Adcock Ingram is ranked as the second largest manufacturer in the private pharmaceutical market and is the second largest supplier to the public sector. Of note is the major share of the critical care market held by the company, being the largest supplier of critical care products to the public sector and hospitals. Adcock Ingram is a committed supplier of antiretroviral (ARV) medicines to the public sector through the highly competitive tender system.

The Consumer division competes mainly in the unregulated Fast Moving Consumer goods (FMCG) market. Products are also distributed and marketed in modern and traditional trade outlets. It continues to focus on the marketing, selling and distribution of healthcare, personal care and homecare brands. The well-known Epi-max skin care range was transferred from the Prescription division on 1 January 2021.

Consumer

Pain The consumer pain market has seen double digit growth with the Adcock Ingram Consumer pain portfolio growing slightly behind the market. The COVID-19 pandemic has driven a significant increase in tablet format with aspirin driving the segment growth. Panado, a proudly South African brand, ranks second in the total pain market and has shown positive growth across all formats with continued investment in campaigns driving trust, equity and awareness. Whilst the brand's strength remains in the tablet format as segment leader, overall brand growth is driven by innovative formats – effervescent and capsules. Compral remains the fifth biggest player and has achieved double digit growth, ahead of the market, with significant growth in the powders format.	Gut/ Probiotics1 The probiotics market has shown positive growth, with Probiflora, the market leader, growing ahead of the category. Probiflora growth was driven by refocusing on the consumer in the self-select space.	Energy1 The energy market is split into energy supplements and energy drinks with Bioplus competing in both segments. The supplements category has experienced declines driven by the impact of COVID-19 through the decline of on-the-go sachet format, whilst the drinks category has achieved double digit growth. Whilst Bioplus is declining within the category, the brand remains market leader within the liquid tonics format. Bioplus drinks are growing in double-digits, ahead of the drinks segment, driven by increased distribution across all channels.
Vitamin, mineral and supplements (VMS)1 The VMS market has shown double digit growth driven by COVID-19. The immune health, multivitamin and single vitamin categories saw significant growth as consumers behaviour shifted towards preventative healthcare. The division’s VMS portfolio saw double-digit growth across the portfolio driven by Viral Guard and Gummy Vites.	Hand & Body1 Epi-max, contests in a highly competitive market that is cluttered with many multinational players, but despite this, managed to grow in double digits year on year. Epi-max is in the Top 6 skincare - hand and body products in South Africa competing with major players like Nivea, Vaseline and Ingrams. Epi-max is the market leader of emollient creams with a 44% market share. Its strong heritage and well-known reputation at doctor level have translated into a strong consumer presence with a trusted formulation.	Home care2 Home care performance in the market has shown growth driven by COVID-19 and an increase in antibacterial and disinfectant product usage in the home. Plush is the 4th largest player in the market and has held share in an increasingly competitive environment. Our multi surface cleaner is the number 1 brand in the furniture category and over the past year has delivered category growth, winning share in the market. Our market performance is a result of our continued focus on delivering value for money, quality products for customers, as well as new product development.
Shoe care1 Shoe care performance has been negatively impacted by COVID-19, as people worked more from home and go out less. Despite the declines, Plush has remained competitive in the market and has won share over the last 12 months. Share gains have been driven by shoe polish as the market consolidates around trusted brands. Our liquids portfolio, which is the market leader, has also delivered share growth and as the market recovers, we expect to expand on this performance.

References
IRI MAT June 2021- Modern Trade
Euromonitor Homecare in South Africa February 2021

The Over the Counter (AI OTC) division manufactures, markets and sells medication with a focus on brands sold predominantly in retail pharmacy, where the pharmacist plays a role in the product choice. Pharmacy-initiated therapy is the main driver of product use in the Schedule 1 (S1) and Schedule 2 (S2) space, satisfying a growing need for primary healthcare in South Africa.

Pain The self-care pain management market is highly competitive, and consists of several major players employing strong competitive strategies, leading to high rivalry and immense pressure for real estate on the pharmacy shelf. The Adco-Pain OTC portfolio offers the pharmacist and the consumer a broad spectrum of analgesic choice, thus ensuring that market share leadership is maintained in this category. Such brands include Mypaid, Adco-Napamol and Spasmend.

Cough & Cold Due to the advent of COVID-19 and the absence of the traditional cold and flu season, many of AI OTC’s cough, cold and flu products achieved lower sales. However, during periods of spontaneous demand, the stalwart AI OTC brands found favour within the pharmacy and with the consumer. Corenza C remains the market leader in the division’s cough and cold’s basket, with annual sales of R226 million.

