Iqvia Covid 19 Eu4 and Uk Newsletter

Impact of COVID-19 on the
Pharmaceutical Market – EU4 & UK

Monthly Newsletter: May 04, 2021
Data week ending: April 04, 2021
European Thought Leadership
© 2021. All rights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States, the European Union, and various other countries.
Impact of COVID-19 on the Pharmaceutical Market
+ Deep dive into COVID-19 Vaccination
• Vaccine candidates
• Vaccination strategies in EU4 & UK
• Technology contribution to vaccine uptake
• Vaccination tracker
+ US – 2020 Year in Review
+ Overview of COVID-19 and its impact on sales across the EU4 & UK countries
+ Appendix
1
Deep Dive into
COVID-19 Vaccination
2
Of the thirteen COVID-19 vaccines approved globally, three are approved in
the UK and four in EU4
ROW ROW ROW ROW
Vaxzevria/Covishield Ad26.COV2.S CoronaVac BBIBP-CorV Convidecia Vero cells

(AstraZeneca/ (Janssen) (Sinovac) (Sinopharm) (CanSino) (Sinopharm-Wuhan institute)
Oxford University)
Comirnaty mRNA-1273 Sputnik V EpiVacCorona Covaxin KoviVac ZF2001

(Pfizer-BioNtech) (Moderna) (Gamaleya research (Bektop) (Bharat biotech) (Chumakov centre) (ZFSW)
institute)
ROW ROW ROW ROW ROW
Vaccines approved after Jan 2021
Vaccines are arranged in the order to approval in EU4 and UK followed by Rest of World (RoW)
Refer appendix section for sources
Impact of COVID-19 on the Pharmaceutical Market – EU4 & UK - April 2021 3
Nearly 2 billion doses of approved vaccines are secured by EU & UK
Vaccine Purchase Agreements (EU & UK) – Vaccine Purchase Agreement Details (EU & UK) –
Approved Vaccines Approved & Pipeline Vaccine Candidates
600 EU UK
EU UK
• 67.2 Mn doses delivered in Q1 2021
• Secured 100 Mn doses to support
• May order additional doses securing
booster program
Approved Vaccines
460 up to total of 1.8 Bn doses
400 400 • 9.8 Mn doses received in Q1 2021

• 17 Mn doses purchased
• 150 Mn doses expected in 2021 &
• Roll-out began in early April 2021
Million doses
2022 each
• 29.8 Mn doses received in Q1 2021 • Purchased 100 Mn doses
• 200 Mn doses to be delivered in Q2
• Under rolling review in UK
2021, with agreement for additional
• Purchased 30 Mn doses in advance
200 Mn
100 100 • Purchased 200 Mn doses in advance • Purchased 60 Mn doses in advance
Pipeline Candidates
• EMA started rolling review
• Purchased 50 Mn doses in advance
30 • Purchased 405 Mn doses in advance
17
• Purchased 100 Mn doses of which 60
Mn doses are to be delivered by H2
Pfizer-BioNtech Moderna AstraZeneca J&J • Purchased 60 Mn doses in advance
2021 and 40 Mn in 2022. Further
option of 90 Mn between 2023-25
Y axis - Cumulative doses from Nov 2020-Apr 2021 • Purchased 300 Mn doses in advance • Purchased 60 Mn doses in advance
Johnson & Johnson vaccine is not yet approved in UK; Novavax, Curevac, Valneva and Sanofi-GSK vaccines are pipeline candidates in EU & UK. Clover and Reithera vaccines are also in late phase of development in EU
& UK but with no advance purchase as of now; Refer appendix section for sources
In Germany, GPs can choose and administer the vaccines directly to patients
Italy changed its Germany’s vaccine rollout is Spain’s vaccination France ramps up vaccine UK is one of the world’s
vaccination guidelines to at slow pace, but they aim to strategy has progressed to rollout; currently vaccinating front runners in terms of
prioritize elderly hasten it with flexibility mass vaccination phase all aged 55+ vaccine coverage
• • Spanish govt. prioritized • In first vaccination phase elderly •

• Initially Italy prioritized Highest priority group (80+ age
vaccinating people based on
Everyone over the age of 50 and
vaccinating health workers group & health workers) has people and staff in nursing high-risk categories population
health condition, essential and homes, healthcare workers,
population
followed by nursing home staff, been vaccinated in most high exposure job roles and age received their first vaccine dose
Priority
German states firefighters, home helpers aged before April 15, 2021
over 80s and people with • In late March and early April
serious conditions but since Mar • Vaccination is ongoing onto most regions finished 50+ and 75+ were vaccinated • Currently govt. is vaccinating
2021, govt. is prioritizing elderly second group (70+ age group, vaccinating their 80+ age group • Anyone over the age 55 is now people below the age of 50
population over other groups people with serious illnesses and are now proceeding with eligible for vaccination, however
and primary school teachers) those in 70s few professions are prioritized • Govt. aims to vaccinate entire
adult population by July 2021
• Aims to vaccinate 80% • Vaccination drive started slowly, • Govt. aims to vaccinate around • Vaccination is expected to be in age order i.e., 40-49 followed
population by September 2021 but picked up pace as more 70% of the population by opened to all by mid June, by 30-39 followed by 20-29
Vaccination Drive Overview
vaccine doses arrived and September 2021 with a target to vaccinate

• Military barracks, production • Lockdown was imposed from
general practitioners/family • Spain is one of the countries everyone who wants it by
sites, large-scale retail outlets, doctors were allowed to early January to tackle surging
that has administered the August 2021
gyms, schools and Catholic administer jabs which were infections caused by the Kent
highest percentage of its • The vaccine is being
church are also used as previously administered only variant of the virus
population with the second dose administered in specialist
vaccination centers through 430 vaccination centers vaccine centres, sports • England has now started to
• Pop-up vaccination hubs are set- • Govt. aims to vaccinate everyone of the vaccine reopen after 3 months of
stadiums, drive-in centres and
up with primrose flower theme to by September 2021 • Mass vaccination sites are lockdown
through GPs or family doctors
encourage Italians to vaccinate • Govt. doesn’t intent to delay 2nd created in sports facilities,
and pharmacies • The number of new COVID-19
• Partial lockdown was imposed vaccine dose public hospitals • A limited lockdown for four infections in Britain dropped by
from March 15, 2021, with some • Strict lockdown rules imposed in • Country is under lockdown 60% in March due to lockdown
weeks was enforced from
ease from April 26 onwards hotspot regions & effective until since mid March 2021 April 3, 2021 & vaccination drive
June 30, 2021

12-week gap and switching vaccine types between first and second dose are
ways being considered to stretch scarce supplies of vaccines
Vaccination Strategy Strategy Details WHO’s Take
✓ Recommended gap between COVID-19 vaccines: 4-12 weeks for Oxford-

Delaying Second Dose
AstraZeneca vaccine, 3 weeks for Pfizer-BioNTech vaccine & 4 weeks for WHO suggests that
Moderna vaccine there is some data to
UK introduced a 12-week
✓ Scientific rationale for delaying doses: For the AstraZeneca vaccine, clinical trial support delay in
gap policy between two
data suggests that a single dose provides protection for more than 12 weeks, and doses for the Oxford/
COVID-19 vaccine doses at
that the booster effect of the 2nd dose is stronger when the gap between doses is AstraZeneca vaccine.
the end of Dec’20. The goal
longer. However, for Pfizer-BioNTech vaccine there is less evidence. But a review of However, there is no
was to stretch vaccine
unpublished data for Canada’s National Advisory Committee on Immunization, found scientific evidence to
supplies to provide first
that leaving 6 weeks between doses resulted in no less protection than a stretch the second
dose protection to larger dose of the
3-week gap
number of people quickly Pfizer/BioNTech
✓ Data overall suggest the first doses work quiet well however, scientists are not
aware of its durability. It’s the second dose that optimizes the efficacy vaccine to 12 weeks
and durability
✓ Germany and France advocate mixing of two different coronavirus vaccine

WHO does not
Switching
✓ No solid evidence yet on whether switching vaccines between doses can

Vaccines
recommend
Germany & France make any difference, but some immunization programs for other diseases do this
switching between
recommend giving because the results are better
COVID-19 vaccine
different 2nd jab (Pfizer or ✓ Mixing different manufacturers vaccines i.e., “heterologous prime boost' often
doses, due to
Moderna) provides better protection although this is not known for COVID-19. Trials are
inadequate data
underway to test whether this might work for the COVID-19 vaccines

Vaccine temperature tracker, Apps for predicting risk, determining vaccine
queue are ways for supporting vaccination drives
Storage & Supply Vaccination Updates
German based technology company aids COVID-19 vaccine

Vaccine Queue Calculator for the UK
distribution
• Online calculator estimates how soon you're likely to get the coronavirus
• va-Q-tec, technology company specializes in ultralow freezers is
vaccine based on nine-point priority list released by the UK government
working hard to ensure the mass shipment of vaccines through
high-performance transport containers UK’s new tech to pick out people at high COVID-19 risk
• A risk prediction model, QCovid is helping clinicians to prioritize high risk
group patients for vaccination
Scotland launches vaccination app for healthcare staff
• Scotland launched an app - Vaccination Management Tool that enables
healthcare and care home staff to obtain patient information when carrying out
vaccinations against COVID-19
ACF Technologies supports UK’s mass vaccination goals
• ACF Technology partnered with UK NHS to deliver Intelligent Appointment
Scheduling (IAS) capable of scheduling a half a million appointments per day
UK hospitals using blockchain to track the temperature of • The appointment booking system is capable of automatically adjusting to
COVID-19 vaccine complex vaccination regimes, including multiple vaccine types and
• NHS facilities in England using technology developed by UK firm dosage variations
Everyware and US blockchain organization Hedera Hashgraph France launches COVID-19 app to prevent wastage of COVID-19 vaccines
• This technology keeps a tamper-proof digital record of • The Covidliste mobile application, connects people who wish to be vaccinated
temperature-sensitive vaccines and pick up on any irregularities (even non-priority ones) with professionals in possession of unused doses that
in their storage must be consumed quickly
Vaccination registries, AE monitoring tools & digital vaccination passports
along with other technologies are being adopted by EU4 & UK
Vaccination
Database/Registry Monitoring
Passport
TURAS Vaccination Management Tool,

UK to use AI for COVID-19 vaccine
supports COVID-19 vaccine rollout
• MHRA has paid tech company (Genpact) a
• It is a web-based tool that enables front
tender of £1.5m to develop an AI tool to
line Health & Social Care staff to capture EU emphasizes on digital vaccination
process the adverse reactions of the
and create real-time patient vaccination passports/vaccine certificates
COVID-19 vaccines
records • British cyber technology company VST
Enterprises has developed and launched a
France to use medication shield digital health passport called V-Health in April
Spain to keep registry of people who 2021 which includes passengers’ COVID-19 test
technology for COVID-19 vaccine adverse
refuse COVID-19 vaccine status and vaccination records
drug reactions
• Spain will set up a registry of people who • French government has similar plans to initiate
• French medication intelligence company
refuse to be vaccinated against COVID-19 a Vaccine Passport scheme for air passengers
Synapse Medicine has rolled-out its
and share it with other European Union reaching the country with carrier Air France
Medication Shield technology which
member states
claims to increase the safety of the COVID- • Deutsche Telekom, a Germany telecom
19 vaccination by managing the adverse company has pitched in to design a digital
drug reactions (ADRs) signals on a vaccination passport
reporting portal
• Many European countries including Spain and
Italy are also looking forward to the initiative

The US and China with their large populations and rapid vaccine rollout
currently lead overall vaccination distribution
Top 10 countries – Total vaccinations (Mn of doses)
0 50 100 150 200 250 300 350 400 450 500 550 600 650 700 750 800 850 900 950
US (20th Apr) 213.4
China (19th Apr) 195.0 *

