uprisings have
had the effect of suspending that collabora-
PB: Many experts believe that emerging tion. In Algeria, we will soon be creating the
countries like Algeria are the future of centre of excellence and are starting with the
the pharmaceutical industry. In your creation of a commission to determine its
opinion, what can the LNCPP bring not needs in terms of training, expertise and
only to developed countries but also to human resources.
the developing world?
MOHAMED MANSOURI: The construction PB: What are the next steps for the
of two new public laboratories is going to be LNCPP?
paramount if Algeria is to catch up with the MOHAMED MANSOURI: We are hoping
leading countries of the pharmaceutical that a framework can be created to separate
industry. I am confident that once we have commercial considerations from purely phar-
developed our expertise in biotechnology, maceutical and scientific questions. I believe
we will be able to enter the ranks of the world this next step would enable us to make our
leaders. The idea is not to compete against organisation even more efficient.
other countries. On the contrary, our devel-
opment of this expertise would be to benefit

46 Interview
Reconfiguring hospital
procurement
PharmaBoardroom: Could you please ensure no shortages. The PCH, with its
start by introducing the PCH and its public service mission and its culture to
mandate? serve the patient, prioritizes the avail-
AYAD M’HAMED: Our forerunner, the ability of pharmaceutical production
Algerian Central Pharmacy (Pharmacie according to the commercial mandate
Centrale Algérienne) was created in underlined in its creation.
1963, and restructured in 1982 to create It is important to highlight that when
three regional directions: Enopharm in shortages occur, it is often the conse-
Oran, Enapharm in Algiers and Eco- quence of non-expressed needs of hos-
pharm in Constantine. Those directions’ pitals, and are therefore difficult to antic-
mission was the supply of medicines to ipate. However, in the defense of
the hospitals and pharmacies in each hospitals, there are an ever-increasing
region. Meanwhile, an entity called Ene- number of patients entering the system,
medi was established for the acquisition as access to healthcare is a constitu-
and purchase of medical material, instru- tional right, as well as the population
ments and everyday health products. choosing to seek treatment rather than
The PCH (Pharmacie Centrale des prevention, or specific diseases that
Hopitaux, Central Pharmacy for Hospi- cause spikes in supply and demand.
tals), created in 1994, is the result of a However, by and large, supplying hos-
second restructuring of the pharmaceu- pitals is marked by its regularity. In order
tical sector. At that point, the govern- to carry out this objective, the PCH
ment expressed its concerns about the schedules supplies based on average
security of supply of medicines to hos- consumption and launches tenders to
pitals and pharmacies, and its desire to allow hospitals to operate normally.
protect them from fluctuations, short-
ages and shortfalls. Additional public PB: What systems would allow a bet-
services also fall under the remit of the ter coordination between the hospi-
PCH such as the responsibility for main- tals and the PCH?
taining strategic stock and a disaster AYAD M’HAMED: Public authorities
contingency stock. As a public enter- have placed increasing importance on
prise, the PCH is also able by law to con- ensuring availability of medicines. To
duct industrial and commercial activity. date, the PCH has a management sys-
tem and plans to implement software
PB: Last year, Algeria experienced a enabling the creation of a functional and
shortage of medicines. What have open link between the stocks of hospi-
you been doing to remedy this? tals and our system. An electronic order
AYAD M’HAMED: I don’t think it is fair system for monthly and weekly needs is
to use the word ‘shortages’. Saying that, currently in the works. Among other
from time to time, there have been some things, the PCH is in the process of
out-of-stock situations would be more acquiring Enterprise Resource Planning
appropriate. The management of supply (ERP) methodologies and technologies.
and stocks requires daily actions to We have already installed fiber optics at
Ayad M’Hamed, DIRECTOR GENERAL - PCH

