Pfizer Inc.,'is a research-based, global pharmaceutical company. We discover,
develop, manufacture and market leading prescription medicines for humans and
animals as well as many of the world's best-known consumer healthcare products.
The Company was incorporated under the laws of the State of Delaware on June'
2, 1942.
We operate in three business segments: Pharmaceutical, Consumer Healthcare
and Animal Health.
We also operate several other businesses, including the manufacture of empty
soft-gelatin capsules, contract manufacturing, bulk pharmaceutical chemicals
and diagnostics.
We have significant operations outside the United States. They are conducted
both through our subsidiaries and through distributors, and involve the same
business segments - Pharmaceutical, Consumer Healthcare and Animal Health -
as our U.S. operations.
In our global Pharmaceutical business, we promote our products to health care
providers such as doctors, nurse practitioners, physician assistants, pharmacists,
hospitals, Pharmacy Benefit Managers (PBMs), Managed Care Organizations (MCOs)
and government agencies. Through our marketing organizations, we explain the
approved uses and advantages of our products to health care providers. We also
market directly to consumers in the U.S. through direct-to-consumer print and
television advertising. In addition, we sponsor general advertising to educate
the public about our innovative medical research.
Our operations include several pharmaceutical sales organizations. Each sales
organization markets a distinct group of products. Our prescription pharmaceutical
products are sold principally to wholesalers, but we also sell directly to retailers,
hospitals, clinics, government agencies and pharmacies.
We seek to gain access to health authority, PBM and MCO formularies (lists
of recommended or approved medicines and other products) and reimbursement lists
by demonstrating the qualities and treatment benefits of our products. We also
work with MCOs and PBMs to assist them with disease management, patient education
and other tools that help their medical treatment routines. For example, we
sponsor a program offered by the State of Florida Agency for Health Care Administration
that is designed to help manage chronic diseases among Florida's Medicaid population.
Our Consumer Healthcare business primarily uses its own representatives to
directly promote its products, including marketing certain products directly
to professionals using a professional detail force. We also use print and television
consumer advertising and offer sales incentives such as coupons. Our consumer
products are sold through various retailers.
Our Animal Health business also uses its own sales organization to promote
its products. Its advertising and promotion are generally targeted to health
professionals, directly and through medical journals. Animal health and nutrition
products are sold through veterinarians, drug wholesalers, distributors and
retail outlets as well as directly to users. Where appropriate, these products
are also marketed through print and television advertising.
Competition
Competition is intense in all of our businesses and includes many large and
small competitors. The principal means of competition vary among product categories
and business groups. However, efficacy, safety, patients' and customers' ease
of use and cost effectiveness are important factors for success in all of our
principal businesses.
Our human pharmaceutical business is the largest in the world. We compete with
other worldwide research-based drug companies, many smaller research companies
with more limited therapeutic focus and generic drug manufacturers.
We focus on unmet medical needs and therapeutic improvements. Our emphasis
on innovation has led to our multi-billion-dollar research and development investments
over the past decade.
In recent years, a comparison of the total cost of medical treatments using
pharmaceuticals versus alternative treatments for the same condition has become
an important basis of competition. MCOs and PBMs look to cost advantages as
well as medical benefits in making their drug formulary decisions.
Our pharmaceutical sales and marketing organization is a valuable competitive
asset. Our salespeople's ability to reach medical professionals with information
about our products helps us respond to competitive efforts and launch new products.
Our consumer healthcare business is one of the largest in the world. However,
many other companies, large and small, manufacture and sell one or more products
that are similar to our consumer healthcare products. Sources of competitive
advantage include product quality and efficacy, brand identity, advertising
and promotion, product innovation, broad distribution capabilities and price.
Significant expenditures for advertising, promotion and marketing are generally
required to achieve and maintain both consumer and trade acceptance of consumer
products.
While our animal health business is the largest in the world, many other companies
offer competitive products. Altogether, there are hundreds of producers of animal
health products throughout the world. The principal methods of competition vary
somewhat depending on the particular product. They include product innovation,
quality, service, effective promotion to veterinary professionals and consumers
and price. We promote our products directly through our sales representatives
as well as through advertising.