India (19th Apr) 127.1 **
UK (19th Apr) 43.5
Brazil (20th Apr) 33.8
Germany (20th Apr) 22.9
Turkey (20th Apr) 20.3
France (19th Apr) 17.4
Indonesia (20th Apr) 17.3
Russia (20th Apr) 16.6
Others (Sum) 219.5
World (Sum) 926.8
Sources: IQVIA European Thought Leadership, 22/04/2021. Refer appendix section for sources
Notes: *China and the UAE have authorized use of two vaccines developed by Sinopharm, BBIBP-CorV and the Wuhan Institute vaccine. All other countries have authorized the Sinopharm BBIBP-CorV vaccine only.
**The Serum Institute of India produces the AZ-Oxford vaccine under the local name Covishield.
Per capita COVID-19 vaccination progress is skewed towards countries with
small dense populations
Top 10 countries – Vaccine doses per 100 people
0 10 20 30 40 50 60 70 80 90 100 110 120
Israel (20th Apr) 119.6
Seychelles (19th Apr) 118.9 *

UAE (19th Apr) 97.8 *
Chile (19th Apr) 69.8
Bahrain (20th Apr) 65.7 *

San Marino (18th Apr) 64.5
US (20th Apr) 64.5
Malta (19th Apr) 64.1
UK (19th Apr) 64.0
Bhutan (19th Apr) 62.1
Others (Avg) 8.7
World (Avg) 12.0
Notes: *China and the UAE have authorized use of two vaccines developed by Sinopharm, BBIBP-CorV and the Wuhan Institute vaccine.
All other countries have authorized the Sinopharm BBIBP-CorV vaccine only.
The UK currently exhibits nearly double the absolute vaccine rollout of any
EU4 country
Total vaccinations (Mn of doses)
Spain 0 50 100 150 200 250 300 350 400 450
France
Germany EU4 & UK 22.9 43.5 112.8
Italy 13.0 17.4 15.9
UK
Japan 2.2
China
India
Brazil Pharmerging 195.0 127.1 33.8 90.7 446.6
Other Pharmerging (Sum)
Chile
RoW 13.4 118.4 151.8
Israel
UAE 10.4 9.7
Other RoW (Sum) US 213.4
Note: Pharmerging countries include China, India, Brazil, Turkey, Russia, Indonesia, Bangladesh, Mexico, Saudi Arabia, Pakistan, Egypt, Algeria, Colombia,
South Africa, Ukraine, Phillipines and Vietnam.
Unique national scenarios drive notable intraregional variation in per capita
vaccine rollout
Vaccine doses per 100 people
Vaccine doses
Country
per 100 people 0 5 10 15 20 25 30 35 40 45 50 55 60 65
UK 64.0
EU4 & UK 34.48
Spain 27.9
Italy 26.3
France 25.6
Japan 1.73
Germany 27.4
Turkey 24.0
Saudi Arabia 21.3 Pharmerging 9.73
Brazil 15.9
Other Pharmerging (Avg) 9.0
RoW 6.40
Israel 119.6
Seychelles 118.9
UAE 97.8 US 64.47
Other RoW (Avg) 5.6
Note: Pharmerging countries include China, India, Brazil, Turkey, Russia, Indonesia, Bangladesh, Mexico, Saudi Arabia, Pakistan, Egypt, Algeria, Colombia,
South Africa, Ukraine, Phillipines and Vietnam.
Ranking by full vaccinations does not fully correlate with number of doses
administered due to different national dosing policies
Top 10 countries – Fully vaccinated people (Mn) Top 10 countries – Share of population fully vaccinated (%)
0 20 40 60 80 100 120 140 160 180 200 220 0 5 10 15 20 25 30 35 40 45 50 55 60

US (20th Apr) 86.22 Israel (20th Apr) 57.67
India (19th Apr) 17.47 Seychelles (19th Apr) 51.38
UK (19th Apr) 10.43 UAE (19th Apr) 38.79
Brazil (20th Apr) 9.00 Chile (19th Apr) 29.16
Turkey (20th Apr) 7.86 Bahrain (20th Apr) 28.88
Russia (20th Apr) 6.23 Monaco (20th Apr) 27.67
Indonesia (20th Apr) 6.16 US (20th Apr) 26.05
Germany (20th Apr) 5.65 San Marino (19th Apr) 24.88
Chile (19th Apr) 5.57 Malta (20th Apr) 19.88
Israel (20th Apr) 4.99 Serbia (20th Apr) 18.21
Other (Sum) 52.29 Others (Avg) 1.00
World (Sum) 211.86 World (Avg) 2.70
• Graphs represents the number/share that have received all doses prescribed by the vaccination protocol
• Individuals are counted if they have received one dose of a vaccine with a one dose protocol or two doses of a vaccine with a two dose protocol
• Data is only available for countries which report the breakdown of doses administered by first and second doses
US – 2020 Year in Review
14
2020 In Review
Levers of pressure and areas of acute impact for system and life sciences companies in the US
A generational public health challenge A disrupted, but resilient industry
Pandemic trajectory dictates Shifting sites of care, boosted

resources and response by technology
Healthcare
Economic and affordability Pandemic
system Patient access,
crises impact access crisis impact utilization and outcomes
Environment
conditions
Regulatory decisions support Life
Launch and product uptake
system adaptation Sciences
impact
Clinical development rises to

Commercial disruption
the challenge

Disruption by number
Understanding the magnitude of COVID-19 impact, and the momentum of change
Patient access,
utilization and outcomes
997M Missed patient
diagnosis visits
3.0% Newly diagnosed
cancer patients
Healthcare
system
impact Shifting sites of care,
boosted by technology
3,059% Increase in
telehealth visits 20%
Elective
procedures
Life
Commercial
disruption
60% In-person rep
details
225% Remote
details
Sciences
impact
Difference in
Launch and YTD NBRx
product uptake 11% vs. 2019 22M sales first 6
months launch

What a difference a year makes.
An unprecedented public health challenge, and response
28 million 115 million

Confirmed US cases Confirmed cases worldwide
78.6 M
529,000+ 2.5 million Vaccine doses
Deaths in the US Deaths worldwide administered in the
1 February 2020 31 January 2021
US (3/1/2020)
N=8 N=26.1M
7
Therapeutics with
FDA EUA
First death likely
6 February 2020
Covid.cdc.gov March 1, 2021

A generational public health challenge:
Pandemic trajectory created heterogeneous response
State Type 1: State Type 2: State Type 3:
Surge-Naïve Constant Pressure Repeated Waves
• These states are arguably • These states have experienced a • These states have had time to
experiencing high COVID-19 prolonged high COVID-19 case recover, and are experiencing
case counts for the first time count from the summer another resurgence
• Example: Wisconsin • Example: Mississippi • Example: California

YOY growth for prescriptions, elective procedures
and labs reinforce local variation from the national trend.
Year over Year Growth
2019 vs. 2020 Time Aligned Weeks
Wisconsin Mississippi California
Elec. Elec. Elec.

TRx Procedure Labs TRx Procedure Labs TRx Procedure Labs
0.0% 0.0% 0.0%
-2.8% -2.8% -5.0% -2.7%

-5.0% -5.0% -4.1%
-2.7% -2.7%
-10.0%
-10.0% -10.0%
-12.2% -15.0%
-15.0% -15.0% -…
-16.1%
-16.0% -16.0% -20.0%
-19.9%
-20.0% -20.0%
-19.9% -19.9% -20.3% -25.0%
-24.7%
-22.5% -22.1%
-25.0% -25.0% -30.0%
State National State National State National

A generational public health challenge
Economic effects on stakeholders impact access and affordability
What happened Implications
“Temporary” unemployment could delay patients

Unemployment skyrocketed PATIENTS from pursuing a public alternative to employer
with ~20M continuing claims care. Income loss further strains affordability.
Disproportionately affecting
younger, and part-time workers
Delayed treatments and COVID-19 related costs
are straining practice economics and could
PROVIDERS
Nearly 27M patients could increase pressure to consolidate or find other
lose employer sponsored efficiencies.
insurance
Nearly half of which are estimated Downward pressures due to changes in payer mix,
to be eligible for Medicaid MANUFACTURERS increased used of patient assistance programs
and expanded 340b utilization challenge margin.
Small shifts from commercial
coverage with some patients
foregoing/delaying treatment Loss of commercial enrollees and COVID-19
altogether PAYERS related costs could lead to premium increases in
2021. Payers may recoup losses via rebating.

Regulatory decisions, system adaptations may persist beyond COVID-19
Improving Access to Improve Access to

Expand Telemedicine Expand System Capacity
Medicine Healthcare
• Reimburse telemedicine at • Permit early refills, expanded • Permit licensed physicians • Reopening of healthcare
the same rate as in-person Rx size (90 day) and remove in good standing to work exchanges in many states
• Permit telemedicine for first- prior authorizations across state borders • Approvals of Medicaid
time visits • Waive charges for at home • Allow states to mobilize waivers to improve access
• Wave cost sharing for all delivery and permit use of inactive physicians into the and care
telemedicine visits out-of-network pharmacies workforce • Covered costs of all COVID-
• Expand approved • Relaxed requirements for • Provide care and realize 19 testing and treatments
technologies and audio REMS and adverse event savings from alternative • Parachute Rx (ESI)
only visits reporting sites of care (e.g. home providing deep discounts on
• Expanded patient assistance infusion, ambulatory surgery drugs to recently uninsured
programs centers, hotels, dormitories) members
• Value domestic production
for drugs and supplies

Clinical development rises to the challenge
Accelerated Timelines Meaningful areas of acceleration
Traditional Pre-COVID-19 Post-COVID-19

5-10 years
vaccine development
Vaccine technology
Accelerated vaccine focused on platform Newer technology - mRNA
1-2 years
development in a pandemic1 technologies4
Remote site monitoring &
10 Primary on-site
Pfizer-BioNTech vaccine approved under EUA2 in U.S. activation, source data
months operations verification & remote visits
Novel trial design with

Traditional
COVID-19 Vaccines COVID-19 Therapeutics3 external comparators;
randomized trials hybridization of studies
Casirivimab and imdevimab
Clinical development combination (11/21/20) Site-based study Study procedure digitization
procedure & IP delivery; virtual trials
Baricitinib and remdesivir
240+ combination (11/19/20) Limited patient Digital patient engagement,
Vaccine trials in Bamlanivimab (11/09/20) communication including connected devices
Preclinical development5
Convalescent plasma (8/23/20) Limited role of Accelerated RWE and value
evidence of community data
Remdesivir (5/1/20, 10/22/20)

Telehealth surged early, then leveled out
Year over Year Growth – Telehealth Claims Across Time Aligned Weeks
Jan. Feb. Mar. Apr. May. Jun. Jul. Aug. Sep. Oct. Nov. Dec.
7000%
5991%
Weekly Growth % Cumulative Growth %
6000%
5000%
Year over Year %
3051%
3044%
4000%
3024%
3013%
3001%
2955%
2933%
2899%
2896%
2749%
2640%
2486%
3000%
2000%
1000%
59%
0%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51
Week
Data for latest week date controlled against prior periods; estimates have been applied to reflect anticipated late-adjudicated claims based on historical rates
Source: IQVIA: Medical Claims Data Analysis, 2020; Week 1 2019 = W/E 1/11/2019; Week 1 2020 = W/E 1/10/2020, Week 51 2019 = W /E 12/27/2019; Week 51 2020 = W/E 12/25/2020
Estimated amounts for latest weeks applied based on likely claims still to be received due to data latency or claim processing delays; See Appendix for further details
Engagement with patients in office and telehealth
was heterogeneous across specialties
Diagnosis visit YoY Weekly Cumulative Growth – W/E 12/25/2020 vs. 12/27/2019
0%
Year over Year %
-20% -14%
-21% -20% -21% -17% -20%
-24% -22% -23% -24%
-40%
-40% -44%
-60% DEPRESSION OFFICE
TRADITIONAL SPECIALTY
PSORIASIS
MIGRAINE
CROHN’S
HIV/AIDS
LUPUS
GERD
ADHD
HTN
MS
T2D
RA
40000% TELEHEALTH 33981%
Year over Year %
30000%
24417%
18295% 19264% 17638%
20000% 17093% 16693%
13825%
9287% 9734%
10000%
2080% 3536%
0%
Source: IQVIA: Medical Claims Data Analysis, 2020;