47
our four regional offices as part of a project “There are an ever-increasing number
managed by the Office of the Minister of
Health in partnership with Telecom Algeria. of patients entering the system, as
The modernization of the PCH in all its access to healthcare is a
aspects will allow better control of supply,
and will allow us to focus on drug availability, constitutional right as well as specific
quality and cost. diseases that cause spikes in supply
PB: You have previously spoken about and demand. “
delays in the payments to the PCH from
the hospitals. What is the current situ-
ation and how has this evolved in recent losing sight of the importance of making
years? innovative molecules available to patients
AYAD M’HAMED: The hospital debts to the as required.
PCH haven’t stopped increasing. The PCH
has experienced some cash flow problems PB: You also want a see a change in the
as a result of this, effectively paralyzing it. role of PCH with an increased role in
In this context, the public authorities have packaging and the production certain
decided to simplify the rules when it comes elements. How do you see this develop-
to the awarding of contracts to hospitals. ment taking place?
Mutual contrac ts are now the chosen AYAD M’HAMED: Our priority, for the time
method of execution with all hospitals for all being, is about modernizing the PCH, as well
drugs requested. as ensuring the compliance of its infrastruc-
ture to international standards. The question
PB: Algeria’s objective is to locally pro- of the packaging and manufacturing of
duce 70 percent of the pharmaceutical pharmaceutical products is our second pri-
products consumed in the country. ority.
What role do you see the PCH playing The PCH follows the policies of the Min-
to reach this goal? istry of Health, Population and Hospital
AYAD M’HAMED: Public authorities have Reform and of his Excellency the President
shown their willingness to adopt a drug pol- of the Republic, by working to reduce the
icy in Algeria. Coordinated actions by the drug import bill, promote the consumption
General Directorate of Pharmacy of the Min- of generic drugs and foster a favorable envi-
istry of Health, Population and Hospital ronment with the right conditions to enable
Reform and the various producers have to the birth of a fully-fledged Algerian phar-
been implemented to identify the essential maceutical industry.
products required to create functioning hos- It is important that the PCH acts as an
pitals, and to ensure a certain percentage instrument of the state in the service of
of drug production in Algeria. Generic prod- patients and the country’s health infrastruc-
ucts available in Algeria have already ture, with a regulatory role in addition to
relieved the country’s drug bill, but to a ensuring the availability of pharmaceutical
large extent, Algeria remains dependent on products anywhere across the country.
originator molecules. The PCH supports
local producers and is working actively to
reverse the trend of consumption to achieve
the desired ratio of 70 percent generics to
30 percent originators. The government’s
drug policy aims to increase the share of
generic drugs on the market, but without

48 Interview
The strategic relevance

of Algerian Pharma PharmaBoardroom: As COO of Novo PB: What is the strategic importance of
Nordisk, what is your evaluation of Novo Nordisk’s Algerian operations at
the Algerian pharmaceuticals mar- the global level?
ket? KÅRE SCHULTZ: From a global manage-
KÅRE SCHULTZ: Novo Nordisk has ment viewpoint, we think about these issues
been at the forefront of the fight against across two dimensions. Firstly we look for
diabetes in Algeria for many years, so the high value generating business right
we view the market very much from the now which tends to be in high end markets
standpoint of helping people with dia- such as North America, Switzerland and
Japan, and top tier emergent markets such
betes to have a longer and better life.
as Mexico and Brazil. Secondly we look for
In Algeria, and across North Africa as a
the places where there are considerable
whole, we identify a large and growing
unmet needs and spiraling demographic
patient population with a substantial
growth. Algeria falls into this latter category
unmet medical need for optimal ther- where there is substantial current demand
apy. For Novo Nordisk, therapy consti- and even greater future demand.
tutes of not just intervention and man-
agement of the disease, but also the PB: You obviously have finite resources
preventative steps governing diet and at your disposal and have to take hard
exercise and early diagnosis. In Algeria, decisions concerning where to and
there are needs and opportunities in where not to invest. Where does Alge-
each of these areas. ria lie on your order of priorities?
The difference today compared with KÅRE SCHULTZ: Algeria is, without doubt,
25 years ago is that the population one of the strategic markets in Novo Nor-
growth has been dramatic and so too disk’s portfolio of emerging markets world-
socio-economic change with increased wide. In our way of structuring the business,
urbanization and industrialization. Life- the emerging market portfolio accounts for
style changes associated with these phe- some 4.5 billion inhabitants and Algeria is
nomena, whether increased pollution or one of the key contributors to that equation.
poor diet, are driving the incidence of Algeria is unequivocally the lead market for
diabetes to the point where it has now us in Africa.
reached “epidemic like” proportions. We It’s always vitally important to establish
are talking about a big-scale problem a footprint early on as this is the only effec-
affecting millions of people where our tive way to connect to the authorities and
intervention can concretely improve peo- patients and really understand the dynam-
ple’s livelihoods. Our objective is to ics at play in a country. There are different
ensure that an expanding patient group ministries, different social security systems
is taken care of in the best possible man- and key opinion leaders in every market and
ner and to establish a sustainable busi- if you want to truly work to improve the sys-
ness in the region. With the Algerian mar- tem then you have to do it from the inside.
ket we see an opening to realize these You need to have people on the ground
twin goals. that live and breathe that local situation.
Kåre Schultz, PRESIDENT AND COO - NOVO NORDISK