Allergy The COVID-19 outbreak has seemingly not had any serious implications on the growth rate of the allergy care market. AI OTC’s Allergy portfolio has annual sales of R250 million. Allergex is the market leader in this category, with annual sales of at R220 million, and growing in market at 12%1. The allergy portfolio also comprises other brands such as Levogex Ceticit and Adco-Desloratidine. Growth in this category continues as lay consumers are well versed on treatment options that pertain to their specific allergy. In congruence with the AI OTC Division’s ambition to promote its brands in a purpose-driven fashion, Allergex promotions include support and awareness of social struggles such as gender-based violence.

Heartburn & Digestion COVID-19 has had a direct impact on digestive remedies. Social distancing resulted in consumers dining out less during the year, thus decreasing their chance of picking up gastric complaints. These restrictions also led to fewer opportunities to go out consuming alcohol in bars, clubs and taverns and therefore, again reducing digestive complaints. The AI OTC division competes in the heartburn and indigestion category with brands such as Citro-Soda and Adco-Mayogel. The division’s digestive portfolio with annual sales of R245 million, is growing ahead of the market at 13%1.

Energy Vita-thion is a legendary brand in the division’s energy portfolio. It remains a popular choice in a tightly contested market with many new supplements entering this segment on a regular basis. Above-the-line advertising helps protect its market attractiveness whilst brand expansion strategies introduced during earlier years, afford the consumer a variety of options to purchase.

Reference
1 IQVIA MAT June 2021

The Prescription division focuses on building and offering a broad range of medicines in targeted therapeutic areas for patients consulting healthcare professionals, where prescriptions are generally required, including antiretroviral medicine, and the Genop business which is a specialised instrument, surgical and pharmaceutical products enterprise focused on servicing the ophthalmic, optometry, skincare, aesthetic and plastic surgery segments in Southern Africa. During the financial year, the Genop business’s finance, human Capital and logistics functions were fully integrated into the Prescription division. At the same time, the well-known Epi-max skin care range was transferred to the Consumer division.