Latest two weeks are estimates using a recency data factor that is adjusted out as all claims are received; See Appendix for further details
Telehealth proves to be a complicated hero; It is difficult to initiate new
therapy in virtual settings
NBRx Per Patient Visit Potential Drivers of Difference
Specialty
4 W/E 1/31/20 4 W/E 1/29/21 4 W/E 01/29/21 Difference (%) • Patient mix skews towards existing
Office Office Telehealth Office v. TM patients replacing office visits with
Dermatologists 1.21 1.21 0.91 -25% telehealth
Allergists 1.08 1.08 0.80 -26% • Willingness to initiate new therapy
PCP 1.16 1.16 0.82 -29% remotely
Pulmonologists 1.02 1.02 0.70 -31% • Lack of diagnostics such as vitals
Gastroenterologists 1.08 1.08 0.70 -35% and labs are impeding diagnosis of
Ophthalmologists 1.39 1.39 0.90 -35% new conditions
Ob/Gyn 1.22 1.22 0.78 -36% • Prescribers are reporting spending
Cardiologists 0.71 0.70 0.44 -38% less time on a telehealth call with
Rheumatologists 0.56 0.56 0.34 -38% patients which may reduce NBRx
Pediatrics 1.30 1.29 0.78 -39% opportunity
Neurologists 0.59 0.59 0.35 -41% • Many offices have now adapted
Psychiatry 0.47 0.47 0.27 -42% protocols to safely see patients
Endocrinologists 0.67 0.67 0.36 -46% enabling the preference to NBRx
Oncology 1.47 1.48 0.70 -53% office prescribing
Source: NPA New To Brand (NPA NTB); Medical Claims analysis; 2020; Custom analysis
Evaluation of medical claims visit with same patient/prescriber combination occurring as NBRx within 2 weeks of medical claim service date
Missed diagnosis visits: A leading indicator of long term impact
Actual Data Week Ending November 27, 2020
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Total Gap of Diagnosis
120M
100M
Visits in 2020
(Unique patient-provider diagnosis events)
-997M
80M
% of Expected
60M Diagnosis Visits
in 2020
-30.0%
40M Projected diagnosis visits if
there was no COVID-19 Top 5 Specialties by Dx Visits Gap/HCP
20M The projected diagnosis visits in ONCOLOGY

2020 with actual data through 10/2
and forecast data through 12/31 GASTROENTEROLOGY
0M
DERMATOLOGY
What is the “diagnosis visit gap”?
ANESTHESIOLOGY
Difference between diagnosis expected during a visits1 Dx Visit/HCP Ratio
OPHTHALMOLOGY
hypothetical non-COVID-19 scenario and the number of
diagnosis visits we actually see -1400 -1200 -1000 -800 -600 -400 -200 0
COVID-19 Diagnosis Visit Backlog - w/e Oct 2, 2020; Source: IQVIA: Medical Claims Data Analysis, 2020, IQVIA Analysis; 1A diagnosis visit is for one single diagnosis per patient, per HCP; a patient can have more than
one diagnosis visit assigned to them, with either more than one diagnosis per doctor or more than one doctor per diagnosis
Oncology experiences the largest diagnosis visits gap
per HCP through the end of 2020
Monthly Average Diagnosis Backlog per HCP by Specialty
March April May June July August September October November December
0
• Oncology HCPs have
experienced the largest
-500 gap/HCP in the past
6 months
-1000 • Both Oncology and

Anesthesiology HCPs
routinely miss a similar
-1500 amount of diagnosis
visits as the other
specialties in a month,
-2000 but have far fewer
prescribing HCPs to
recoup these losses
-2500
ANESTHESIOLOGY FAMILY PRACTICE INTERNAL MEDICINE
ONCOLOGY PEDIATRICS
Source: IQVIA: Medical Claims Data Analysis, 2020, IQVIA Analysis. Sum of projected diagnosis visit difference from 3/13/20 through the end of the year
No one got the flu last year. What does that mean for next year?
Influenza Like Illnesses Diagnoses
9M
Compared to the 2019-2020
season, the current season
8M
is down an unprecedented
7M
93.5%
6M
Social distancing, masking
5M
and other non medical
interventions reduced non-
4M COVID-19 viral respiratory
infections
3M
Reduction in community
2M immunity but increased risk
of “warehousing”
1M vulnerable individuals –
especially children
0M
Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul
2020-2021 2019-2020 2018-2019
Source: IQVIA: FAN US Consumer Healthcare Sales
Week 26 2019 = W/E 7/5/2019; Week 26 2020 = W/E 7/3/2020
After a significant drop at COVID-19 onset,
in-person visits have recovered to varying levels by specialty
Rheum in-patient visits experienced a greater dip at the start of the pandemic and have seen that loss continue into 2021
120%
In-person Patient Visits as % of Baseline
100%
90%
87%
80% 84%
72%
71%
60%
57%
40%
20%
0%
4/3/20
5/1/20
5/8/20
6/5/20
7/3/20
9/4/20
1/8/21
2/5/21
8/7/20
10/16/20
10/23/20
10/30/20
11/13/20
11/20/20
11/27/20
12/11/20
12/18/20
12/25/20
1/1/21
3/13/20
3/20/20
3/27/20
4/10/20
4/17/20
4/24/20
5/15/20
5/22/20
5/29/20
6/12/20
6/19/20
6/26/20
7/10/20
7/17/20
7/24/20
7/31/20
8/14/20
8/21/20
8/28/20
9/11/20
9/18/20
9/25/20
10/2/20
10/9/20
11/6/20
12/4/20
1/15/21
1/22/21
1/29/21
Cardio Gastro Neuro Onc PCP Rheum
Onc in-patient visits have maintained a higher-than-average count of in-person patient visits as % of baseline
Source: IQVIA BrandImpact

Condition YTD Growth: Selected Traditional vs. Specialty Conditions
Diagnosis visit YoY Weekly Cumulative Growth – W/E 12/25/2020 vs. 12/27/2019
Year over Year %
0%
-20% -14%
-21% -20% -21% -17% -20%
-24% -22% -23% -24%
-40%
-40% -44%
-60% DEPRESSION OFFICE
TRADITIONAL SPECIALTY
PSORIASIS
MIGRAINE
CROHN’S
HIV/AIDS
LUPUS
GERD
ADHD
HTN
MS
T2D
RA
40000% TELEHEALTH 33981%
Year over Year %
30000%
24417%
18295% 19264% 17638%
20000% 17093% 16693%
13825%
9287% 9734%
10000%
2080% 3536%
0%
Source: IQVIA: Medical Claims Data Analysis, 2020;

Prescription volume is down, and staying down?
A signal that how people are getting, and receiving care, has changed.
YoY Cumulative NBRx/TRx Growth by Selected Specialty
5% Rolling 52-Week YoY Comparison
2%
0% 0%
0%
-1% -1%
-2% -2% -2% -2%
-5% -3% -3% -3% -3%
-4%
-5% -5% -5% -5%
-7% -7% -7%
-10% -8%
-9%
-11%
-12%
-15% -13%
-14%
-20% -18%
-25%
-26%
-30% Pediatric NBRX is markedly lower as
children remain at home lessening
the transmission of many illnesses
-35% -34% and associated use of medications
-40%
ALLER CARD DERM ENDO GE NEURO OB/GYN OPHTH ONC PCP PED PSYCH PULM RHEUM UROL
NBRx % Change TRx % Change
Source: IQVIA: National Prescription Audit (NPA), National Prescription Audit: New to Brand (NPA NTB); Time aligned weeks W/E 2/7/20-1/29/21
Elective Procedures: Weekly YoY and Cumulative Growth
Year over Year Growth – Elective Procedure Across Time Aligned Weeks
Jan. Feb. Mar. Apr. May. Jun. Jul. Aug. Sep. Oct. Nov. Dec. Jan.
40%
21%
20% 14%
8%
0% 1% 0% 0%
0%
-3% -1% -1%-1%
-4% -4% -4% -4%
Year over Year %
-6% -7%
-5% -10% -10% -8% -5% -3% -5% -12%
-11%
-12% -12%
-20% -14% -16% -9% -9% -15%
-16%
-18% -12% -11%
-13% -22%
-27% -26%
-40% -34% -23%
-42%
-46%
-60%
-60%
-80% YoY Cumulative Growth

-77%
-81%
-86% -87%
-88% -84%
-100%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
Week
Source: IQVIA: Medical Claims Data Analysis, 2020; Week 1 2019 = W/E 1/11/2019; Week 1 2020 = W/E 1/10/2020, Week 52 2019 = W /E 01/03/2020; Week 52 2020 = W/E 01/01/2021
Elective procedures based on IQVIA custom analysis; Data includes claims from inpatient and outpatient sites of care
COVID-19 brought different challenges to brands
dependent upon lifecycle stage
Launch products Growth products Mature products Declining products

COVID-19 crisis impact: high COVID-19 crisis impact: high COVID-19 crisis impact: medium- COVID-19 crisis impact: medium-
low low
Key challenges: Key challenges:
Key challenges: Key challenges:
1. Collapse of the dynamic 1. Collapse of the dynamic
(new+switch) market removes (new+switch) market removes 1. Maintaining repeats easier,
1. Manage for profitability,
the engine of launch growth the engine of growth need focus on compliance if
divert resource to launch /
winning new / switch harder
2. Payers and HTA slows down growth brands
2. Lack of F2F engagement
launch path to reimbursement with HCPs one to one or in 2. Loss of new starts / switches to
3. Time pressured doctors conference to consolidate generics in budget constraint
addressing backlog may be launch accelerates decline
less receptive to launch
products unless significant 2. Manage for profitability,
treatment improvement divert resource to launch /
growth brands, consider
how to maintain carryover
on minimal spend
3. Loss of new starts / switches
to generics due to budget
constraints
LAUNCH GROWTH MATURE DECLINE

FDA approvals have not decreased during the COVID-19
pandemic and brand teams are moving forward with commercialization
FDA Approvals Number of Launches Launches Delayed Launch Trajectories

The FDA has not slowed In FY 2020, there have been 63 Of the 49 products approved,
Ten months into COVID-19
down NME approvals since launches compared to 69 in FY only 3 announced a delay due
launches appear to be
the start of the pandemic 2019 (NMEs + promoted to COVID-19 but are
impacted
branded generics) subsequently launched
49
80
69
70
60%
61 63
in 2020 60 53
50 sales
vs.
40
30
44 in 2019
20
10
0 35% EUTRx
2019 2020
Total Mar-Dec

As a result of the COVID-19 pandemic, brands launched in
2020 have a much softer trajectory compared to previous years
The launch trajectories are 60% lower compared to the average of launches from 2015 to 2019
Time-Aligned Average Monthly Sales The factors impacting the 2020
COVID-19 Launches vs. Launches by Year of Launch
$16
launch trajectories are:
Year 6M Sales % Diff
COVID-19 (n=43) $13.6M • Decreased patient pools
$14
2015 (n=67) $38.3M -64.5%
2016 (n=43) $54.3M -74.9%
• Lack of impactful promotion and
$12
2017 (n=53) $40.3M -66.2% access to HCPs
2018 (n=61) $24.4M -44.3%
$10 2019 (n=46) $49.3M -72.4% - In-person vs. remote
Millions
2020 Pre-COVID-
$8 19 (n=11)
$35.5M -61.7%
- HCPs typically require five to seven
details to fully activate
$6
- Access to hospital staff and P&T
$4
committee
$2 • Building economic crisis for hospitals
$0
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6
2015 (n=67) 2016 (n=43) 2017 (n=53)