Managed Care Organizations
The growth of MCOs in the U.S. has been a major factor in the competitive make-up
of the health care marketplace. A substantial portion of the U.S. population
now participates in some version of managed care. Because of the size of the
patient population covered by MCOs, marketing of prescription drugs to them
and the PBMs that serve many of those organizations has become important to
our business.
MCOs can include medical insurance companies, medical plan administrators,
health-maintenance organizations, alliances of hospitals and physicians and
other physician organizations. The purchasing power of MCOs has been increasing
in recent years due to their growing numbers of enrolled patients. At the same
time, those organizations have been consolidating into fewer, even larger entities.
This enhances their purchasing strength and importance to us.
The growth of MCOs has increased pressure on drug prices. A major objective
of MCOs is to contain and, where possible, reduce health care expenditures.
They typically use formularies, volume purchases and long-term contracts to
negotiate discounts from pharmaceutical providers. They use their purchasing
power to bargain for lower supplier prices. They also emphasize primary and
preventive care, out-patient treatment and procedures performed at doctors'
offices and clinics. Hospitalization and surgery, typically the most expensive
forms of treatment, are carefully managed. Since the use of certain drugs can
prevent the need for hospitalization, professional therapy or even surgery,
such drugs can become favored first-line treatments for certain diseases.
As discussed above in Marketing, MCOs and PBMs typically develop formularies
to reduce their cost for medications. Formularies can be based on the prices
and therapeutic benefits of the available products. Due to their generally lower
cost, generic medicines are often favored. The breadth of the products covered
by formularies can vary considerably from one MCO to another, and many formularies
include alternative and competitive products for treatment of particular medical
problems. MCOs use a variety of means to encourage patients' use of products
listed on their formularies.
Exclusion of a product from a formulary can lead to its sharply reduced usage
in the MCO patient population. Consequently, pharmaceutical companies compete
aggressively to have their products included. Where possible, companies compete
for inclusion based upon unique features of their products, such as greater
efficacy, better patient ease of use or fewer side effects. A lower overall
cost of therapy is also an important factor. Products that demonstrate fewer
therapeutic advantages must compete for inclusion based primarily on price.
We have been generally, although not universally, successful in having our major
products included on MCO formularies.
The impact of MCOs on drug prices and volumes may increase as the result of
their role in negotiating on behalf of Medicare beneficiaries in connection
with the recently enacted, limited out-patient drug benefit under Medicare,
as discussed below under Government Regulation and Price Constraints.
Another way we address the interests of MCOs is by developing disease-management
programs. These programs can be attractive to MCOs by improving patient communications
and compliance with dosage directions, which are important for effective disease
treatment. They can help MCOs address various aspects of disease management,
such as prevention, diagnosis and treatment of certain diseases, including use
of pharmaceutical products. This comprehensive approach can improve the quality
of care and lower costly complications of chronic diseases. As noted above in
Marketing, one such program, which is sponsored by us and offered by the State
of Florida Agency for Health Care Administration, is designed to help manage
chronic diseases among Florida's Medicaid population.
Generic Products
One of the biggest competitive challenges that we face in the U.S. and that
is growing internationally is from generic pharmaceutical manufacturers. Upon
the expiration or loss of patent protection for a product, we can lose the major
portion of sales of that product in a very short period. Generic competitors
operate without our large research and development expenses and our costs of
conveying medical information about the product to the medical community. In
addition, the FDA approval process exempts generics from costly and time-consuming
clinical trials to demonstrate their safety and efficacy, and allows generic
manufacturers to rely on the safety and efficacy of the pioneer product. Generic
products need only demonstrate a level of availability in the bloodstream equivalent
to that of the pioneer product. This means that, after we have borne the expenses
of discovering, developing and testing a medicine for safety and efficacy, obtaining
regulatory approval and informing the medical community about its therapeutic
benefits, generic competitors can market a competing version of our product
after the expiration or loss of our patent and charge much less.