The Brazil edition of our Boyden Global Market Outlook, Talent-Led Growth, addressing concerns about talent in specific countries, focuses on the healthcare and life sciences industry in Brazil. It includes a Q&A with Alexandre Sabbag, a Boyden Partner in São Paulo, on the issues most often discussed in a life sciences senior executive search.
Welcome to Boyden’s Global Market Outlook on talent-led growth in healthcare and life sciences. This series of country reports addresses our clients’ overriding concerns about talent: where it is, what it looks like and how much it costs.
From Boyden’s perspective, ’talent-led growth’ is the result of a combined business and talent strategy. Plans for taking products or services into new markets, or expanding in existing ones, involve knowing where the capabilities are and understanding talent mobility, including local remuneration.
While governments foster greater access to healthcare, those in the industry strive to deliver it. Our role, as a leading global executive search firm, is to help our clients discover the right leadership to sustain operations and achieve growth.
These country reports provide a framework for this, covering:
Please note that all data is indicative only and is not intended for use without consultation. Please contact Boyden if you have any questions or would like to discuss specific requirements.
Looking for more data? Download a copy of the Talent-Led Growth in Healthcare & Life Sciences: Data Digest by clicking here.
Global developments in personalised therapies, breakthroughs in oncology and the management of autoimmune diseases are accelerating transformation in healthcare & life sciences. However, against a backdrop of modest GDP growth worldwide, government spending on healthcare is forecast to increase by just 1% globally between 2014 and 2018, compared with 2008 and 2013.
As a consequence, pressures on healthcare infrastructure and cost containment are driving consolidation and collaborative partnerships, shifts in financial risk, and changes in the global supply chain. Innovation in healthcare IT (HIT) and big data, together with integrated delivery and more knowledgeable patients, are supporting better health outcomes.
Emerging markets offering significant growth prospects were dubbed by IMS Health in 2010 as ‘pharmerging’ and categorised into three tiers, according to growth forecasts and per capita pharma sales:
These growth opportunities are spurring organisations to target global populations with unmet needs.
Challenges in healthcare economics are being met with business model innovation, supporting the industry in its commercial and humanitarian quest: universal healthcare coverage.
From a talent perspective, leaders of big pharma and healthcare organisations are under pressure to increase transformation capabilities to contain costs, comply with growing regulation, further innovation and move from volume-based to value-based payment models.
As business leaders recalibrate regional growth prospects, the top three concerns among global CEOs are ‘over-regulation, geopolitical uncertainty and exchange rate volatility2.
Against this backdrop, access to ‘the right talent at the right time in the right place’ is a mantra among growth organisations. These interconnections are becoming increasingly complex as borders dissolve for those seeking the best career opportunities and new geographic hubs and centres of scientific excellence emerge.
Pharmerging markets, notably China, Brazil, India and Russia, as well as others in Eastern Europe and Latin America, are creating new challenges and opportunities. In 2014, pharma markets in Brazil and China grew by 12.6% and 11.6% respectively, compared to average market growth of 2.4% in Europe3. The US market grew by 12.5%4 and by 2014 the US had already overtaken Europe in the creation of new chemical or biological entities5.
These geographic shifts create cross-border opportunities for high-performing leaders, scientists and academics keen to flex their muscles in a global environment that rewards combined scientific and commercial capabilities. And for health leaders, much needed and readily deployed people in a volatile market for talent. The migration of health workers has therefore become a formal priority for knowledge and understanding at the World Health Organisation6.
Global migration is also a priority for organisations creating leadership pipelines and needing to identify locations where new skill sets are emerging, the hubs around which they will coalesce, and the people with the global fluency and flexibility to drive innovation in a more fluid market.
Changes in the flow of people and money connected to healthcare & life sciences have significant implications for governments pressed to explore new political, economic and social models.
From a purely economic perspective, in 2012 the global pharma industry employed 4.4 million7, with 3 million in Asia, compared to 750,000 in Europe and 270,000 in North America. Global employee remuneration was $91.3 billion, an increase of 41.9% over six years. In 2012, the global pharma industry had increased its contribution to global GDP value-add by 6%, reaching a total of $437 billion8.