2018 (n=61) 2019 (n=46) 2020 (n=54)
2020 Pre-COVID-19 (n=11) 2020 COVID-19 (n=43) Through the first 6 months, products
launching prior to COVID-19 attained
an average $22M more than products
launching after COVID-19
Gilead’s Veklury for COVID-19 leads 2020’s launches in sales
followed by Horizon’s Tepezza (thyroid eye disease) and
Allergan’s Ubrelvy (acute migraine)
2020 – 63 Launches 2020 – Top 5 Performers by value
All Others 8% $600.0

Musculo-skeletal system 3%
$519.5
Digestive 3%
$500.0
Genito-urinary $438.8
system and sex $420.2
hormones 3% $400.0
Oncology
Dermatology 3% 37%
$ Million
Cardiology 3% $300.0
$236.1
Diabetes 5% $200.0 $173.1
$100.0
Infectious
Disease 10%
$-
Veklury Tepezza Ubrelvy Nurtec Ruxience
(Gilead) (Horizon) (Allergan) (Biohaven) (Pfizer)
CNS 25%
COVID-19 Thyroid Eye Migraine Migraine NHL,CLL,MPA
% share represents the number of 2020 NAS launches in particular therapy area Disease
*NAS: New active substances
2020 promotional investment for launch brands skew more
heavily towards sampling as compared to previous years
Increased sampling could be driven by companies promoting product access during the pandemic
Launch Brands Promotional Spend by Channel by Year
10-Month Average
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
2015 (n=66) 2016 (n=44) 2017 (n=52) 2018 (n=60) 2019 (n=47) 2020 (n=55)
DTC Mail* Samples Contacts Meetings Journal
Source: IQVIA Channel Dynamics
Adaptation has focused on enhanced patient support and
new HCP engagement models
Shifted Messaging
Early DTC & Social Highlight advantages of at home
Platform administration during the
Accelerated DTC to first month, pandemic
including TV ads and built social
platform
COVID-19 Focus & SF downsizing

Virtual Launch
Included personalized emails,
year Highly complex administration
and high HCP involvement meant
virtual training and welcome kits launch a different salesforce and focus
on existing administration sites.
model
Delayed Launch Digital HCP

Patient target mix included engagement
elderly/vulnerable population. KOL national broadcasts, virtual
HCP detailing and education,
targeted KOL outreach
Telemedicine scheduling
Redirected patients to online community of physicians.
Shipping to patient pharmacy
Biopharma in-person details have rebounded to 34% vs. baseline US Primary Intelligence
Cardiology and Gastroenterology in-person both exceed 50% of baseline, while Oncology in-person remains
lowest at 16%
Biopharma In-Person Details In-Person Details as % of Baseline
100%
Oncology 16%
• Specialty continues to lead with 38% vs. baseline
90%
• Primary Care and Oncology in-person details are at 32% Endocrinology 24%
80% and 16% of baseline, respectively
Rheumatology 26%
70%
Nephrology 30%
60%
Primary Care 32%
50%
Biopharma 34%
40% 34%
Psychiatry 38%
30%
Neurology 42%
20%
Respiratory 45%
10% 16%
Dermatology 47%
0%
4/3
5/1
5/8
6/5
7/3
8/7
9/4
1/1
1/8
10/16
10/23
10/30
11/13
11/20
11/27
12/11
12/18
12/25
3/13
3/20
3/27
4/10
4/17
4/24
5/15
5/22
5/29
6/12
6/19
6/26
7/10
7/17
7/24
7/31
8/14
8/21
8/28
9/11
9/18
9/25
10/2
10/9
11/6
12/4
Cardiology 51%
Base1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44
Gastroenterology 53%
Oncology Primary Care Specialty Total
Note that weeks 12, 17, 27, 38, 42 and 43 are holiday weeks; Baseline is the weekly average of the 8 weeks ending 3/6/20 of stable detail, patient visit and treatment volumes.
BrandImpact HCP Network = ~3600 unique HCPs including: Oncology, Specialty and Primary Care; Specialty includes, but not limited to, Allergy, Cardiology, Dermatology, Gastroenterology, Endocrinology, Neurology,
Pulmonology, Psychiatry and Rheumatology
Recently, we observe a slow return to F2F detailing
for some specialties, though most remain remote
Gastros saw a more pronounced shift back toward in-person detailing in September, but Oncs saw a drastic
and sustained loss of F2F visits
80% In-person Details as % of Total Details
Cardio HCPs quickly pivoted during re-openings, stressing
70% importance of ability to redeploy sales force to field
61%
60%
58%
50%
42%
40%
36%
30% 31%
20% 20%
10% Oncologists remained largely and steadily remote from

May; likely a longer-term trend
0%
5/1/20
5/8/20
6/5/20
7/3/20
8/7/20
9/4/20
1/1/21
1/8/21
2/5/21
10/16/20
10/23/20
10/30/20
11/13/20
11/20/20
11/27/20
12/11/20
12/18/20
12/25/20
5/15/20
5/22/20
5/29/20
6/12/20
6/19/20
6/26/20
7/10/20
7/17/20
7/24/20
7/31/20
8/14/20
8/21/20
8/28/20
9/11/20
9/18/20
9/25/20
10/2/20
10/9/20
11/6/20
12/4/20
1/15/21
1/22/21
1/29/21
Cardio Gastro Neuro Onc PCP Rheum
Source: IQVIA BrandImpact; Baseline is the weekly average of the 8 weeks ending 3/6/20 of stable detail, patient visit and treatment volumes
In the midst of COVID-19, organizations must adapt their
promotional strategy to adjust to the rapidly changing environment
Adjustments to Sales Force strategy
Reevaluation of deployment mix in terms of the right

size, roles and organization
Adaptation of process and technology to drive

adoption of virtual engagement channels
Smart analytics, including segmentation, to

continuously track virtual engagement preferences and
personalize messaging to HCPs and patients

Even before COVID-19 commercial models had to balance a
complex engagement environment
Commercialization Commercialization
Simple Complex Simple Complex
Challenges to
Easy to engage No/Low OOP, no Complex
engage (e.g.
patient population PA/SE Reimbursement
elderly, pediatric)
Target population Target population

No safety Safety monitoring
is easily reachable is difficult to reach
monitoring needed
(urban/suburban) (rural)
Therapeutic area Therapeutic area has

has high Dx/Tx via low Dx/Tx via Oral Infused
telemedicine telemedicine
No need for
No diagnostic or Diagnostic or labs Need for disease
disease
labs required required education
education

COVID-19 has accelerated complexity and the imperative to evolve
Traditional Engagement Today’s Engagement
74% of measured Today, a third of

Product-centric Patient-centric
channel spend on total HCP contacts
sales force detailing are digital
Face-to-face Multichannel
Around 50% of HCPs
For almost 60% of
prefer individual Push Two-way HCPs, information
interactions as source
is accessible
of treatment
Siloed Connected across multiple
information
channels
‘One size’ Personalized

Traditional contacts Overall digital
>60% more likely than contacts result in
digital contacts to Noise, Coverage Value, Outcomes 27% INCREASE
INCREASE (prescribing) intent
(prescribing) intent post post interaction
interaction Sales Service

HCPs are getting more comfortable with remote channels
Q: To what extent is a 1-1 videoconference with a biopharma company representative as helpful/valuable as an in-person visit?
Q: If you could choose the ideal mix of meeting/receiving information from a biopharma company representative that you know and trust, what % would you assign to each method below?
N = 300: Sample of respondents from BrandImpact Syndicated Physician panel, evenly split among Primary care, Specialty (mix),and Oncology
Next-decade priorities for biopharma
Re-define customer
engagement
Patient access,
utilization and outcomes
Re-evaluate
Healthcare portfolio priorities
system
impact Shifting sites of care,
boosted by technology Next-Decade
Systems and
Biopharma
analytics
Priorities
Commercial
Life disruption
Sciences Address care gaps
impact for patients
Launch and
product uptake
Re-think evidence
development

Overview of COVID-19
and its impact on sales
across the EU4 & UK
countries
46
Across EU4 & UK, COVID-19 has negatively impacted pharma sales
evolution across channels
Total Cases 3,981,512 3,338,564 3,496,134 5,490,025 4,409,631

COVID-19 Reported 7-day New Cases 155,881
76,613 115,676 50,062 13,928
Numbers**
Total Deaths 119,912 82,325 77,855 102,907 127,451
YTD-20211 -7.3% -19.6% -10.8% -7.0% -6.8%

CH Market Units Growth
Latest Week1 -4.5% -18.9% -10.4% +0.4% -10.0%
YTD-20211 -6.2% -7.2% -3.5% -4.1% -2.3%

Rx Retail Units Growth
Latest Week1 -3.3% -28.6% -11.7% -1.2% -7.8%
Rx Hospital Units YTD-20212 -20.6% -20.9% -11.6% -14.5% -9.3%

Growth Latest Month2 -18.4% -16.2% -7.8% -11.6% -8.4%
Note: a. Retail pharmacy sales/Rx data has been used across countries. Any cross-country analysis needs to account for differences in healthcare systems
1: Weekly sell out data –Germany, Spain, Italy, France, UK (Rx) – Latest week starting 29th March 2021
2: Monthly IQVIA MIDAS data – Hospital panel –Germany, Spain, UK, France, Italy – Latest month - February 2021
**Source: Center for System Science and Engineering (CSSE) at John Hopkins University (JHU), data extracted on 27th April 2021
Across EU4 & UK, overall promotional volume and F2F interactions
substantially improved compared to 2020
April* 2020 vs. April* 2021 – % Change in absolute recorded HCP interaction volume
YoY
+139% +23% +102% +67% +48%
% Change
% Change in overall
+138% points -6% points +124% points +73% points +54% points
interactions++
% Change in F2F
+2278% points +301% points +456% points +495% points +147% points
interactions++
2,300 2265%
454%
388%
400
% Change
F2F
300 243% Remote
200
100 58% 48%
16% 34% 32%
0
-25%
-100
Italy Germany Spain France UK
*30 day period to 14/03; ++ Change over previous release (30 day period to 14/03)
Source: IQVIA European Thought Leadership; ChannelDynamics 25/04/2021; F2F includes detailing and meetings, Remote includes phone detailing, e-detailing (live+automated), postal & e-mailings, e-meetings
(live+automated)
Within both Retail and Consumer Health market, decline is observed across
all EU4 & UK in latest week of current year
% Growth in Units – Rx retail market, Hospital market, Consumer Health market
Retail Rx market Hospital market Consumer Health market
*% Growth – Units Current Year vs. % Growth – Units Current Year vs. *% Growth – Units Current Year vs.
same week Previous Year same month Previous Year same week Previous Year
80% EU4 & UK 40% EU4 & UK 80% EU4 & UK
60% 30% 60%

2021 compared
% Growth – Units
% Growth – Units
% Growth – Units
2021 compared 20% 40% to 2020 calibrated
40%
to 2020 calibrated values^
values^ 10% 20%
20%
0% 0%
0%
-10% -20%
-20% -40%
-20%
-40% -30% -60%

W42: 12-Oct
W46: 09-Nov
W50: 07-Dec
W42: 12-Oct
W22: 25-May
W46: 09-Nov
W50: 07-Dec
W14: 30-Mar
W18: 27-Apr
W22: 25-May
W34: 17-Aug
W38: 14-Sep
W2: 04-Jan
W6: 01-Feb
W10: 01-Mar
W14: 29-Mar
W14: 30-Mar
W18: 27-Apr
W34: 17-Aug
W38: 14-Sep
W2: 04-Jan
W6: 01-Feb
W10: 01-Mar
W14: 29-Mar
W26: 22-Jun
W30: 20-Jul
W26: 22-Jun
W30: 20-Jul
-40%
Mar-20
May-20
Jul-20
Apr-20
Feb-20
Oct-20
Feb-21
Jan-20
Jun-20
Aug-20
Sep-20
Nov-20
Dec-20
Jan-21
Week Starting Dates Month Week Starting Dates
Italy Germany Spain France UK