49
PB: You have mentioned that it is not only PB: What was the reasoning behind locating
important to deliver a top-of-the-range your facility in Tizi Ouzou?
product, but also to work in collaboration KÅRE SCHULTZ: We always like to have our
with the medical community, state and main manufacturing facilities away from the
other key actors. How supportive do you capital city and instead in a regional centre
find the government in Algeria, and how where we have a better chance of linking up
receptive are the other stakeholders in with educational institutions and local employ-
Algeria? ment. That way, we can play bigger role in
KÅRE SCHULTZ: For our two core therapeutic supporting local society and spreading wealth
areas in Algeria – diabetes and hemophilia – I across the nation. People outside of Algeria
have found the government to be extraordinarily tend to have a misconception about the secu-
receptive and supportive of our initiatives. I am rity scenario within the country. In that sense
confident that they understand the gravity of the we are supporting the government by being
situation and are committed to facilitating real in an area where many people are afraid to go
transformation. They know they have to consis- and by demonstrating that the reality on the
tently improve the level of healthcare for these ground is very different from many people’s
types of chronic diseases and are more than will- perceptions.
ing to engage in constructive collaboration to
achieve this. PB: How do you see the Novo Nordisk prod-
There is also a clear understanding on the uct line compared to competition?
part of the authorities of what we can bring in
KÅRE SCHULTZ: It’s second to none because
terms of optimized operations, innovative treat-
we have what can be termed a world class prod-
ments and rigorous standards. We maintain a
uct in each category – either within the market,
single quality standard for all of our manufactur-
or about to get on the market or in phase three
ing sites worldwide. If a site is unable to attain
trials. None of our competitors enjoys such as
that level of specifications, then we will prevent
broad and comprehensive diabetes portfolio. In
it from producing until the necessary improve-
that sense, we are very optimistic because we
ments have been implemented to bring it up to
see ourselves within the next ten to twenty years
scratch. The government seems appreciative this
feasibly delivering a number one or number two
level of rigour, and hopefully we will even have
product for each and every category. It is pre-
contributed towards raising the benchmark for
cisely because we have this long term future in
good manufacturing practice within the country.
place that we can justify the sort of investments
we are making in countries such as Algeria.
PB: With your global perspective you can
compare what’s been happening here with PB: What are your priorities looking for-
what’s been happening in other countries ward?
where you have established local produc-
KÅRE SCHULTZ: Any growth in commercial and
tion facilities. How easy has it been here in
manufacturing competency takes time. There is
Algeria to attain the necessary level that no nirvana scenario overnight. To properly put
you have just referred to? in place these sorts of infrastructural investments
KÅRE SCHULTZ: It has been easier than I initially takes patience and perseverance. Within the
feared and we are immensely proud of what we next ten years, we want to add more product
have achieved thus far. The products that we are lines to the manufacturing base and to expand
manufacturing in Algeria are of a very high stan- our reach. We also hope our partnership with
dard indeed. Compared to other countries that Saidal for in-country manufacturing of insulin will
we have entered, however, the Algerian market bear fruit by touching the lives of many patients
does present some fairly unique challenges and while simultaneously radically improving Alge-
we are still in the process of identifying ways to ria’s insulin security outlook.
surmount them.