Governments are therefore monitoring the contribution of healthcare & life sciences to their country’s GDP, with broader hopes in Europe that the pharma industry can strengthen economic recovery and ensure future competitiveness.
To summarise, advances in science, new commercial models and shifts in global opportunities are driving major change for people, organisations, governments and global competition. Experts in retained search specialising in healthcare & life sciences find themselves consistently advising organisations on where the talent is, what it looks like, and how they can attract it.
Private insurance coverage | percentage of population
50.3 million | 25%
GDP spend on healthcare | OECD average
9.1% | 8.9%
Forecast growth in average annual pharma spending, 2014- 2018
Number of people employed in healthcare | % of population
4.2 million | 2.1%
Doctors per 1,000 population | number of active doctors
2.2 | 451,000
Hospital beds per 1,000
Total private hospital beds
Total public hospital beds
Rank in global pharma market by revenue
Share of global pharma market
Net importer or exporter of pharma products
Trade balance (2014 exchange rate)
Pharma exports: top partners are Denmark, Venezuela, the US
Pharma imports: top partners are US, Germany, Switzerland
-R$13.9 | -US$5.9bn
Brazil has a unique healthcare system, providing universal coverage to all Brazilians in accordance with their Constitutional right to medical treatment. It is one of the largest public healthcare systems in the world, catering to almost 200 million people. The private healthcare system covers 50 million people, equivalent to the population of Colombia and more than the population of Spain.
Brazil has one characteristic in common with the United States: private spending outstrips public expenditure on healthcare10.
Public sector funding comes from three sources: federal, state and municipal. The national health priority system is completely funded by the federal government and managed by centralised tenders.
Pharmaceutical funding comes from the Ministry of Health, which accounts for 50%, covering low-complexity products; individual states, at 30%, cover high-cost, high complexity products; and municipalities, at 20%, oversee the purchasing and dispensing of medicines.
The private system offers both choice and treatments not covered by the public system, and is funded by healthcare plans or insurance companies. Half the individuals with private plans are covered by the top 30 largest insurance companies, out of approximately 1,000 in the country, while one million beneficiaries are concentrated in the hands of just seven companies – equivalent in size to the Swiss market.
The supplementary private sector comprises third-party payers with different business models, primarily group medicine companies similar to managed care organisations; cooperatives, or medical societies which are non-profit organisations whose shareholders are physicians; and self-managed care – large employers with their own healthcare plans.
Insurance companies in the supplementary sector tend to be managed by Brazilian financial services companies, such as SulAmerica and Bradesco.
As an emerging market, Brazil has not yet reached full maturity in the healthcare industry.
The stage of maturity differs for each segment. Overall, the industry is still growing, but at a slower rate. On one hand, a greater proportion of Brazilians entered the middle class over the last decade and therefore increased demand for better healthcare products and services. On the other hand, the current economic crisis – the economy is expected to shrink for the second consecutive year, with the real devalued considerably against the US dollar – has put extra pressure on costs throughout the healthcare value chain.
The pharmaceutical industry still sees Brazil as an important market with some significant opportunities in prescription drugs and OTC medicines. For prescription drugs, there are important initiatives in the public sector, which accounts for a large share of the business, covering areas such as infectious diseases and oncology.
Organisations are investing in broadening their product portfolios to include drugs sold primarily to the government, as well as high value-added products to address immature segments such as infertility and rare diseases. Many domestic and multinational organisations are restructuring their consumer health business into a separate division; this is designed to better meet the requirements and dynamism of an area that is attracting executive talent from fast-moving consumer goods.
The healthcare service provider segment is growing at a faster pace. Increasing demand for healthcare services has saturated the public sector, which has proven unable to cope with the new customer base. This leaves room for the private sector not only to close the gap, but also provide the market with new business models and healthcare technologies.
