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Statistics on Medicines

Estonian annual statistics on medicines is based on wholesalers’ quarterly reports. The statistics of human medicinal products includes sales to general and hospital pharmacies and to other institutions, i.e. state and scientific institutions.

Wholesalers

In 2023 there were 66 licensed medicinal product wholesalers in Estonia, and 28 of them distributing human medicines to general or hospital pharmacies or to other institutions. Two major wholesalers covered 82% of human medicinal products market: Magnum Medical (48.3%) and Tamro Estonia (33.4%). Followed by Baltfarma OÜ (5.7%), Estonian Health Insurance Fund (4.5%), Roche Estonia OÜ (4.2%) and Oribalt Tallinn AS (1.2%). The total market share of the other 22 wholesalers was under 3%.

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Medicinal products market of human medicines

The medicinal products market has grown rapidly during the last five years. In 2023 the human medicinal products market share reached 456 mln euros, showing 5.8% increase compared to the previous year. Sales to general pharmacies covered 71% (321 mln euros), sales to hospital pharmacies 28% (129 mln euros) of total medicinal products market and sales to other institutions 1% (6 mln euros). In 2021 and 2022 the market share of other institutions was remarkably higher, mainly due to Covid-19 vaccines, which reached the market (Figure 1).

Figure 1. Estonian medicinal products market in 2019-2023. The medicinal products market is expressed in wholesale prices, which includes the price of the manufacturer and wholesaler’s mark-up and does not include the VAT.

The sales of prescription medicines covered 87% and the sales of over-the-counter medicines 13% of the pharmaceutical market. During last five years, we can clearly distinguish the exceptional year 2020, with Covid-19 pandemic influencing the quarterly dynamics of pharmaceutical market (Figure 2 and 3).

Figure 2. Prescription medicines turnover in 2019-2023 quarterly.

Figure 3. Over-the-counter medicines turnover in 2019-2023 quarterly.

Medicinal product market share and drug consumption

Based on ATC classification, antineoplastic and immunomodulating agents (ATC group L) had the greatest market share of 24%. Alimentary tract and metabolism medicines (ATC group A) covered 12% and antiinfectives for systemic use (ATC group J) 12% of the market. The market share of these three ATC groups was altogether ca 50% (Figure 4).

Figure 4. Estonian medicinal products market share between ATC groups in 2021-2023

DDD/1000/day describes often population drug consumption better than turnover which can be quite unstable, for example new generic drugs that come to market affect prices greatly or the fact that some medicines are remarkably expensive, i.e. antineoplastic and immunomodulating agents, antiviral medicines.

Defined Daily Dose (DDD) is the assumed average dose per day for the drug used in its main indication in adults. Defined Daily Dose per thousand inhabitants a day (DDD/1000/day) expresses the proportion of the population within a defined area treated daily with certain drugs. However, the DDD system cannot be applied to all medicines, mainly due to very individual dosing. For example, most of the dermatological medicines as well as antineoplastic and immunomodulating agents or preparations in ATC group Various (diagnostic agents, contrast media) have not been assigned DDDs.

Analysing the medicinal product consumption in Estonia by using the unit DDD/1000/day, we can see that the most consumed medicines are cardiovascular system drugs (471 DDD/1000/day), forming more than one third of the total consumption of medicines. Alimentary tract and metabolism medicines cover 15% (198 DDD/1000/day) and nervous system medicines 12% (158 DDD/1000/day) of the total consumption (Figure 5).

Figure 5. Consumption of medicinal products in Estonia in 2023 (defined daily doses per 1000 inhabitants a day).

Rosuvastatin (58 DDD/1000/day), Ramipril (53 DDD/1000/day), and Atorvastatin (43 DDD/1000/day) and of OTC medicines the combination of Acetylsalicylic acid and Magnesium oxide (28 DDD/1000/day), Xylometazoline (26 DDD/1000/day) and Ibuprofen (23 DDD/1000/day).

4728 medicinal preparation packages and 1420 active substances were marketed in Estonia.

More information about medicines consumption in Defined Daily Doses:

Summary of 2023 medicinal product market:
  • Medicinal products market: 456 mln euros / 32.9 mln packages
  • Sales to general pharmacies: 321 mln euros / 30.4 mln packages
  • Sales to hospital pharmacies: 129 mln euros / 2.2 mln packages
  • Sales to other institutions: 6 mln euros / 0.3 mln packages
  • Prescription medicines: 396 mln euros / 20.8 mln packages
  • OTC medicines: 60 mln euros / 12.1 mln packages
  • Antineoplastic and immunomodulating agents: 110 mln euros
  • Alimentary tract and metabolism medicines: 59 mln euros
  • Antiinfectives for systemic use: 54 mln euros

Last updated: 17.04.2024