50 Interview
An unorthodox approach
to local pharmaceutical
manufacturing
PharmaBoardroom: What is the scope been willing to go out of its way to be
of the company’s activities today and supportive and to back us in our endeav-
how El Kendi has evolved over time? ors.
ESSAM FAROUK: El Kendi is privately We started building our 8000 square
owned with shareholders from Saudi Ara- meter flagship facility in Zeralda in 2006
bia and Jordan in a ratio of 35 to 65 per- and within two years started manufactur-
cent. We were the first foreign firm to be ing 19 products which has nowadays
established in Algeria without having a increased to a portfolio of 140. Around 85
mother company abroad. This actually percent of those are generics, ten percent
placed us in a unique situation compared value-added generics and the remaining
to other Arab players such as Hikma or five percent are totally new, innovative
Daw al Dawa that could rely on their par- products.
ent entities during the early phase of El Kendi’s product selection strategy
operations. By contrast, we needed to is quite distinctive from most of your com-
be self-sufficient right from the start and petitors. Please tell us about that.
to generate sufficient revenues to cover That is absolutely correct. We see our
our operating costs because there was product selection strategy as one of our
no parent to bequeath riches. Equally we primary assets. In view of Algeria’s shifting
had to build up our very own resource disease profile we consciously decided to
base from local talent in the absence of focus in on seven therapeutic classes that
an in-house human capital pool that we directly relate to the future needs of the
could leverage to parachute in workers population. These included: immunology,
from abroad. oncology, cardiovascular, central nervous
Despite these early challenges, our system (CNS) and auto-immune diseases.
unconventional market entry allowed us What’s more, within those highly relevant
to act much more like a home-grown, segments, we deliberately concentrated
local outfit and this has brought its own on particular niche products where there
benefits. For a start, the government would be unmet need and where we
could see that we were thoroughly com- could deliver the greatest value. Then,
mitted to the Algerian market and were over time, we have been building-up our
putting down roots for the long haul. We know-how and human expertise in those
were also making a tangible benefit to directions to gain a level of mastery.
the country not only by engaging in local Our third asset after our product selec-
production, but also by creating jobs and tion and high caliber personnel is then our
training up local talent through our skills state-of-the-art, fully integrated Zeralda
and development program. The govern- facility which was financed to a tune of 22
ment appreciates this and having seen million euros and conducts 100 percent
what we are bringing to the table has local manufacturing. We are immensely
Essam Farouk, CEO - EL KENDI

51
proud to be the only company apart from the request approval for 47 products all at once,
state entity Saidal that can do this. All other then as long as we can secure permission to
local producers are reliant on some sort of proceed with 15 of those, then we can be very
importation. Either they bring bulk products successful. This is what has made us the num-
in and assemble and package them or they ber one company for volume of product reg-
import ready-made granules from which to istrations over the last five years. Because we
manufacture their products. We are now reap- submit a whole basket of products all at once,
ing the success of this strategy. If you consult then even if only 30-35 percent of them get
the IMS statistics and league tables, you will registered, we are still going to be outper-
find that we have risen from ranking 174 to forming any country that develops only one
number 5 within a mere five years. And now or two products at a time in sequential fash-
we are preparing ourselves to take on the top ion.
four companies in the market.
PB: How is El Kendi going about manag-
PB: El Kendi has an excellent track record ing the challenge of sourcing and retain-
for the speed in which the company man- ing skilled workers?
ages to secure approval and launch new ESSAM FAROUK: From a very early stage, I
products. What is the secret to this suc- noticed that Algerians employed abroad tend
cess? to be successful wherever they go. What then
ESSAM FAROUK: First of all we have been is the difference between the external and
able to develop a very high level of mutual internal environments? I am firmly convinced
trust with the state over time. We have always that if you are respectful of Algerians, trust
been very honest, upfront and direct in our them and are full of warmth towards them,
dealings with the government. On arrival, we then they can be just as successful at home as
informed them that we would be the first pri- they are abroad. The first step is to communi-
vate sector entity to do 100 percent manufac- cate with them in the right way, to be motiva-
turing in the country and we delivered on our tional and to lead through example. My expe-
promise. We had many lucrative offers to do rience is that Algerians have an educational
the packaging of imported products, but we level that is above the norm, but tends to be
always refused because we committed to theoretical rather than practical. In other
keeping our promises. Then we informed the words, they have all the right qualities to
state of our intention to concentrate only on become the skilled workers that you require
therapeutic solutions of tangible benefit the of them, but need additional exposure and
country and we have been delivering on that hands-on experience to attain that level.
too. Over time this leads to a scenario where
the state trusts our products and where we PB: What do our international readers
trust the state in its actions. need to know about the Algerian market?
The real secret to the speed with which we ESSAM FAROUK: Algeria had the fastest
gain approval to launch new products is again growing pharmaceuticals sector in the MENA.
our product selection and manufacturing It has even surpassed Saudi Arabia. It is also
strategy. My own professional background rare in the region for having a bill of medicines
and expertise is actually in manufacturing and that is fully supported and reimbursed by the
that has enabled me to apply some of my prior government. In terms of human capital you
learnings to El Kendi’s current endeavor. will also find the right variety of talents for your
Unlike virtually all of our competitors, we man- business, just so long as you know how to
ufacture a wide variety of product lines in par- hand pick them and develop them in the right
allel rather than sequentially. Within our first manner. Whatever the economic statistics and
month we already had 19 product lines in whichever way you look at it, this is a highly
motion. When we go to the authorities and attractive market.