In January 2015, legislative change allowed foreign investors to own service providers in Brazil. However, an unattractive cost structure – due to inefficiencies in the system – coupled with high labour costs, particularly compared with Colombia for instance, mean that few foreign groups are entering the market.
Devaluation of the Real has impacted asset values, creating acquisition opportunities. The US-based UnitedHealth Group, which invested heavily in Brazil through its majority acquisition of AMIL in 2012, bought its 32nd hospital in São Paulo, increasing its service network as a healthcare delivery business11.
The hospital segment is expected to continue to benefit from being more closely tied to the international market. This brings greater exposure to international benchmarks and models that enable resource optimisation, which will further develop local businesses.
This Q&A with Alexandre Sabbag, a Boyden Partner in São Paulo, focuses on the issues that are most often discussed in a life sciences senior executive search. If you would like more detail, or have a specific question, please contact us directly.
Is it true that the most prominent senior executives in Brazil’s healthcare & life sciences industries – those most in demand in executive search – are bilingual in Portuguese and English?
Unfortunately, proficiency in foreign languages is still a barrier when conducting an executive search in Brazil. Being a continental country with a sole official language, people have not been incentivised to learn other languages.
In the healthcare industry, the context is no different, but the level of proficiency varies dramatically according to the segment or academic background. Professionals who completed medical school and other demanding academic programs tend to be more fluent in English and in some cases, also in Spanish. In addition, those in the pharmaceutical and medical devices segments, especially with experience in multinational organisations, have better language skills. It is common to find little knowledge of English in parts of the C-suite in local healthcare businesses. This puts Brazil below the average in Latin America, where smaller economies are more dependent on North America, which gives executives greater exposure to foreign markets and languages.
Among the BRIC countries, Brazil has the highest spending on healthcare as a percentage of GDP12. How deceptive is this, given Brazil’s lacklustre economic performance over the last few years?
Brazil has been focusing on the healthcare industry to meet rising middle-class demand. The current economic crisis has not stopped the emergence of projects and new technologies in healthcare. We have seen that the industry as a whole, just like agribusiness, is much less impacted by economic contraction and political turmoil.
Given the significant expertise in areas such as oncology, cardiology and organ transplants, can we describe Brazil as ‘the most advanced emerging market’ in healthcare and life sciences?
In neighbouring Spanish-speaking countries, people joke that ‘Brazil is the largest country in the world!’ given that Brazilians tend to see their own businesses on a much larger scale than those in other markets in the region. Nevertheless, there are several areas of medicine and healthcare that are genuine islands of excellence in Brazil, not just in these areas, but also in plastic surgery, fertility and complex diagnostic testing. For instance, local hospitals offer services to international patients who see the balance Brazil achieves between high end treatment and the excellent care environment, which is a cultural Latin trait.
How well connected is Brazil to the international medical community?
Brazil is very well connected to the international medical community. The country has globally recognised opinion leaders in most areas of medicine, and some local hospitals and diagnostic centres are considered to be world-class. In the pharmaceutical segment there is an intense exchange of knowledge in clinical research, involving top universities in and outside the country. Local residency programmes, as well as graduate studies in teaching hospitals, are expanding the number of international students and professors in Brazil.
High-performing doctors and medical experts are often attracted to the private sector for potential career advancement, remuneration and lifestyle reasons. Is that the case in Brazil?
This is definitely the case in Brazil. The private sector offers good career opportunities and pays well. In relative terms, Brazil has quite a significant private sector – on average, one in four Brazilians relies on private healthcare service providers.
Thus, top healthcare professionals work mostly with the private sector, attracted by better compensation schemes, either as an employee or in their own practice. Nevertheless, many high calibre physicians will also have links with public services, mostly for academic reasons, given that the best medical schools are part of federal or state universities. Thus, top professionals do keep their ties with the public sector, not due to remuneration, but
to the prestige of being connected with public medical schools at top universities. Many of them find that the public system provides a much richer base for learning about their specialties, given its more comprehensive characteristics in terms of socioeconomic reach and diversity.
