BMI View: We expect growth in Estonia’s healthcare expenditure to decelerate over the long term given the
country’s fiscally conservative nature, the limited capacity of the national health insurer to accommodate
further healthcare spending growth and BMI’s outlook for the country’s economy over the long term.
Drugmakers can expect to see constrained revenue growth in the country as pricing pressures and
restrictive drug reimbursement are employed by the Estonian health insurance fund to restrict healthcare
expenditure.
Headline Expenditure Projections
? Pharmaceuticals: Sales will rise from EUR310mn (USD341mn) in 2015 to EUR328mn (USD351mn) in
2016, up 6.0% in local currency terms and down 3.2% in US dollar terms. Forecast stayed flat from last
quarter.
? Healthcare: Spending will rise from EUR1.22bn (USD1.34bn) in 2015 to EUR1.29bn (USD1.38bn) in
2016, up 5.8% in local currency terms and down 2.9% in US dollar terms. Forecast stayed flat from last
quarter.

Table of Contents

BMI Industry View 7
Table: Headline Pharmaceuticals & Healthcare Forecasts (Estonia 2014-2020) 7
SWOT 9
Industry Forecast 11
Pharmaceutical Market Forecast 11
Table: Pharmaceutical Sales, Historical Data And Forecasts (Estonia 2012-2020) 13
Healthcare Market Forecast 14
Table: Healthcare Expenditure Trends, Historical Data And Forecasts (Estonia 2012-2020) 16
Table: Government Healthcare Expenditure Trends, Historical Data And Forecasts (Estonia 2012-2020) 16
Table: Private Healthcare Expenditure Trends, Historical Data And Forecasts (Estonia 2012-2020) 16
Prescription Drug Market Forecast 17
Table: Leading Anatomical Therapeutic Chemical (ATC) Groups By Pharmaceutical Sales, 2004-2010 (%) 18
Table: Prescription Drug Market Indicators, Historical Data And Forecasts (Estonia 2012-2020) 20
Patented Drug Market Forecast 21
Table: Patented Drug Market Indicators, Historical Data And Forecasts (Estonia 2012-2020) 22
Generic Drugs Market Forecast 23
Table: Generic Drug Market Indicators, Historical Data And Forecasts (Estonia 2012-2020) 24
OTC Medicine Market Forecast 25
Table: Over-The-Counter (OTC) Medicine Market Indicators, Historical Data And Forecasts (Estonia 2012-2020) 27
Pharmaceutical Trade Forecast 28
Table: Pharmaceutical Trade Data And Forecasts (Estonia 2014-2020) 29
Table: Pharmaceutical Trade Data And Forecasts local currency (Estonia 2014-2020) 30
Pharmaceuticals Risk/Reward Index 31
Central And Eastern Europe Risk/Reward Index 31
Estonia Risk/Reward Index 37
Rewards 37
Risks 37
Regulatory Review 39
Intellectual Property Issues 42
Pricing Regime 43
Reimbursement Regime 44
Table: Key Health Insurance Indicators, 2007-2011 44
Table: Expenditure By Reimbursed Prescription Medicinal Products, 2005-2010 (EEK '000) 46
Market Overview 48
Healthcare Sector 49
Table: Healthcare Resources (Estonia 2010-2015) 51
Table: Healthcare Personnel (Estonia 2010-2015) 51
Table: Healthcare Activity (Estonia 2010-2015) 52
Table: HIF Healthcare Expenditure, 2006-2011 (EURmn) 53
Table: Reimbursement Spending By Key Therapeutic Area, 2010-2011 (EURmn) 54
Table: Medicinal Products Reimbursed For Insured Patients, 2009-2011 (EURmn) 55
Research And Development 56
Table: Members Of EBio, 2011 57
Clinical Trials 59
Table: Leading Causes Of Death, 2005-2010 61
Competitive Landscape 63
Research-Based Industry 63
Table: Members Of The Association Of International Pharmaceutical Manufacturers In Estonia 64
Table: Table: Multinational Market Activity 64
Generic Drugmakers 65
Pharmaceutical Distribution 66
Pharmaceutical Retail Sector 67
Table: Pharmacies And Pharmacy Market Ratios, 2004-2009 68
Company Profile 70
Grindeks (incorporating Tallinn Pharmaceutical Plant) 70
Demographic Forecast 74
Table: Population Headline Indicators (Estonia 1990-2025) 75
Table: Key Population Ratios (Estonia 1990-2025) 75
Table: Urban/Rural Population & Life Expectancy (Estonia 1990-2025) 76
Table: Population By Age Group (Estonia 1990-2025) 76
Table: Population By Age Group % (Estonia 1990-2025) 77
Glossary 79
Methodology 81
Pharmaceutical Expenditure Forecast Model 81
Healthcare Expenditure Forecast Model 81
Notes On Methodology 82
Risk/Reward Index Methodology 83
Index Overview 84
Table: Pharmaceutical Risk/Reward Index Indicators 84
Indicator Weightings 85

List of Tables

Table: Headline Pharmaceuticals & Healthcare Forecasts (Estonia 2014-2020)
Table: Pharmaceutical Sales, Historical Data And Forecasts (Estonia 2012-2020)
Table: Healthcare Expenditure Trends, Historical Data And Forecasts (Estonia 2012-2020)
Table: Government Healthcare Expenditure Trends, Historical Data And Forecasts (Estonia 2012-2020)
Table: Private Healthcare Expenditure Trends, Historical Data And Forecasts (Estonia 2012-2020)
Table: Leading Anatomical Therapeutic Chemical (ATC) Groups By Pharmaceutical Sales, 2004-2010 (%)
Table: Prescription Drug Market Indicators, Historical Data And Forecasts (Estonia 2012-2020)
Table: Patented Drug Market Indicators, Historical Data And Forecasts (Estonia 2012-2020)
Table: Generic Drug Market Indicators, Historical Data And Forecasts (Estonia 2012-2020)
Table: Over-The-Counter (OTC) Medicine Market Indicators, Historical Data And Forecasts (Estonia 2012-2020)
Table: Pharmaceutical Trade Data And Forecasts (Estonia 2014-2020)
Table: Pharmaceutical Trade Data And Forecasts local currency (Estonia 2014-2020)
Table: Key Health Insurance Indicators, 2007-2011
Table: Expenditure By Reimbursed Prescription Medicinal Products, 2005-2010 (EEK '000)
Table: Healthcare Resources (Estonia 2010-2015)
Table: Healthcare Personnel (Estonia 2010-2015)
Table: Healthcare Activity (Estonia 2010-2015)
Table: HIF Healthcare Expenditure, 2006-2011 (EURmn)
Table: Reimbursement Spending By Key Therapeutic Area, 2010-2011 (EURmn)
Table: Medicinal Products Reimbursed For Insured Patients, 2009-2011 (EURmn)
Table: Members Of EBio, 2011
Table: Leading Causes Of Death, 2005-2010
Table: Members Of The Association Of International Pharmaceutical Manufacturers In Estonia
Table: Table: Multinational Market Activity
Table: Pharmacies And Pharmacy Market Ratios, 2004-2009
Table: Population Headline Indicators (Estonia 1990-2025)
Table: Key Population Ratios (Estonia 1990-2025)
Table: Urban/Rural Population & Life Expectancy (Estonia 1990-2025)
Table: Population By Age Group (Estonia 1990-2025)
Table: Population By Age Group % (Estonia 1990-2025)
Table: Pharmaceutical Risk/Reward Index Indicators