52 Interview
Albeit belated, clinical research is

finally taking-off
PharmaBoardroom: What initially lio, but we intend to make it the center-
brought ARIANNE to the MENA piece of operations in this part of the
region and Algeria in particular? world. We arrived here with a strong clin-
CELLIA HABITA: We are headquartered ical operations expertise particularly in
in the US with an emphasis on providing interventional clinical trials. When we
both clinical and regulatory services speak to local investigators they are tre-
worldwide. We cover 25 countries across mendously excited about working with
the globe. The Middle East and North us because it offers them an opportunity
Africa (MENA) is actually a rather under- to gain exposure to clinical research and
represented region with less than one to develop new investigational products
percent of all global ongoing clinical tri- from the latest and the best of what R&D
als. American CROs are not established has to offer. In terms of therapeutic areas,
in the region and have mostly ignored we have expertise and an excellent track
this region possibly due to geopolitical record in cancer and diabetes research,
factors. It is nevertheless well-known that amongst other indications which also
specific countries such as South Africa happen to represent some of the largest
and Algeria represent sizable markets for market segments for pharmaceutical
the pharma industry. The same can be product development in the region. All
said of the MENA region as a whole with of this makes us a great fit and natural
important pharma markets developing in participant in the market.
Saudi Arabia, the UAE and Egypt. We felt
it was important for us to be present here PB: During this era of globalization
as a differentiator within the CRO market, of clinical research, what would you
but also because of a growing willingness say are the key selling points for
within the research world to incorporate Algeria?
countries such Algeria in their studies. CELLIA HABITA: The main appeal is the
These demands will only continue to large untapped population. We are talk-
increase since the MENA market is one ing, just in Algeria, about 40 million peo-
of the few growing pharmaceutical mar- ple, many of whom are “naïve” when it
kets and with the current saturation of comes to prior pharmaceutical treatment
clinical research in North America, West- and their correct usage. The whole MENA
ern Europe and even CEE (Central and region represents close to 600 million
Eastern Europe). We were keen to be at inhabitant s, not a number to be
the forefront of that. I myself was also neglected. Add to that the fact that they
born here, so have an additional incen- are well-educated with a high level of
tive to be contributing to a place that is adult literacy, with government actively
dear to me. working on improving the quality of care,
of research and the regulatory environ-
PB: How then would you describe ment.
your market offering in Algeria? Look back 10-15 years ago, how the
CELLIA HABITA: Algeria very much rep- newly joined central and Eastern Euro-
resents the latest addition to our portfo- pean countries to the EU were when it
Cellia Habita, CEO - ARIANNE

