Efient was launched in the UK in 2009 and the first parallel imports appeared on the UK market in 2011 after a two year ‘honeymoon’ period. In the graph below each colour represents a UK wholesaler selling parallel imported Efient to UK pharmacies and dispensing doctors.
In the discussion below we will talk about full line wholesalers which distribute the majority of their clients’ product requirements (AAH, Alliance and Phoenix), their short line partners (OTC Direct, Trident, Nupharm and Numark) and true short liners which include all the others. Short line wholesalers tend to supply generics and parallel imports rather than all their clients’’ requirements.
Most individual wholesalers do not remain active throughout the full ten year period. Instead they put a lot of effort into selling PI Efient for 3 or 4 years, and then either completely stop or dramatically reduce their efforts. Full line wholesalers on the other hand have the resilience to reengage with the product after extended periods of absence. They also rely on the presence of their short line partners to do most of the selling for them.
In the early stages of PI introduction it was the full line wholesalers with their short line partners which did most of the selling, however the first true short liner was doing 50% of the selling by the end of the first year. After this the first short line entrant saw its market share squeezed as other short liners got in on the action.
By the end of the fifth year most of the selling was being done by the true short liners, with full liners and their short line partners taking about 25% of the market. Then as the amount of PI stock declined, probably due to exchange rate changes, both the full liners and their partners became more active, taking up as much as 70% of the market at one point.
Then as the market matured, and the amount of PI available declined market share was more evenly spread, so that in August 2022 the full liners had 14%, their short line partners 21% and the rest of the short line market 64%.