Healthcare needs in Brazil are increasing while the pressure on costs is escalating. How does Boyden advise clients faced with these challenges?
Overall, healthcare clients are struggling with escalating costs due to currency devaluation and rising labour costs, and in some segments, stronger competition. We have been working with clients on improving the efficiency of their operating models, and introducing professionals who add value through business acumen and a more cost-effective mindset. In the years prior to economic contraction, many organisations started new initiatives and built capabilities to cope with expected growth – unfortunately growth that in many cases slowed down.
Many of the executives who recently moved are focusing their management agenda on re-prioritising their efforts and restructuring their teams. In addition, Boyden has helped people migrate from other industries to healthcare service providers, in some cases to fill a void in professionals experienced in efficiency management. This resource optimisation is usually more critical in healthcare service providers, where inflation in medical costs tends to be much higher than in other industries. In many cases, new technology must coexist with previous technology, which must still be offered in parallel, adding extra pressure to the system.
Given challenges facing the government, particularly the Ministry of Health, how do you balance the required executive competencies – particularly those relating to political and regulatory expertise – that are often so important for senior executives in healthcare & life sciences?
It is true that senior executives need to interact with public entities, either due to regulatory issues or because governmental organisations are in many cases their core clients.
That context makes matching an ideal executive to a senior position an even greater challenge. At the same time, the professional needs to be result-oriented, have a strong business drive, and understand the nuances of governmental entities and the rhythm of decision-making, while building a diplomatic relationship and ethical stance. In addition, trustworthiness, tolerance of frustration and risk-taking are competencies normally requested by our clients. Executives with a balanced profile are scarce and therefore competed for by a number of organisations in the local market.
You have long-term experience working with both pharma companies and service providers. What are the most important skills for a search consultant in these two areas?
In both areas the search consultant is expected to introduce people who are well trained and demonstrate technical and management competence in how they talk and conduct themselves.
It is common to hear from clients that executives from sophisticated organisations in other industries can be too cautious and need supporting evidence before launching a new idea or project. This is more critical in hospitals and other service providers, where the physician mindset is to incorporate new medical protocols into their routines only if proven through major studies.
In the pharmaceutical area, executives are often required to be good team players and results-oriented, given the more professionalised stage of their organisations. On the service provider side, executives are often expected to make rapid decisions and to be at the company’s disposal for long working hours. We have seen executives not entering or even leaving the hospital environment because they could not cope with personal responsibilities due to a heavy workload.
What is the most important question your clients should ask you before engaging you to run an executive search for them?
I believe that the most important questions are how the search firm will work and who will lead the engagement. Our longer-term clients expect us to work with them in a consultative mode, supporting them in designing the role requirements and customising the search process together.
At Boyden, we make sure that we apply our seniority to each search, with a Director leading through a hands-on approach. When dealing with healthcare professionals, it is critical that potential candidates engage with consultants who demonstrate good market knowledge and seniority, in order to attract talented professionals to the process.
What does being a search consultant mean to you personally?
After a decade in this profession I understand that a search consultant helps people and organisations to achieve a higher degree of effectiveness and happiness. By ensuring a good match, we can get the best out of each person and offer them a favourable context in which to further develop a sound and successful career.
When I was an executive, I confess that I did not see the value in search consultants, and I avoided using their services until I had a miss-hire in my team. We all paid a high price for the mismatch, particularly the executive involved. I believe that search consultants are brokers of human capital, and therefore have to be sensitive to both management and people issues, trying constantly to identify what each side can offer to the other.
Healthcare & life sciences is one of the most diverse sectors for salaries and remuneration packages. Local, regional and global market knowledge, together with expertise in negotiation, are two of the key decision-drivers in choosing an executive search consultant.
Acquiring the right leader and negotiating the right remuneration package involves synthesising numerous elements, such as the political, fiscal and regulatory environments, subsector trends, organisation type, medium- and long-term strategic goals, target populations, ownership structure and funding, specific location, emerging market participation, competitive developments and shifts in the global talent pool.