53
came to clinical research. They had a very PB: As a relative newcomer to the clini-
limited exposure and experience. Today, no cal research scene, what has Algeria still
global study passes on that region, and it to learn if it is to establish itself as a
must be noted that it is a saturated region heavyweight destination for clinical
when it comes to clinical trials. Plus they do studies?
not represent the market share MENA repre- CELLIA HABITA: It’s really about the rule of
sents for pharmaceutical companies. There numbers. You have to do 10,000 hours of
is always a snowball effect. What started off something to really become good at it. The
as quite small and insignificant, rapidly more local Investigators gain exposure and
matured into booming industries. Imagine, practice in conducting studies, the more
then the potential of Algeria with its much competent they will become at it. It is some-
larger starting base when compared to coun- thing relatively new here and that’s why it is
tries such as the Ex-Jugoslav republic or cer- very important for the country to be partici-
tain ex-Soviet countries. pating in international trials. Same for the
regulatory agencies, the EMA, 15 years ago,
PB: In this game, the key is to have a fast did not have all the directives and guidelines
timetable to market and speedy patient it has today. It takes time and it is based on
enrolment. How does Algeria fare on experience and exposure.
these fronts? Outsiders sometimes ask about the reli-
CELLIA HABITA: Algeria has surprisingly ability of the country regulatory framework
attractive timelines for regulatory approval. and wonder about the integrity of the data
A comparison with other regulatory agencies coming from clinical trials in Algeria. In real-
around the world is indicative of this. In Bra- ity Algeria has much stronger regulations in
zil, for example, you can expect a 12 month place to protect IP than the rest of the region
wait; elsewhere 9 and 6 months for China and and also compares very favorably to coun-
Eastern Europe, respectively. In Algeria, by tries like India and China. The quality of the
contrast, the whole process is complete data is also respectable despite the much
within only 3 months. Ethical committees in smaller volume of studies that have been
Algeria are also centralized which is helpful completed to date. The Maghreb region, as
because it means submitting all your sites to a whole, complies with ICH guidelines and
a single center. The local regulatory system Algeria is no exception.
is sequential, and once ethical approval is The country is on the right track and there
granted, submissions can be made to the are no specific major shortfalls. This is a work
Ministry of Health. Approvals are usually in progress that will take time. Right now,
granted within 2 months, but of course could there are probably 200 trials, 80 to 90% of
be longer if queries arise. which are observational. We believe that in
The Lebanese model is the fastest and a country like Algeria, with the right policies
one of the oldest frameworks in the MENA and training, this number could surpass 2000
region and is notable for allowing Phase I trials per year, bringing in millions of dollars
clinical trials. For timeframes in the Maghreb, in new investment and linking Algerian clini-
you can think of three months, and in the Gulf cians to the global research community.
there is much more of a differentiation
between observational and interventional
with each country reliant upon its own spe-
cific system. North Africa holds the advan-
tage in being much more homogenous –
both in terms of its populations and its
regulatory frameworks.

54
Company index
AHK 9
AREES 5, 11, 31
Arianne 22, 52
*AstraZeneca 13, 22, 28
*Bayer 22, 25
*Biocare 25, 28
Boehringer Ingelheim 27, 28
Bouygues Batiment international 18, 32
CCIAF 19, 24
Chiesi 20
CHU of Ben Aknoun 25
Clinica Research 2
CMS 19, 30
Council of the Nation 25, 30, 42
Dar Al Dawa 9, 30, 37
*Deloitte 9,11,13, 19, 20
*El Kendi 9,15, 17, 24, 37, 50
*Faderco 13, 27, 28
*Ferring 13, 14, 25
GSK 24, 25
Hikma 37
IMC 29
*IMS Health 9, 17
Innotech 13, 24
Inpha-MEDIS 24, 28, 29
IPMED 8, 24, 28
*Janssen p9, 18
LNCPP 11, 44
Medicalliance 24
*Merck 19, 23, 28, 30
*Ministry of Health 9, 13, 14, 15, 30, 31, 38
Ministry of Labour & Social Security 13
MSD 17, 30
*Novo Nordisk 11, 22, 30, 35, 48
Pasteur Institute of Algeria, 11
PCH 11, 46
Pfizer 9, 17, 20
*Pierre Fabre 15
Plan Cancer 15
Propharmal 27
Roche 11, 34
Saidal 5, 24
Salem Laboratories, 28
*Sandoz 9, 24, 29
Sanofi 17
*Servier 14, 28
Societe Algerienne de Pharmacie 24
UNOP 14
USABC 30
VAMED 18, 31
Varian 9, 33
* Advertiser