Pain The pain portfolio, includes leading, well-known brands such as Mypaid Forte, Myprocam, Synaleve, Gen-Payne and Myprodol. The comprehensive portfolio offers healthcare professionals and patients effective pain solutions for mild to severe acute and chronic pain, including pain associated with cancer and auto-immune diseases, in a variety of dosage forms such as oral, topical, parenteral and transdermal. Maintaining the position as the leading prescription pain franchise in the country, three of the division’s pain brands feature within the top 10 brands within the non-narcotic analgesic market. Synaleve exceeded R100 million in sales in 2021, and grew by 14% compared to the market growth of 4%1. This despite the impact of COVID-19, which limited access to doctors and let to elective surgeries to be postponed.	Women's Health This portfolio recognises and celebrates the uniqueness of women and includes treatments for conditions that occur frequently in women. These include symptoms related to menopause, vaginal dryness, urinary tract infections (UTIs) and osteoporosis. The portfolio also recently expanded into the oral contraceptives market with the signing of a licence agreement with UK-based company, Theramex, to distribute and market Zoely in South Africa. As the leading Women’s Healthcare franchise in the country, with a 36% market share, the portfolio offers flexible, high-quality treatment options to meet the needs of South African women through specific stages of their journey through life, and empowering them to make informed decisions about their health. The urology portfolio, which includes well-known brands such as Urispas and Urizone, is market leader in the treatment of Urinary Tract Infections, with a 33% market share1.	Central Nervous System (CNS) Mental health has been thrust into the spotlight due to COVID-19, which has had a significant impact globally on the mental health of many people. New realities like working from home, unemployment, home-schooling of children, and the lack of physical contact with other family members, friends and colleagues has meant that taking care of our mental (as well as our physical) health has become all the more important. This franchise remains a partner of choice for multinational companies with CNS brands; and offers treatments for a wide range of psychiatric and neurological disorders. Stresam, a treatment option for anxiety has demonstrated excellent ex-factory growth of 22% in 2021, and in-market1, at 24% is the fastest growing originator anxiolytic in the class. Other key brands which are promoted and distributed for multinational partners are Cipramil, Cipralex and Fluanxol on behalf of Lundbeck and Rivotril which is promoted on behalf of Roche. The CNS franchise has the second largest growth (8%) among the top 6 competitor companies and is growing 4% faster than this market1.
Dermatology As the leading medical dermatology franchise with well-known brands like Advantan, Fucidin, Protopic, Dovobet and SBR, we offer treatments for a wide range of dermatological conditions including eczema, fungal and bacterial skin infections, psoriasis, acne and dry skin. Advantan remains the leading topical corticosteroid brand in the market with a 29%1 share. As a result of down scheduling to S2, Fucidin Topical now holds the number 2 position1 in its class. Dovobet, the only fixed dose combination anti-psoriasis product remains the leader1 with 59% (ointment) share in the market. Dovobet gel holds 11% share1.	Gastroenterology This portfolio comprises of principal or partner brands for the treatment of reflux disease, mild to moderate ulcerative colitis and haemorrhoids. The portfolio has brands in a variety of formulations including oral, rectal suppositories and topical ointment. The Gastroenterology portfolio includes leading brands in the market, such as Topzole and Scheriproct.	Biologics The division has partnered with Celltrion Healthcare in the launch of the first infliximab and rituximab biosimilars in South Africa. These launches will give Adcock Ingram a footprint within the biologics market and allow for competition with some of the top pharmaceutical products in the country. Biological medicines are very expensive and thus inaccessible to many patients suffering with serious autoimmune and oncological conditions. Biosimilar products are cost effective alternatives that provide similar efficacy and safety to originator products. Extending the access of treatment to more patients is the goal of biosimilar therapy.
ARVs The ARV portfolio includes a range of antiretroviral products indicated for the prevention and treatment of HIV and is currently the fourth-largest ARV franchise in the private sector, with a 9% market share1. ARV’s remain a key strategic pillar for the division based on the Company’s commitment to local manufacturing and international partnerships. This portfolio continues to face intense generic competition in the private sector and pricing pressure from funders with a greater number of generic entrants within this market driving down reference pricing. The switch to the Dolutegravir based regimen has been slower than anticipated and the Tenofovir/Emtricitabine/Efavirenz combination remains the most prescribed in the private sector. Trivenz remains the largest product within the portfolio. Adco-Emtevir which is the second largest product within the portfolio has maintained market leadership1 in its molecule class with a market share of 38%. The Company was awarded as 12% share of the Government anti-retroviral tender in 2019, valued at R1.9 billion over a three-year period, to supply ARV medication to the state-run hospitals. While the switch to the new DLT treatment regime was slow in gaining traction in the first year of the tender, orders placed by Government increased in the current financial year.	Generics Generics includes a portfolio of medicines across therapeutic areas such as CNS, Cardiovascular, Pain, Gastroenterology and Dermatology. Genpayne is the leading brand in the portfolio with an in-market value of R180 million1. The portfolio has also recently acquired a range of generic products across a number of therapeutic categories from Aspen Pharmacare and this has strengthened the portfolio’s basket of products. The aim within the portfolio is to ensure that patients have access to a comprehensive basket of products at competitive prices. This requires constant engagement with suppliers to manage product profitability and sustainability.	Genop Due to restrictions on elective surgeries during the financial year, the eyecare business was negatively impacted, however the aesthetic skincare business performed well as the year progressed showing growth of 19% on the prior year. The business represents a number of well-respected and market-leading brands from its international partners, including Johnson and Johnson (J&J Vision and Neostrata), DORC, Nidek, Heidelberg, Oculus, BVI, Heliocare, Teoxane and Dermapen.

Reference
1 IQVIA June 2021 MAT data

The Adcock Ingram Critical Care (AICC) is a leading manufacturer and supplier of hospital and critical care products in Southern Africa. Products are offered through multiple portfolios and across wide ranging customer channels. The business is a fully integrated operation which spans through regulatory, R&D, manufacturing, marketing, sales and distribution. Beyond its world-class commercial capability, AICC manufactures an extensive range of products in its unique dual process factory which comprises a comprehensive plastic extrusion plant together with a fully accredited pharmaceuticals manufacturing facility.

Pharma-Q (PQ)
PQ contributes 10% to medicine delivery, reflecting 20% growth, with 10 products contributing 80% of sales. The growth was driven by the following three products:

• Dexamethasone - 136%;
• Betamethasone – 30%; and
• Midazolam - 200%.