*Units Growth Latest week 2021 vs. 2020 respectively; ^2020 calibrated (2019 scaled to SS growth): Week 10 to Week 25 of 2020 takes 2019 actuals and applies the average YoY growth rate from the “steady state (SS)”
period of 2020 (week 26-52)
Source: IQVIA weekly sell out data – Week 14 2020 starting 30/03/2020; Week 14 (latest week) 2021 starting 29/03/2021 | Retail pharmacy panel – captures sales of products at retail pharmacies and IQVIA MIDAS data –
starting 01/01/2020 | Hospital panel
The Italian retail prescription market has shown a decline in YTD and latest
week compared to the same period of 2020
Top* 2 ATC3 classes within Top* 5 Units Growth Units Growth Units Growth
% Growth – Units Current Year vs. same week Previous Year ATC1 classes by Units Growth YTD Jan 2021 Latest Week YTD 2021
Total market and Top 5* YTD 2021 vs. YTD 2020 vs. 2020 2021 vs. 2020 vs. 2020
Stop-and-Go Local Lockdowns
Partial Lockdown Rx Market -9.4% -3.3% -6.2%
through the entire winter
40%
Dermatologicals -2.0% 2.1% 0.0%
Top Corticosteroids Combs 0.2% 5.3% 1.7%
20% Top Corticosteroids Plain 1.1% 0.1% 1.4%
% Growth – Units
Genito-urinary system and sex

-3.3% 0.1% -1.2%
hormones
0% Hormonal Contracept Syst -1.2% 1.6% -0.9%
BPH Products -4.1% -1.5% -1.2%
Cardiovascular system -3.9% -1.8% -1.6%
-20%
2021 compared to 2020 Beta Blocking Agent Plain -1.6% 1.4% 1.0%
calibrated values^ Cholesterol & Triglyceride Regulator -2.5% -0.5% 0.1%
-40% Nervous system -5.2% 2.2% -1.9%
W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W14: 30-Mar
W42: 12-Oct
W44: 26-Oct
W2: 04-Jan
W4: 18-Jan
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W16: 13-Apr
W18: 27-Apr
W20: 11-May
W22: 25-May
W24: 08-Jun
W26: 22-Jun
W28: 06-Jul
W30: 20-Jul
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W6: 01-Feb
W8: 15-Feb
Hypnotics & Sedatives 1.5% -0.1% 1.6%
Anti-Epileptics -1.5% 5.6% 1.3%
Alimentary tract and metabolism -3.1% -5.0% -2.0%
Week Starting Dates Vit A & D Inc. Combs 17.3% 0.4% 14.5%
Rx Market Dermatologicals Antacids Antiflatulents 3.4% 2.7% 2.8%
Genito-urinary system and sex hormones Cardiovascular system
Nervous system Alimentary tract and metabolism
*Top in terms of YTD Growth
^Week 10 to Week 25 of 2020 takes 2019 actuals and applies the average YoY growth rate from the “steady state (SS)” period of 2020 (week 26-52)
Source: IQVIA weekly sell out data – Week 14 2020 starting 30/03/2020; Week 14 (Latest Week) 2021 starting 29/03/2021 | Retail pharmacy panel – captures sales of products at retail pharmacies
The Italian hospital market showed a YTD decline of ~21% compared to
2020; Within top 5 classes alimentary tract & metabolism was worse affected
Units Growth Units Growth Units Growth

% Growth – Units in Current Year vs. same month Previous Year Top* 10 ATC Classes by Units Growth
Jan 2021 Latest Month YTD 2021
Total hospital market and Top 5* YTD YTD 2021 vs. YTD 2020
vs. 2020 2021 vs. 2020 vs. 2020
Stop-and-Go Local Lockdowns
Hospital Market -22.7% -18.4% -20.6%
through the entire winter
35%
Antineoplastic and immunomodulating
-9.3% -1.0% -5.4%
agents
25%
Musculo-skeletal system -18.5% -16.2% -17.4%
15% Systemic hormonal preparations,
% Growth – Units
-18.8% -16.3% -17.6%

excluding sex hormones and insulins
5%
Nervous system -21.8% -15.7% -18.8%
-5% Alimentary tract and metabolism -23.0% -18.7% -20.9%
Blood and blood forming organs -23.0% -19.7% -21.4%
-15%
Anti-infective for systemic use -25.7% -21.3% -23.6%
-25% Cardiovascular system -26.9% -23.2% -25.1%
Dermatologicals -30.0% -30.0% -30.0%
-35%
Mar-20
May-20
Jul-20
Apr-20
Feb-20
Oct-20
Nov-20
Dec-20
Feb-21
Jan-20
Jun-20
Aug-20
Sep-20
Jan-21
-33.9% -28.1% -31.1%
hormones
Hospital total
Antineoplastic and immunomodulating agents
Musculo-skeletal system
Systemic hormonal preparations, excluding sex hormones and insulins
Nervous system
Alimentary tract and metabolism

Source: IQVIA MIDAS data – starting 01/01/2020 | Hospital panel
The Italian consumer health market has shown a YTD decline of 7.3%
compared to 2020
CH Categories and top* 2 classes Units Growth Units Growth Units Growth
% Growth – Units Current Year vs. same week Previous Year within each category by Units Growth Jan 2021 Latest Week YTD 2021
CH market and CH categories YTD 2021 vs. YTD 2020 vs. 2020 2021 vs. 2020 vs. 2020
Stop-and-Go Local Lockdowns Partial Lockdown CH Market -10.1% -4.5% -7.3%
80% through the entire winter
Over-the-Counter Drugs (OTC) -8.3% -1.4% -7.6%
2021 compared to 2020
60% calibrated values^ Circulatory Products 4.0% 3.5% 4.1%
Vitamins, Minerals And Nutritional

% Growth – Units
40%
Supplements, Tonics And Other 9.8% -2.9% 0.8%
Stimulants
20% Personal Care (PEC) -22.3% -5.3% -16.5%
Hair Products -7.1% 11.1% -0.5%
0%
Personal Hygiene 8.2% -0.3% -3.7%
-20% Patient Care (PAC) 27.8% -6.7% 18.5%

Medical/Surgical Aids 184.1% -7.7% 76.6%
-40% Advanced Dressings 10.8% 3.0% 7.6%
W14: 30-Mar
W42: 12-Oct
W44: 26-Oct
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W16: 13-Apr
W18: 27-Apr
W20: 11-May
W22: 25-May
W28: 06-Jul
W30: 20-Jul
W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W24: 08-Jun
W26: 22-Jun
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W2: 04-Jan
W4: 18-Jan
W6: 01-Feb
W8: 15-Feb
Nutrition (NTR) -8.7% -0.9% -7.7%
Enteral Nutrition Products 6.6% 8.6% 3.7%
Gluten-Free & Low Protein Products -8.6% 4.5% -4.5%
Week Starting Dates
CH Market OTC PEC PAC NTR
*Top in terms of YTD Growth; ^Week 10 to Week 25 of 2020 takes 2019 actuals and applies the average YoY growth rate from the “steady state (SS)” period of 2020 (week 26-52)
In Italy, F2F detailing still holds major share of the market; Overall promotion
has improved significantly compared to 2020 but still lower than 2019
Promotional volume share by channel % Change in promotional volume by channel

April* 2020 – April* 2021
7%
2,378%
19%
107%
F2F Detailing
F2F Meeting
71% -34%
28% E-Detailing
Phone Detailing
-38%
1% E-meetings
E-mail 104%
Postal Mailing
5%
43% Instant Messaging/Texting -22%
7%
1%
14% -35%
2% 1% 1%
April April All channels total 139%
2020 2021
Results from CD Italy panel of 4,190 HCPs *30 day period to 25/04
Source: IQVIA European Thought Leadership; ChannelDynamics 25/04/2021
The German retail prescription market shown decline in the latest week
compared to same week of 2020
One-month partial Rx Market -11.2% -28.6% -7.2%
national lockdown
100% Antineoplastic and immunomodulating
0.3% -21.2% 2.5%
agents
80% 2021 compared to 2020
calibrated values^ Protein Kinase Inhibitor A-Neo 9.4% -3.6% 10.5%
60% All Other Antineoplastics 8.0% -20.1% 9.0%
% Growth – Units

40%
Direct Factor Xa Inhibitors 2.1% -24.8% 4.6%
20% Erythropoietin Products 3.3% -12.3% 1.6%
0% Cardiovascular system -5.1% -30.4% -1.8%

Cholesterol & Triglyceride Regulator 2.0% -29.6% 4.5%
-20%
Angiotensin-II Antagonist Plain -4.7% -21.3% 1.9%

W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W14: 30-Mar
W42: 12-Oct
W44: 26-Oct
W2: 04-Jan
W4: 18-Jan
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W16: 13-Apr
W18: 27-Apr
W20: 11-May
W22: 25-May
W24: 08-Jun
W26: 22-Jun
W28: 06-Jul
W30: 20-Jul
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W6: 01-Feb
W8: 15-Feb
GLP-1 Agonist A-Diabetes 35.9% -7.5% 36.0%
Inflammatory Bowel Disorder Products -0.8% -20.6% 1.3%
Top Corticosteroids Plain -6.6% -28.0% -0.4%
Week Starting Dates
Rx Market Antineoplastic and immunomodulating agents Other N-Ster Inflam Skin -8.7% -25.3% -0.7%
Blood and blood forming organs Cardiovascular system
Alimentary tract and metabolism Dermatologicals
The German hospital market showed a decline of ~16% in February 2021
compared to the same month last year
Total hospital market and Top 5* YTD Jan 2021 Latest Month YTD 2021
YTD 2021 vs. YTD 2020
vs. 2020 2021 vs. 2020 vs. 2020
One-month partial
Hospital Market -25.3% -16.2% -20.9%
national lockdown
15%
Systemic hormonal preparations,
-20.4% -13.9% -17.3%
5% excluding sex hormones and insulins
-23.9% -12.3% -18.4%
% Growth – Units
hormones
-5%
-27.2% -11.7% -19.9%
agents

Nervous system -25.0% -15.4% -20.4%
-25% Cardiovascular system -25.8% -16.4% -21.3%

Sensory organs -31.2% -13.4% -22.6%
-35%
May-20
Feb-20
Mar-20
Apr-20
Jul-20
Feb-21
Oct-20
Aug-20
Sep-20
Nov-20
Dec-20
Jan-20
Jun-20
Jan-21
Hospital Market
Blood and blood forming organs
Genito-urinary system and sex hormones
The German consumer health market has shown a YTD decline compared to
the same period last year
% Growth – Units Current Year vs. same week Previous Year CH Categories and top* 2 classes Units Growth Units Growth Units Growth
Total market and Top 5* YTD within each category by Units Growth Jan 2021 Latest Week YTD 2021
YTD 2021 vs. YTD 2020 vs. 2020 2021 vs. 2020 vs. 2020
50% One-month partial CH Market -22.6% -18.9% -19.6%
national lockdown 2021 compared to 2020
40% Over-the-Counter Drugs (OTC) -19.0% -17.9% -12.1%
calibrated values^
30% Vitamins, Minerals And Nutritional
Supplements, Tonics And Other -0.7% -18.2% -0.8%
20% Stimulants
% Growth – Units
Skin Treatment -5.1% -22.5% -7.5%

10%
Personal Care (PEC) -28.8% -21.0% -25.6%
0%
Hair Products -4.8% -6.7% 0.2%
-10% Beauty Products For Women -12.4% -14.4% -9.2%
-20% Patient Care (PAC) 4.8% -12.7% 5.0%

Surgical Absorbents -1.3% -4.0% 5.1%
-30%
Products For Bladder Problems 5.5% -28.0% 2.8%
-40% Nutrition (NTR) -9.1% -13.2% -6.4%
W20: 11-May
W22: 25-May
W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W14: 30-Mar
W42: 12-Oct
W44: 26-Oct
W2: 04-Jan
W4: 18-Jan
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W16: 13-Apr
W18: 27-Apr
W28: 06-Jul
W30: 20-Jul
W24: 08-Jun
W26: 22-Jun
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W6: 01-Feb
W8: 15-Feb
Enteral Nutrition Products -1.0% -12.0% 1.5%
Baby Foods -14.9% -16.9% -0.4%
Week Starting Dates
In Germany, Postal mailing and E-mail holds major share of
promotional volume; F2F interactions show growth compared to 2020