Evolution in the supply chain has been one of the biggest drivers of change in both hiring and remuneration, together with consolidation and the need for global fluency. Regional shifts in R&D, manufacturing of generics and biosimilars, health economics and new blends of academic and commercial skill sets are changing the global landscape.
In a tough economic climate, clients tell us that they value Boyden’s ability to restrain escalating salary expectations. Across all subsectors in this industry, our focus on how a role impacts an individual’s career is a crucial area for discussion with both clients and candidates. In the latter group, personal drivers are extremely strong, and we spend a lot of time with preferred candidates exploring these in the context of future change and career impact.
Boyden’s other country reports in this series include charts showing indicative, local remuneration figures.
Due to the devaluation of the Brazilian Real, it would not be meaningful to provide senior-level remuneration and incentive data here. Rather, below are additional insights from Boyden’s Alexandre Sabbag on salaries and other benefits in Brazil. Readers needing specific remuneration advice for their organisation are encouraged to contact Mr Sabbag at firstname.lastname@example.org.
Given the pressures on budgets and escalating health costs in Brazil, what is the impact on remuneration today?
Given the lack of experienced professionals in the healthcare industry, we see no decrease in remuneration. Supply still lags demand, especially for management positions requiring technical knowledge.
At the same time, senior corporate roles in areas such as HR, finance and technology tend to have a much wider recruiting base. This makes it easier for clients to find the right profile from a talent pool where executives do not demand higher salaries. This happens for two reasons: many are at a transition stage in their career, and those who are working do not want high salary increases to make them vulnerable if a crisis impacts their new employer’s business. Most executives value career stability and industry context over a salary increase when making a career move.
Along with currency volatility, there seems to be a lot of volatility in remuneration in Brazil. Can you explain that?
It’s true that the market in Brazil is very volatile, with certain industries experiencing a boom, followed by a sudden drop in demand. The result of this is that people move to other industries, then when demand picks up there is insufficient experience in their previous industry. This creates a skyrocketing increase in the remuneration level of certain professionals. Then when demand subsides once more, these professionals are out of sync with the market and often out of work for a couple of years. I see this happening across industries every month. It makes clients reticent about hiring; they are concerned about an executive staying with the company in a volatile market that can suddenly present very attractive opportunities.
To what extent is Brazil a global market in terms of competing for the right senior executives through attractive remuneration packages?
Brazil is a global market for healthcare professionals in the pharmaceutical and medical device industries. The great majority of industry players are present in Brazil and send their executives here to experience a tough local business environment where they can prove themselves. Every day here can be different, particularly in pharma, and because of our market size organisations operate on a larger scale. Therefore Brazil is a natural career step for potential leaders coming from other Latin American countries, and in certain cases from other, smaller markets in Europe.
Also, because of fluctuations in demand in several industries, executives don’t want to reach such high remuneration levels that they become vulnerable in a downturn. This can make executives cautious about engaging in the search process. We therefore spend a lot of time anticipating how an industry might change and assessing the implications for both clients and candidates.
Given the fee structure in executive search, what do you say to those who think that search consultants could, in some cases, inflate remuneration expectations?
At Boyden we tend to avoid talking about remuneration throughout the search process.
We know the client budget, but do not mention it to potential candidates. We think that the hiring conditions should represent a natural and sequential step for the selected professional, so remuneration becomes a function of the executive career context. For instance, at the São Paulo office we placed five executives below the initial budget just last year.
We are also good at finding high potential executives with strong promotion prospects. Once they legitimate their position, they grow in seniority and increase their remuneration over time.
If you were still in a leadership position in the industry, as you were for many years, how would you motivate your team in this challenging economic environment?
In very similar ways to my clients in pharma and medical devices, and also service providers: I would invest time and energy in building a high-performing team. The health sector lacks talented and experienced people, and now is a good time to attract talent from other industries. My focus would be on developing a holistic team for the business, rather than covering each function. Cross-functional perspectives would enable each team member thoroughly to understand market needs and the business model. Thus, we could blend our thinking to take the organisation to the next level of professionalism and operational efficiency.