Pain and anaesthesia This portfolio contributes 10% to medicine delivery and experienced a decline of 9% in sales as it is dependent on elective surgeries with Macaine used in theatres and Temgesic IV used in hospitals for post-operative pain control. Temgesic sublingual tablets reflected growth of 14% as focus was put on doctors to prescribe the tablets for short-term use at home. Opioid substitution therapy (OST) OST contributes the balance to medicine delivery with sales reflecting a decline of 7% due to fewer patients seen by doctors and admitted into rehabilitation centres. The latter has changed their approach to care and encourage more outpatient treatment consultations and less admissions due to the pandemic.	Renal The renal division includes the following portfolios: peritoneal dialysis (PD), haemodialysis (HD) and continuous renal replacement therapy (CRRT). AICC remains the largest supplier of goods and services within PD, driven by innovative remote patient monitoring technology. In the face of increased patient mortality during the COVID-19 pandemic, the HD portfolio expanded its customer base, resulting in higher unit sales. Growth in CRRT was driven by the high demand for acute renal replacement therapy brought on by COVID-19.	Blood and specialised therapies Transfusion therapy AICC remains the largest manufacturer and supplier of blood bags in South Africa. We pride ourselves as local suppliers of not only blood collection bags, but also automated blood processing systems and equipment, blood filters, blood warmers and other blood ancillary products. The business continues to foster close associations with its key customers: the South African National Blood Service (SANBS) and Western Cape Blood Service (WCBS), offering not only product, but also excellent service and technical expertise.
Adco path A new addition to the AICC business is the ADCOPATH (pathology) segment. The pathology landscape in South Africa is changing. The COVID-19 pandemic has exposed a greater need for decentralised testing and fast tracked the demand for rapid turnaround times to make informed diagnostic and treatment decisions. Capitalising on our strategic alliances and by leveraging our strength of delivering across the value chain, AICC is perfectly aligned for entry into the point of care (POC) pathology market segment.	Speciality pharma Sales growth of 93% was achieved with the onboarding of the Roche portfolio (Mircera, Recormon and Cellcept) in January 2021. The Roche portfolio of products holds a 42% contribution to the speciality pharma portfolio in the current year and includes: Mircera and Recormon indicated for renal anaemia; and Cellcept is an immunosuppressant indicated for the prophylaxis of organ rejection in patients receiving transplants. The AICC basket of products (One-Alpha, Equifer, Kexelate and Heparin) achieved 12% growth.	Sports Science and Rehabilitation (SSR) Growth of 13% was achieved, despite sales severely impacted due to COVID-19 and the lockdown restrictions. All sports events, gyms, and school sports were halted during most of the lockdown period. As the lockdown regulations eased, the portfolio saw a gradual increase in sales. This was primarily due to more patients being seen by healthcare professionals, more sporting events being allowed and fitness centers re-opened. The primary target audience for this portfolio is healthcare professionals and pharmacies with 80% of the portfolio sales driven through the former.
Adco hygiene Adco hygiene sales declined significantly as the prior year sales included panic buying during the first few months of the COVID-19 pandemic. The business was awarded a tender for the alcohol surface disinfectant and high-level disinfectant.	Consumables and devices Sales from consumables and devices declined 9% due to the reduced number of trauma cases and elective surgeries during the pandemic, which resulted in the decreased usage of IV pumps sets, as well as hospital groups putting Capital spend on hold.

Adcock Ingram has recently undertaken a capital expansion project costing R1.5 billion which was primarily focused on the regulatory compliance status of the three manufacturing facilities situated in Gauteng.

The High Volume Liquids facility situated at Clayville is a state of the art and highly automated factory primarily producing liquids and effervescent formulations.

The Tablet and Capsule facility situated at Wadeville is focused on the manufacture of antiretroviral medicines which are supplied to the public sector through the tender system.

The Critical Care facility situated at Aeroton produces intravenous fluids, blood bags, renal dialysis products and large and small-volume parenterals.

Our Distribution department continues with its focus on improving service levels, maintaining regulatory compliance, and tightly managing costs.

Early in the 2020 calendar year, an initial four-year arrangement was reached with RTT to take over the Company’s product delivery infrastructure, including the owner-drivers and their staff. Subsequent to implementation on 1 March 2020, the scope of services provided by RTT includes despatch management, inter-depot movements, office courier, customer deliveries including cross-border, and the fleet. Our in-house department remains responsible for warehousing, orders, customer service, inventory management and planning, and compliance.

In January 2020, a new distribution centre was established in Halfway House, which houses the Genop laboratory, and training and procedure room. It also serves as the bulk receiving and storage site for Epi-Max. The COVID-19 pandemic added activities and compliance measures to the infrastructure in order to ensure that service delivery levels are maintained, including shift rotations and additional hygiene protocols.

Adcock Ingram covers over 14 markets on the continent with a broad product range of OTC, Prescription, Hospital and FMCG products. Adcock Ingram is making sure that we clearly understand the markets in which we operate and are aware of the risks and opportunities in each. We set out to attract the very best people who have a sound understanding of these markets and their consumers.

We have a state of the art manufacturing facility in Bangalore. Our Indian operation has given us the opportunity to strategically offer development and registration support to our operations in South Africa as well as augment our manufacturing capabilities.