2% 3%
9% 250%
6% 2%
1% 4%
2%
20% 107%
F2F Detailing
23%
F2F Meeting
27%
E-Detailing
Phone Detailing
-23%
E-meetings
E-mail 245%
68%
61% Postal Mailing
Instant Messaging/Texting 42%
9%

2020 2021
Results from CD Germany panel of 1,765 HCPs *30 day period to 25/04
The Spanish retail prescription market showed a decline in latest week
35% Lockdown
Nationwide nighttime curfew Rx Market -4.1% -11.7% -3.5%
during 2nd wave
25% Alimentary tract and metabolism 3.5% -9.5% 2.3%
SGLT2 Inhibitor A-Diabetes 23.3% 19.4% 24.0%
15% GLP-1 Agonist A-Diabetes 22.6% 21.4% 23.7%
% Growth – Units
Cardiovascular system 3.5% -7.9% 1.9%

5%
Lip. Reg. Co. W. Oth. Lip. Reg 24.1% 13.7% 23.6%
-5% Cholesterol & Triglyceride Regulator 4.6% -8.2% 2.7%

Nervous system 0.8% -9.3% 0.9%
-15% Anti-Epileptics 6.9% -6.8% 5.2%
Antidepressant.& Mood Stabilizer 5.5% -6.9% 4.3%
-25% 2021 compared to 2020
calibrated values^ Blood and blood forming organs 2.7% -11.2% 0.2%
-35% Direct Factor Xa Inhibitors 24.2% 9.3% 21.8%
W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W14: 30-Mar
W20: 11-May
W22: 25-May
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W42: 12-Oct
W44: 26-Oct
W2: 04-Jan
W4: 18-Jan
W6: 01-Feb
W8: 15-Feb
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W16: 13-Apr
W18: 27-Apr
W28: 06-Jul
W30: 20-Jul
W24: 08-Jun
W26: 22-Jun
Heparins 14.2% -14.2% 6.2%

3.9% -16.2% -0.5%
agents
Cyto Hormone Antagonists 3.0% -11.3% 1.3%
Week Starting Dates
Other Immunosuppressants 4.1% -16.0% 1.1%
Rx Market Alimentary tract and metabolism
Cardiovascular system Nervous system
Blood and blood forming organs Antineoplastic and immunomodulating agents
The Spanish hospital market showed a YTD decline of ~12% compared to the
same period last year; Growth in antineoplastic & immunomodulating agents

vs. 2020 2021 vs. 2020 vs. 2020
Nationwide
Hospital Market -15.2% -7.8% -11.6%
nighttime curfew
40%
-2.1% 9.9% 3.4%
30% agents
Sensory organs 0.3% 0.0% 0.2%
20%
-8.4% -3.5% -6.1%
% Growth – Units
10% excluding sex hormones and insulins

0% Blood and blood forming organs -7.8% -6.4% -7.1%
-10% Genito-urinary system and sex
-10.4% -6.9% -8.8%
hormones
-20%
-30%
Alimentary tract and metabolism -13.7% -9.7% -11.8%
-40% Anti-infective for systemic use -16.1% -7.1% -11.9%
-50% Nervous system -17.7% -9.6% -13.8%
May-20
Feb-20
Mar-20
Apr-20
Jul-20
Feb-21
Oct-20
Aug-20
Sep-20
Nov-20
Dec-20
Jan-20
Jun-20
Jan-21
Hospital Market
Sensory organs
The Spanish consumer health market showed YTD decline compared to
same period of 2020, while high growth continued in PAC category
Lockdown during 2nd CH Market -15.0% -10.4% -10.8%
Nationwide nighttime curfew
wave
35% Over-the-Counter Drugs (OTC) -15.4% -18.4% -14.8%
2021 compared to Skin Treatment 9.9% -14.5% -0.7%
25%
2020 calibrated
Vitamins, Minerals And Nutritional
values^
Supplements, Tonics And Other 8.2% -24.0% -1.2%
15%
Stimulants
% Growth – Units
5% Personal Care (PEC) -28.2% -7.8% -18.4%

Oral Hygiene -1.1% -18.8% -2.3%
-5% Hair Products -7.2% -19.6% -7.0%
Patient Care (PAC) 15.4% -5.9% 8.8%
-15%
Medical/Surgical Aids 148.1% 8.4% 79.4%
-25% Stomach care Products 6.8% -3.8% 3.1%
Nutrition (NTR) -4.8% -15.8% -8.3%
-35%
Enteral Nutrition Products 8.2% -10.5% 4.0%
W14: 30-Mar
W42: 12-Oct
W44: 26-Oct
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W16: 13-Apr
W18: 27-Apr
W20: 11-May
W22: 25-May
W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W2: 04-Jan
W4: 18-Jan
W24: 08-Jun
W26: 22-Jun
W28: 06-Jul
W30: 20-Jul
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W6: 01-Feb
W8: 15-Feb
Baby Foods -16.6% -16.5% -17.1%
Week Starting Dates

In Spain, F2F interactions share has started to improve compared to 2020

387%
19%
46% 500%
F2F Detailing
24% F2F Meeting
66%
E-Detailing
1% Phone Detailing
-7%
19% E-meetings
28%
E-mail 138%
Postal Mailing
2% 13%
2%
25%
18% 3%
2% 1%
2020 2021
Results from CD Spain panel of 2,500 HCPs *30 day period to 25/04
The French retail prescription market showed a YTD decline compared to the
same period last year
% Growth – Units Current Year vs. same week Previous Year Top* 2 ATC3 classes within Top* 5 Units Growth Units Growth Units Growth
Total market and Top 5* YTD ATC1 classes by Units Growth YTD Jan 2021 Latest Week YTD 2021
Second national 2021 vs. YTD 2020 vs. 2020 2021 vs. 2020 vs. 2020
35%
lockdown Rx Market -6.2% -1.2% -4.1%
25% 2021 compared to 2020 Alimentary tract and metabolism 2.9% 3.7% 5.3%
calibrated values^ Vit A & D Inc. Combs 42.9% 23.1% 38.2%
15%
GLP-1 Agonist A-Diabetes 18.8% 21.0% 18.7%
% Growth – Units
5% Antineoplastic and immunomodulating

3.5% 2.0% 2.4%
agents
-5% Protein Kinase Inh A-Neo 10.6% 18.3% 11.4%

Anti-TNF Products 9.0% 7.1% 8.5%
-15% Dermatologicals 2.4% -2.6% 1.3%
Oral Anti-Acne Preps 13.8% 6.2% 12.9%
-25%
Topical Anti-Acne Preps 9.0% -0.3% 7.9%
-35% Blood and blood forming organs 2.2% 1.5% 1.1%
W42: 12-Oct
W44: 26-Oct
W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W2: 04-Jan
W4: 18-Jan
W14: 30-Mar
W16: 13-Apr
W18: 27-Apr
W20: 11-May
W22: 25-May
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W6: 01-Feb
W8: 15-Feb
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W24: 08-Jun
W26: 22-Jun
W28: 06-Jul
W30: 20-Jul
Direct Factor Xa Inhibs 16.5% 15.9% 15.5%

Erythropoietin Products 3.7% 7.8% 3.4%
Nervous system 0.7% -1.5% -0.2%
Antidepressants.& Mood Stab. 5.1% 5.2% 4.8%
Week Starting Dates
Rx Market Alimentary tract and metabolism Antipsychotics 3.2% 0.7% 2.7%
Antineoplastic and immunomodulating agents Dermatologicals
Blood and blood forming organs Nervous system
The French hospital market showed YTD decline compared to 2020 whereas
antiparasitic, insecticides & repellents category showed growth since Jan’21

vs. 2020 2021 vs. 2020 vs. 2020
Second national
Hospital Market -17.2% -11.6% -14.5%
lockdown
40%
Antiparasitic products, insecticides and r
8.8% 18.6% 13.0%
epellents
30%
-9.7% -6.9% -8.4%
20% hormones
% Growth – Units
Musculo-skeletal system -17.2% -1.1% -9.6%

10%
Antineoplastic and immunomodulating a
-18.2% -2.9% -11.2%
0% gents
-10%
Nervous system -15.2% -10.4% -12.8%
-20% Sensory organs -13.5% -13.3% -13.4%
-40% -21.1% -8.9% -15.3%
May-20
Feb-20
Mar-20
Apr-20
Jul-20
Feb-21
Oct-20
Aug-20
Sep-20
Nov-20
Dec-20
Jan-20
Jun-20
Jan-21
Hospital Market
Antiparasitic products, insecticides and repellents
The French CH market has shown stability in latest week compared to same
week of 2020
40% Second national CH Market -9.9% 0.4% -7.0%
lockdown
30% Over-the-Counter Drugs (OTC) 2.1% -1.0% 0.2%
2021 compared to 2020 Vitamins, Minerals And Nutritional
20% calibrated values^ Supplements, Tonics And Other 8.9% -1.3% 3.3%
Stimulants
% Growth – Units
10% Skin Treatment -0.5% -3.3% -3.1%

0%
Unisex Beauty Products 2.6% 19.7% 3.1%
-10% Beauty Products For Women -2.3% 8.1% -0.5%
Patient Care (PAC) -0.9% -1.5% -1.7%
-20%
Tests and Measuring Instruments 6.9% -0.3% 2.4%
-30% Advanced Dressings 1.9% 3.1% 1.6%

Nutrition (NTR) 0.6% 6.2% -1.7%
-40%
W14: 30-Mar
W42: 12-Oct
W44: 26-Oct
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W16: 13-Apr
W18: 27-Apr
W20: 11-May
W22: 25-May
W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W24: 08-Jun
W26: 22-Jun
W28: 06-Jul
W30: 20-Jul
W2: 04-Jan
W4: 18-Jan
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W6: 01-Feb
W8: 15-Feb
Baby Foods -0.9% 4.0% 0.0%
Week Starting Dates

In France, F2F interactions has started gaining more share in
Promotional volume

8%
2% 1% 495%
6% 27%
1%
70%
F2F Detailing
3% 1%
4% F2F Meeting
2% 146%
E-Detailing
Phone Detailing
67% 15%
E-meetings
50% E-mail 174%
Postal Mailing
16% 14% 43%

2020 2021
Results from CD France panel of 2,830 HCPs *30 day period to 25/04
The UK retail prescription market showed a decline in YTD and latest week
compared to same periods of 2020
Second national Lockdown during 2nd Rx Market 5.5% -7.8% -2.3%
60% lockdown for 4 weeks wave
2021 compared to 11.0% 5.0% 5.6%
2020 calibrated
40%
values^ Thyroid Preparations 9.7% 0.3% 4.4%
% Growth – Units
Growth Hormones -3.1% -9.4% -7.5%

20%
Alimentary tract and metabolism 10.7% -5.7% 1.5%
Glp-1 Agonist A-Diabs 22.8% 31.0% 22.8%
0%
Sglt2 Inhibitor A-Diabs 24.2% 27.9% 22.6%
Blood and blood forming organs 3.4% -4.4% -1.3%
-20%
Direct Factor Xa Inhibitors 24.3% 10.9% 17.7%
Platelet Aggreg Inhibitor's -3.5% -5.1% -6.5%
-40%
W42: 12-Oct
W44: 26-Oct
W14: 30-Mar
W16: 13-Apr
W18: 27-Apr
W20: 11-May
W22: 25-May
W28: 06-Jul
W30: 20-Jul
W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W2: 04-Jan
W4: 18-Jan
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W6: 01-Feb
W8: 15-Feb
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W24: 08-Jun
W26: 22-Jun
Nervous system 9.2% -9.2% -1.6%