For an informal meeting or to discuss the needs of your business for executive search, talent mapping or remuneration advice, please contact Alexandre Sabbag in São Paulo at +55 11 3382 8300 or email@example.com.
Boyden is a leading executive search firm dedicated to globally-oriented growth and emerging organisations in the consumer, industrial, financial services, healthcare & life sciences and technology industries. Our executive search consultants excel in global teaming to secure the right talent in the right locations to help clients expand into growth markets.
Boyden’s healthcare & life sciences expertise extends across 36 markets in Asia/Pacific, EMEA, South America and North America.
Nearly half of our global healthcare assignments are for pharma and biotech clients. We also have a strong track record in medical equipment, devices & supplies and healthcare providers, as well as accidental medical insurance, diagnostic devices & instruments, health information products & services and animal health. We also conduct senior-level assignments in distribution and contract manufacturing & product packaging services.
We handle C-suite and senior leadership positions, together with unusual roles, or those for which there may only be a few appropriate candidates, right down to situations where we find ourselves saying, “There are only two people in the market who could do that role. Let me get them to the table for you.”
Partners in our global healthcare & life sciences practice have typically held leadership roles within their areas of expertise. We therefore provide candidates with a peer-to-peer experience, exploring the client’s objectives for the role, growth plans and risks in light of the candidate’s aspirations, leadership and technical capabilities.
For further information on Boyden’s global healthcare capabilities, please visit our website or contact us directly.
Alexandre Sabbag, Partner
Healthcare & Life Sciences Practice
São Paulo, Brazil
+55 11 3382 8300
Alexandre brings tremendous value to the health management, service operations and Latin American integration groups to Boyden in both Brazil and Chile.
He has a strong background in business development and service management, gained at McKinsey and A.T. Kearney. He also held executive positions at Fleury Medicina e Saúde, Promon Tecnologia and Natura Cosméticos. Alexandre subsequently joined the executive search industry and has led assignments across Brazil, Chile, Colombia and Ecuador.
Alexandre received an MBA from INSEAD, France and holds a Specialisation in Negotiation from the Universidad de los Andes, Colombia. He also completed postgraduate studies in Health Management at the Escola Paulista de Medicina, UNIFESP, Brazil. He also holds a B.Sc. in Engineering from the Escola Politécnica, University of São Paulo USP, Brazil. Alexandre has lived in seven different countries.
Aurea Imai, Managing Partner
Healthcare & Life Sciences Practice
São Paulo, Brazil
+55 11 3382 8300
Aurea Imai has enjoyed over a decade of success in executive search, and has worked with Boyden Brazil since 2009. She is a key member of the firm’s global industrial and life sciences practices.
During her tenure at Boyden she has established a record for client satisfaction and repeat business with major international organisations, which is recognised throughout the firm. She leads top level searches in all functional areas.
Aurea’s early career was in the food sector, where she became the Quality Director of an important industrial fishery. Subsequently she worked at Baker & McKenzie’s Brazilian law office affiliate, and then served as general administrator for the Japan desk at Itochu Brazil, the global Japanese trading company, using her trilingual Portuguese-English-Japanese abilities.
Aurea holds a degree in nutrition from the University of São Paulo, and has completed specialised studies in diet therapy in Japan.
Languages spoken by the Brazil healthcare & life sciences team: Portuguese, English, Spanish, German, Japanese and French
Kerstin Roubin, Managing Partner
Global Healthcare & Life Sciences Practice
+ 43 1 533 83 57
Kerstin Roubin has been working in the executive search business for about two decades. Her broad spectrum of clients includes multinational blue-chip companies, medium-sized and privately-owned businesses. She handles complex, cross-border executive search assignments for C-suite and high-level general management positions, as well as a variety of corporate functions and specialised roles.
Kerstin is highly skilled in bringing top-level candidates to clients in specialised markets such as consumer, pharmaceutical, medical technology and biotechnology, and also suppliers in the healthcare and FMCG industry. Kerstin uses her significant industry experience and global network capabilities to deliver the best possible candidates for her clients.