55

Algeria Pharma Market

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Algeria Pharma Market

Uploaded by

Copyright:

Available Formats

HEALTHCARE

A REGIONAL CHAMPION COMING OF AGE

2013 Brought to you by

Minister of Health of Algeria

ALGERIA DECEMBER 2014

Minister Abdelmalek Boudiaf, Minister of Health and Hospital

as well as all the companies we have met for their support,

ALGERIA DECEMBER 2014

This report was prepared by Pharmaboardroom.com

INTRODUCING ALGERIA’S PARASTATAL

l’Institut Pasteur d’Algérie (IPA)

Laboratoire National de Contrôle des Produits Pharmaceutiques (LNCPP)

Pharmacie Centrale Des Hôpitaux (PCH)

ALGERIA DECEMBER 2014

EVOLUTION OF THE ALGERIAN

ALGERIA DECEMBER 2014

ALGERIA DECEMBER 2014

Credit: Mustapha Raith, mustapha@raith.fr

ALGERIA DECEMBER 2014 deceMBer 2014 FOCUS REPORTS S2

fragmented health coverage, runaway costs and overburdened

S3 FOCUS REPORTS deceMBer 2014 ALGERIA DECEMBER 2014

ALGERIA DECEMBER 2014

A seriously disjointed market is another hallmark, with a a one-size-fits-all

The hyperactive state

S5 FOCUS REPORTS deceMBer 2014 ALGERIA DECEMBER 2014

ALGERIA DECEMBER 2014

dramatically changing eating patterns taboo,” proudly remarks the company’s

S7 FOCUS REPORTS deceMBer 2014 ALGERIA DECEMBER 2014

entire spectrum of activities. This is mani- tion are necessary measures so as to be

ALGERIA DECEMBER 2014 deceMBer 2014 FOCUS REPORTS S8

ALGERIA DECEMBER 2014

“The government’s action dine Ioutichene. “This is an im-

S11 FOCUS REPORTS deceMBer 2014 ALGERIA DECEMBER 2014

out to leaders in hospital construction

proteCting one’s oWn

S13 FOCUS REPORTS deceMBer 2014 ALGERIA DECEMBER 2014

Sandoz Leader mondial de l’Anti-infectieux1

1er fabricant de génériques Européen dans le monde1

Leader mondial des biosimilaires1

1. Document Sandoz France ( PARTAGEZNOTREVISION) - PPR 0660310/1 - Avril 2010: 02 - 24

deceMBer 2014 FOCUS REPORTS S14

ALGERIA DECEMBER 2014

Algeria: Next clinical trial destination of choice?

ALGERIA DECEMBER 2014 deceMBer 2014 FOCUS REPORTS S16

THE FORMULA FOR A BETTER LIFE

ALGERIA DECEMBER 2014

tremendously difficult to formulate a development strategy that

deceMBer 2014 FOCUS REPORTS S18

The human resourcing conundrum

S19 FOCUS REPORTS deceMBer 2014

ALGERIA DECEMBER 2014

information.” “Entrepreneurs setting move was just as significant as the 2008

ALGERIA DECEMBER 2014

perspective, the high

ALGERIA DECEMBER 2014 deceMBer 2014 FOCUS REPORTS S22

achieves the recognition it deserves,”

Promoting Health Improving Life

Science For A Better Life

There are approximately 30,000 different

S23 FOCUS REPORTS deceMBer 2014

ALGERIA DECEMBER 2014 deceMBer 2014 FOCUS REPORTS S24

ALGERIA DECEMBER 2014

Credits: Chiraz Bensemmane

ALGERIA DECEMBER 2014