Antipsychotics 11.7% -6.2% 3.0%
Antidepressants.& Mood Stab. 12.6% -6.5% 0.6%
9.1% -13.9% -1.6%
Week Starting Dates agents
Rx Market
Systemic hormonal preparations, excluding sex hormones and insulins Anti-TNF Products 23.1% -28.4% 9.3%
Blood and blood forming organs Other Immunosuppressants 10.1% -7.7% -0.9%
Nervous system
The UK hospital market has shown a YTD decline of ~9% compared to the
same period last year; Musculo-skeletal category showed growth in 2021

vs. 2020 2021 vs. 2020 vs. 2020
Second national Lockdown
Hospital Market -10.1% -8.4% -9.3%
lockdown for 4 weeks during 2nd wave
20%
Musculo-skeletal system 13.2% 10.0% 11.7%
Antineoplastic and immunomodulating a
10% -8.4% -0.7% -4.7%
gents
% Growth – Units
0%
Nervous system -4.0% -5.9% -4.9%
-10%

-17.7% -20.7% -19.1%
-30%
-40% Genito-urinary system and sex
-25.3% -16.7% -21.3%
May-20
Feb-20
Mar-20
Apr-20
Jul-20
Feb-21
Oct-20
Aug-20
Sep-20
Nov-20
Dec-20
Jan-20
Jun-20
Jan-21
hormones
Hospital Market
Cardiovascular system
Nervous system
Antiinfectives for systemic use
*Top in terms of YTD Growth; Source: IQVIA MIDAS data – starting 01/01/2020 | Hospital panel
The UK consumer health market showed decline of ~10% in latest week
% Growth – Units Current Year vs. same week Previous Year CH Categories and top* 2 classes Units Growth Units Growth Units Growth
CH market and CH categories within each category by Units Growth Jan 2021 Latest Week YTD 2021
YTD 2021 vs. YTD 2020 vs. 2020 2021 vs. 2020 vs. 2020
70% Second national Lockdown during 2nd CH Market -2.2% -10.0% -6.8%
lockdown for 4 weeks wave
Over-the-Counter Drugs (OTC) 7.6% -3.7% 2.5%
50% 2021 compared to
2020 calibrated Digest & Oth Intest Prod 15.2% 0.8% 7.1%
values^
30% Vitamins, Minerals And Nutritional
Supplements, Tonics And Other 14.4% -10.1% 5.1%
% Growth – Units
Stimulants
10%
Unisex Beauty Products -6.3% -15.8% -5.9%
-10%
Beauty Products For Women -15.1% -7.2% -8.7%
-30% Patient Care (PAC) 0.5% -21.1% -3.4%

Stomach care Products 6.4% -6.1% 1.3%
-50% Injection Devices 2.8% 4.8% 1.2%
Nutrition (NTR) -12.8% -25.8% -21.9%
-70%
W46: 09-Nov
W48: 23-Nov
W50: 07-Dec
W52: 21-Dec
W14: 30-Mar
W42: 12-Oct
W44: 26-Oct
W2: 04-Jan
W4: 18-Jan
W10: 01-Mar
W12: 15-Mar
W14: 29-Mar
W16: 13-Apr
W18: 27-Apr
W20: 11-May
W22: 25-May
W24: 08-Jun
W26: 22-Jun
W28: 06-Jul
W30: 20-Jul
W32: 03-Aug
W34: 17-Aug
W36: 31-Aug
W38: 14-Sep
W40: 28-Sep
W6: 01-Feb
W8: 15-Feb
Baby Foods 2.5% 11.1% -3.9%
Please note that UK CH data is based on sell-in, while other countries

report sell-out data for CH
Week Starting Dates
*Top in terms of YTD Growth; **Dip in PEC category during week 31 was driven by a decrease in Oral Hygiene products; ^Week 10 to Week 25 of 2020 takes 2019 actuals and applies the average YoY growth rate from the
“steady state (SS)” period of 2020 (week 26-52)
In UK, the overall promotion shows growth compared to 2020; Email &
Postal Mailing holds major share of promotional volume

1% 4% 3% 2%
3% 8% 16%
6%
1% 7%
4% 263%
F2F Detailing
F2F Meeting
42% 236%
E-Detailing
50% Phone Detailing
60%
E-meetings
E-mail 830%
Postal Mailing
43% Instant Messaging/Texting 74%
26%
-9%
1%
2020 2021
Results from CD UK panel of 1,470 HCPs *30 day period to 25/04
Oncology is the leading therapy area in 2020 NAS launches and Top 5 drugs
contribute ~0.55 Bn USD in EU4 and UK
2020 – 44 Launches 2020 – Top 5 Performers by value
All Others 11% $250.0

$225.0
Diabetes 5%
$200.0
Oncology 27%
$176.6
Digestive 5%
$150.0
$ Million
Cardiology 5%
$100.0
Respiratory
7% $55.1 $54.5
$46.0
$50.0
Hematology
14%
Infectious
Disease 9% $-
Zolgensma Trikafta Veklury Rinvoq Polivy
CNS 9% (Novartis) (Vertex (Gilead ) (Abbvie) (Roche)
Immunology 9% Pharma)
Spinal Diffuse Large
Cystic Rheumatoid
Muscular COVID-19 B-Cell
% share represents the number of 2020 NAS launches in particular therapy area Fibrosis Arthritis
Atrophy Lymphoma
*NAS: New active substances
Appendix: Data Sources
and Methodology
71
Sources from secondary data research
Approved vaccines and advance purchase agreements
Vaccination Strategies (Slide # 6)
(Slide # 3-4)
• https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine- Delaying Second Dose:

tracker.html#vector
• https://wellcome.org/news/what-happens-if-we-delay-second-doses-covid-19-
• https://covid19.trackvaccines.org/vaccines/
• https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/ vaccines-pfizer-oxford-moderna
• https://www.itv.com/news/2021-02-01/deal-for-promising-covid-vaccine-puts-uks- • https://www.cbc.ca/news/health/covid-19-vaccine-spacing-1.5934299
total-dose-order-at-more-than-400m
• https://horizon-magazine.eu/article/five-things-you-need-know-about-delaying-gap-
• https://www.ema.europa.eu/en/news/ema-starts-rolling-review-curevacs-covid-19-
vaccine-cvncov between-covid-19-vaccine-doses.html
• https://www.gov.uk/government/publications/covid-19-response-spring-2021/covid- • https://www.medicalnewstoday.com/articles/astrazeneca-vaccine-3-month-dosage-
19-response-spring-2021#roadmap interval-might-be-preferable
• https://ec.europa.eu/info/live-work-travel-eu/coronavirus-response/public-health/eu-
vaccines-strategy_en • https://www.theguardian.com/world/2021/jan/05/no-data-to-support-uk-delay-of-
• https://www.bbc.com/news/uk-56727510 vaccines-second-dose-says-who
• https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech- Switching Vaccines:
supply-european-union-100-million-0
• https://www.france24.com/en/europe/20210414-germany-to-give-different-second-
• https://valneva.com/press-release/valneva-announces-major-covid-19-vaccine-
partnership-with-u-k-government/ vaccine-to-astrazeneca-recipients-under-60
• https://www.reuters.com/business/healthcare-pharmaceuticals/eu-seals-deal-with- • https://www.moneycontrol.com/news/world/covid-19-vaccine-update-germany-to-
pfizer-biontech-up-18-bln-doses-vaccine-eu-official-2021-04-23/ give-different-second-jab-to-astrazeneca-recipients-under-60-6767741.html/amp
• https://www.bbc.com/news/health-
55274833#:~:text=The%20UK%20has%20ordered%20more,develop%20vaccines% • https://www.businessinsider.in/science/news/some-countries-are-recommending-
20against%20future%20variants that-people-mix-vaccine-doses-to-avoid-taking-a-second-astrazeneca-shot-amid-
• https://www.reuters.com/world/uk/britain-agrees-deal-60-million-more-pfizer-covid- concerns-over-blood-clots/articleshow/81988472.cms
19-vaccines-2021-04-28/ • https://apnews.com/article/europe-coronavirus-pandemic-france-germany-
• https://www.theguardian.com/society/2021/apr/26/what-covid-vaccines-does-uk- coronavirus-vaccine-03f31f2a172594f361e82b7310749a1d
have-valneva
• https://medicalxpress.com/news/2021-03-eu-mn-vax-doses-week.html • https://www.theguardian.com/society/2021/apr/10/france-and-germanys-covid-
vaccination-programmes-pick-up-speed
Please note: IQVIA is not accountable for the accuracy of information from external data sources
Vaccination plans by country & Intention to vaccination (Slide # 5)
Italy: France:
• https://www.thelocal.de/20210415/compared-how-countries-around-europe-are- • https://www.aa.com.tr/en/health/1-in-5-adults-in-france-vaccinated-pm/2202977
organising-their-covid-vaccine-rollouts/ • https://www.france24.com/en/europe/20210304-france-aims-to-vaccinate-30-million-
• https://www.usnews.com/news/world/articles/2021-03-13/italy-announces-plan-to- against-covid-19-by-the-summer
vaccinate-at-least-80-of-population-by-september • https://www.thelocal.fr/20210104/explainer-how-france-is-changing-its-covid-19-
• https://www.bmj.com/content/373/bmj.n905 vaccine-strategy
• https://www.vaccinarsinsardegna.org/en/notizie/2020/12/vaccinazione-anti-sars- • https://www.thelocal.de/20210415/compared-how-countries-around-europe-are-
cov-2-pubblicato-piano-strategico organising-their-covid-vaccine-rollouts/
• https://www.archpaper.com/2020/12/stefano-boeri-reveals-a-pavilion-and- • https://www.thelocal.com/20210420/drivers-shop-staff-cleaners-france-lists-20-
marketing-campaign-to-get-italians-excited-covid-19-vaccination/ priority-jobs-for-covid-vaccines/
• https://www.livemint.com/news/world/italys-covid-19-vaccinations-bypassed-the- Germany:
elderly-and-more-are-dying-11618402761694.html • https://www.thelocal.de/20210415/compared-how-countries-around-europe-are-
• https://www.scmp.com/video/coronavirus/3125687/italy-resumes-partial- organising-their-covid-vaccine-rollouts/
coronavirus-lockdown-country-fights-new-wave • https://www.dw.com/en/germany-merkel-state-leaders-agree-on-strategy-to-jump-
• https://www.wantedinrome.com/news/italy-to-ease-covid-19-restrictions-from-26- start-vaccinations/a-56931483#:~:text=News-
april.html ,Germany%3A%20Merkel%2C%20state%20leaders%20agree%20on%20strategy
%20to%20jump%2D,France%20and%20the%20Czech%20Republic
• https://www.iamexpat.de/expat-info/german-expat-news/gps-join-germanys-
vaccination-drive-what-you-need-know
• https://www.thelocal.de/20210309/explained-when-will-i-be-in-line-for-a-vaccination-
in-germany/
Vaccination plans by country & Intention to vaccination (Slide # 5)
Germany (continued): Spain (continued):