Kerstin holds a university degree in economics and business, with a primary focus on human resources & organisational planning. She is a founding partner of Boyden Global Executive Search in Austria, Boyden’s regional hub for clients expanding in Central and South Eastern Europe.
As Global Practice Group Leader for Healthcare & Life Sciences, Kerstin drives business growth through a number of best practice and client relationship initiatives. Clients particularly value cross-practice teaming, for which Kerstin has developed a structured approach with other sector leaders to find, for example, consumer-driven candidates for pharmaceutical clients or technology leaders for digital health companies.
The Commonwealth Fund: 2014 International Profiles of Health Care Systems, published January 2015
Alessandro Cirrincione, Global Director, Pricing and Government Affairs, Vifor Pharma, at NextLevel Pharma Conference on ‘Pharmaceutical & medical device market & patient access in Latin America’
Deloitte: Global Life Sciences Outlook, 2015 and 2016
Economist Intelligence Unit: Global Outlook – Healthcare, March 2014
The Economist: The World in 2016
European Federation of Pharmaceutical Industries and Associations: The Pharmaceutical Industry in Figures, key data 2015
IFPMA International Federation of Pharmaceutical Manufacturers & Associations: The Pharmaceutical Industry and Global Health, Facts and Figures 2014
IMF World Economic Outlook, 2015
IMS Health: Pharmerging markets - Picking a pathway to success 2013
IMS Institute for Healthcare Informatics: Global Outlook for Medicines Through 2018, November 2014
International Monetary Fund 2015: World Economic Outlook, October 2015
Interpharma 2015: Swiss Healthcare and Pharmaceutical Market 2015
MSCI North America IMI Healthcare Index, January 2016
MSCI Europe Healthcare Index, January 2016
OECD Health Statistics 2015
OECD Health at a Glance 2015, OECD Indicators
OECD Healthcare Data, available at www.stats.oecd.org, February 2016
OECD Pharma Expenditure 2012 from Health at a Glance Europe 2012
Statista Inc.: Pharmaceutical market data, available at www.statista.com, February 2016
United Nations Comtrade Database: Trade Data, available at www.comtrade.un.org/data February 2016
Wirtschaftsforschung (WifOR): The Economic Footprint of the Pharmaceutical Industry, Research Report 2015
The World Bank demographic data, available at www.data.worldbank.org, February 2016
The World Health Organisation (WHO), Migration Policy Institute (MPI), State University of Rio de Janeiro (UERJ): Migration of Health Workers, WHO code of practice and the global economic crisis, published by WHO 2014
1 Talent-Led Growth Healthcare & Life Sciences Series 1 covers the United States, Canada, Brazil, France, Germany and Switzerland
2 PWC 19th annual global CEO survey, published 2016
3 IMS Health, April 2015 4 IMS Health, April 2015
5European Federation of Pharmaceutical Industries and Associates, Key Data 2015, based on SCRIP – EFP 1A calculations
6 Migration of Health Workers, WHO code of practice and the global economic crisis UERJ, MPI, WHO
8 Annualised growth 2006-2012, WifOR, Wirtschaftsforschung, Research report, February 2015
9 Data for market revenue rank and share, trade balance, percent over 65 and average annual growth are from 2014: data for population, median age, healthcare employees, percentage GDP spend on healthcare and doctors/beds per 1000 population are from 2013: Data for practising foreign-born doctors are from 2011. Number of hospital beds, 2016 CNES Cadastro Nacional de Estabelecimentos de Saúde; private insurance coverage 2015 ANS – Agência nacional de saúde suplementar; active medical doctors 2016 CFM – Conselho Federal de Medicina
10 Private healthcare spending accounted for 51.8% in 2013, according to the World Health Organization
11 Fortune has named UnitedHealth Group ‘World’s Most Admired Company in the insurance and managed care sector’ for six consecutive years.
12 9.7% according to The Economist