• https://www.thelocal.de/20210309/explained-when-will-i-be-in-line-for-a-vaccination- • https://www.trtworld.com/life/who-mixing-vaccines-between-doses-not-yet-safe-
in-germany/ latest-updates-45736/amp/?utm_source=googlenewsstand&utm_medium=amp_rss
• https://www.cnbc.com/2021/01/19/germanys-vaccine-rollout-challenges-and- • https://english.elpais.com/society/2021-02-23/spain-among-world-leaders-in-
problems-in-vaccine-strategy.html administering-second-covid-19-dose-but-strategy-under-debate.html
• https://www.dailysabah.com/world/europe/germans-doubt-merkels-promise-to-meet- • https://health.economictimes.indiatimes.com/news/policy/spain-announces-a-
covid-19-vaccine-goals lockdown-france-shuts-down-the-nightlife/74633124
• https://www.euronews.com/2021/03/23/germany-extends-lockdown-until-mid-april- UK:
amid-third-wave-of-infections • https://www.bbc.com/news/health-55274833
• https://www.thelocal.de/20210416/gps-in-germany-will-soon-be-able-to-choose-the- • https://theconversation.com/the-uks-speedy-covid-19-vaccine-rollout-surprise-
covid-vaccine-they-offer-patients/ success-or-planned-perfection-155922
• https://www.theguardian.com/world/live/2021/apr/23/coronavirus-live-news-india- • https://www.gov.uk/government/publications/covid-19-response-spring-2021/covid-
reports-world-record-cases-for-second-day-japan-to-declare-emergency- 19-response-spring-2021-summary?priority-taxon=774cee22-d896-44c1-a611-
measures?page=with:block-6082bccf8f08505668d98f2e#block- e3109cce8eae
6082bccf8f08505668d98f2e
• https://www.bbc.com/news/uk-56158405
Spain:
• https://www.thehindu.com/news/international/uk-reopens-after-three-months-of-
• https://english.elpais.com/society/2021-04-01/vaccination-drive-in-spain-71-of-80- lockdown/article34305540.ece
and-overs-have-had-at-least-first-shot.html
• https://www.euronews.com/2021/04/08/lockdown-and-vaccine-drive-saw-uk-covid-
• https://www.aa.com.tr/en/europe/spain-unveils-coronavirus-vaccination- cases-drop-60-in-march-says-study
plan/2054476
• https://policynetwork.org/opinions/blogs/covid-19-vaccinations-in-spain/
Technology contribution (Slide # 7-8)
• https://www.healthcareitnews.com/news/emea/uk-use-ai-covid-19-vaccine- • https://www.healthcareitnews.com/news/emea/uk-tech-company-launches-global-
side-effects covid-and-vaccination-passport
• https://www.dw.com/en/german-technology-aids-covid-vaccine-logistics/a-55736267 • https://www.schengenvisainfo.com/news/france-set-to-trial-vaccine-passport-for-
• https://www.lbc.co.uk/news/online-covid-vaccine-calculator/ some-air-passengers/
• https://www.euractiv.com/section/justice-home-affairs/news/spain-to-keep-registry- • https://www.schengenvisainfo.com/news/list-of-eu-countries-issuing-asking-for-
of-people-who-refuse-covid-vaccine/ vaccination-certificates/
• http://www.pmlive.com/pharma_news/four_european_nations_form_alliance_to_fast • https://www.mobihealthnews.com/news/emea/france-uses-medication-shield-
-track_covid-19_vaccine_1341492 technology-part-covid-19-vaccination-campaign#:~:text=EMEA-
,France%20uses%20Medication%20Shield%20technology%20as%20part%20of%2
• https://www.nes.scot.nhs.uk/news/new-app-supports-covid-vaccine-rollout/ 0COVID%2D19,safety%20of%20the%20vaccination%20programme
• https://www.ukauthority.com/articles/scotland-launches-vaccination-app-for- • https://www.rfi.fr/en/france/20210404-grassroots-french-covid-app-launched-to-
care-staff/ prevent-wasting-vaccine-doses-health-mobile-phone
• https://www.reuters.com/article/us-health-coronavirus-germany-certificat- • https://www.cnbc.com/2021/01/19/uk-hospitals-use-blockchain-to-track-coronavirus-
idUSKCN2AT36D vaccine-temperature.html
• https://newseu.cgtn.com/news/2021-03-06/Spain-injects-urgency-for-vaccine- • https://www.businesswire.com/news/home/20210202005840/en/ACF-Technologies-
passports-to-boost-tourism-YonbVr83Ys/index.html to-Support-UK%E2%80%99s-Mass-Vaccination-Goals-with-Intelligent-Appointment-
• https://www.spainvisa.eu/spain-introduce-covid-19-vaccination-certificate/ Scheduling
• https://www.livemint.com/news/world/new-tech-to-pick-out-people-at-high-covid-19-
risk-in-england-for-vaccines-11613486570521.html
Understanding vaccination analysis data
• Vaccination rollout data is sourced from the OWID tracker
- Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at
OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/coronavirus’
- Data was processed using IQVIA methodologies and readout metrics may therefore differ from original source
• Vaccine approval/emergency authorisation data is sourced from McGill University, Financial Times, RAPS, and New York Times
vaccine trackers
- https://covid19.trackvaccines.org/, https://www.ft.com/, https://www.nytimes.com/interactive, https://www.raps.org/
• Vaccine policy categorisation: https://www.bsg.ox.ac.uk/research/research-projects/coronavirus-government-response-tracker
• Vaccination rollouts are highly dynamic with regular data updates. The analysis in this deck are based on data released 22/04/2021
• Assumptions/considerations
- Number of vaccinated patients will differ between vaccines depending on dose regimen and national rollout policy
- Vaccines with approval, emergency authorisation, or equivalent are noted on slides for a given country. Vaccines with supply agreements
only are excluded
› Approval or emergency authorisation does not necessarily reflect use
› EMA authorisation represents authorisation in all EU countries plus Norway, Iceland, Liechtenstein
- If multiple vaccines are available in a country, then combined number of doses is presented
- Reporting timepoints differ between countries
- Only reported vaccination rollout can be tracked and therefore unreported vaccination rollout levels may differ
• COVID-19 vaccination - Recent news updates from following links: BBC1, Reuters2, Reuters3, Reuters4, Reuters5 J&J side effects: BBC6
,EMA7, FDA/CDC9, WP10 Sinovac: SSRN11, BBC12, Reuters13, SCMP14, Reuters15
Source: IQVIA European Thought Leadership
IQVIA Sales Data Offerings Used and Methodology
Geographic scope of Measures used

Data source Frequency Data source description Calculations applied
data used in this report for analysis
Weekly Sell-out Weekly Details on sales of products • Italy: Rx and CH • Italy: Units Italy, Germany, Spain, France:
Data dispensed at retail markets • Germany: Units • Units Growth Mar 2021 vs. 2020 – To provide
(Pharmatrend, pharmacies • Germany: Rx and CH • Spain: Units base view of the market from pre COVID-19
Flashtrend) This includes both prescription markets period in the year 2020
• France: Units
and non-prescription products • Spain: Rx and CH • UK: Rx counts • Units Growth Latest week 2021 vs. 2020 –
Prescription products are markets To provide the latest trend in the market to
classified using ATC • France: Rx and CH understand the dynamic changes in trends
classification markets • Units Growth YTD 2021 vs. 2020 – To
Consumer health products • UK: Rx market provide the YTD trend in the market to
cover products from Over the understand the longer term changes in trends
Counter drugs, Personal UK: Rx market
Care, Patient Care and • Rx Growth Latest week Rx 2021 vs.
Nutrition categories Average Rx for Jan 2020 – To provide
comparison of latest market scenario against
Jan 2020 (pre COVID-19 period) as base
where 2019 data was unavailable
• Rx Growth YTD average weekly Rx 2021 vs.
Average weekly Rx for Jan 2020 – To
provide comparison of YTD sales trends in
2020 against Jan 2020 (pre COVID-19 period)
as base where 2019 data was unavailable

IQVIA Sales Data Offerings Used and Methodology (contd.)
Geographic scope of Measures used

Data source Frequency Data source description Calculations applied
data used in this report for analysis
Weekly Sell-in Weekly Details on purchase of • UK consumer health • UK: Units UK: CH market
Data products by retail pharmacies market • Units Growth Mar 2021 vs. 2020 – To
Our current scope covers provide base view of the market from pre
consumer health products COVID-19 period in the year 2020
only • Units Growth Latest week 2021 vs. 2020 –
To provide the latest trend in the market to
understand the dynamic changes in trends
• Units Growth YTD 2021 vs. 2020 – To
provide the YTD trend in the market to
understand the longer term changes in trends
MIDAS Data Monthly Details on hospital panel • Italy hospital market • Italy: Units Italy, Germany, Spain, France, UK:
retail sales • Germany hospital • Germany: Units • Units Growth Mar 2021 vs. 2020 – To
market • Spain: Units provide base view of the market from pre
• Spain hospital market • France: Units COVID-19 period in the year 2020
• France hospital market • UK: Units • Units Growth Latest month 2021 vs. 2020 –
• UK hospital market To provide the latest trend in the market to
understand the dynamic changes in trends
• Units Growth YTD 2021 vs. 2020 – To
provide the YTD trend in the market to
understand the longer term changes in trends

Channel Definitions
F2F Detailing: Sales Rep face-to-face detailing

Face to face
interactions
F2F Meetings: Meetings, events, congresses, seminars
E-Detailing: Online presentations - live with a rep or automated, self guided
Phone Detailing: Telephone communication with reps
E-Meetings: Streaming video – live webinar or pre-recorded webcast

Remote
interactions
Email: Opened email communication
Postal: Opened paper mail received by post
Instant Messaging/Texting: Opened text message communication

For Additional Questions, Service, or Support
A note to our readers:

We are working diligently to provide these insights to the market on a regular basis. As the situation remains fluid so shall
our analytics. We look forward to hearing your feedback as well as viewpoints you would like to see in future editions.
Accordingly we have established a dedicated email box for your feedback and questions: EU4 &
UKCOVIDReport@iqvia.com
This email box will be regularly reviewed and inquiries will be addressed as quickly as possible. Given the high demand
at this time, queries may take additional time to respond. Please be assured your inquiry is being reviewed and will be
addressed when possible.
Thank you and be well.
IQVIA’s European Thought Leadership team

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Impact of COVID-19 on the

Pharmaceutical Market – EU4 & UK

European Thought Leadership

+ US – 2020 Year in Review

ROW ROW ROW ROW

Vaxzevria/Covishield Ad26.COV2.S CoronaVac BBIBP-CorV Convidecia Vero cells

Comirnaty mRNA-1273 Sputnik V EpiVacCorona Covaxin KoviVac ZF2001

ROW ROW ROW ROW ROW

Vaccines approved after Jan 2021

400 400 • 9.8 Mn doses received in Q1 2021

100 100 • Purchased 200 Mn doses in advance • Purchased 60 Mn doses in advance

• • Spanish govt. prioritized • In first vaccination phase elderly •

vaccine doses arrived and September 2021 with a target to vaccinate

Refer appendix section for sources

✓ Recommended gap between COVID-19 vaccines: 4-12 weeks for Oxford-

✓ Germany and France advocate mixing of two different coronavirus vaccine

✓ No solid evidence yet on whether switching vaccines between doses can

Refer appendix section for sources

Storage & Supply Vaccination Updates

German based technology company aids COVID-19 vaccine

TURAS Vaccination Management Tool,

Refer appendix section for sources

US (20th Apr) 213.4

China (19th Apr) 195.0 *

Brazil (20th Apr) 33.8

Germany (20th Apr) 22.9

Turkey (20th Apr) 20.3

France (19th Apr) 17.4

Indonesia (20th Apr) 17.3

Russia (20th Apr) 16.6

Others (Sum) 219.5

World (Sum) 926.8

0 10 20 30 40 50 60 70 80 90 100 110 120

Israel (20th Apr) 119.6

Seychelles (19th Apr) 118.9 *

Bahrain (20th Apr) 65.7 *

US (20th Apr) 64.5

Malta (19th Apr) 64.1

UK (19th Apr) 64.0

Bhutan (19th Apr) 62.1

Others (Avg) 8.7

World (Avg) 12.0

0 20 40 60 80 100 120 140 160 180 200 220 0 5 10 15 20 25 30 35 40 45 50 55 60

A generational public health challenge A disrupted, but resilient industry

Pandemic trajectory dictates Shifting sites of care, boosted

Clinical development rises to

Impact of COVID-19 on the Pharmaceutical Market – EU4 & UK - April 2021 15

Impact of COVID-19 on the Pharmaceutical Market – EU4 & UK - April 2021 16

28 million 115 million

Covid.cdc.gov March 1, 2021

Impact of COVID-19 on the Pharmaceutical Market – EU4 & UK - April 2021 18

Wisconsin Mississippi California

Elec. Elec. Elec.

-2.8% -2.8% -5.0% -2.7%

Impact of COVID-19 on the Pharmaceutical Market – EU4 & UK - April 2021 19

What happened Implications

“Temporary” unemployment could delay patients

Impact of COVID-19 on the Pharmaceutical Market – EU4 & UK - April 2021 20

Improving Access to Improve Access to