scription drugs. SUS was fully responsible for providing health services to 75% of the Brazilian population in 2017. Other indicators reinforce the importance of SUS: it is responsible for 43% of health expenditures in Brazil (2015), 59% of hospitalizations (2016), 53% of medical exams (2016) and 98% of vaccines (2016). From the industry’s point of view, the main advantage of SUS is that it is only a source of payment, which negotiates centrally with the medicine and health products industry, unlike the supplementary health operators, which totaled 766 companies in 2017. In general, three main factors increase Brazil’s competitive advantage as a destination for foreign investment: the size of its health market, the relevance of SUS as a centralized decision maker that affects 75% of the population, and the high rate of local competitiveness, fragmenting the market between local and global players. The growth of the health industry in Brazil should continue in the coming years due to six main trends: the aging of the population, the increase in average income, the increase in chronic diseases, the incorporation of new technologies, the transformation of the patient into a consumer of services, and the judicialization of health. The growth trend of biotechnology-based drugs is also very strong in Brazil. In 2016,
they already accounted for 19% of total market revenue, while globally this figure was 25%. In terms of sales, biological drugs grew 45% between 2015 and 2016, well above the 19% growth in generic drugs and 15% in new prescription drugs. In recent years, there has been a growing share of imports to supply the Brazilian market. Regarding pharmo-chemicals, for example, imports increased from 71.2% in 2010 to 77.4% in 2015. The same occurred with prescription drugs: 21.9% to 26.3%. The growth in the pharmaceutical preparations industry was even higher, with an increase of almost 15%: from 16.3% in 2010 to 30.3% in 2015. In 2017, Brazil imported a total of US$ 6.1 billion in pharmaceutical products. All these trends, summed up, have the potential to boost two sub-sectors in particular: pharmaceutical and health products. This is the main object of the strategy for FDI attraction (FDI) by the Brazilian Trade and Investment Promotion Agency (Apex-Brasil). Brazil is the second largest pharmaceutical market among emerging countries – only behind China – with a total volume of BRL 73.7 billion in 2016. In the coming years, the sub-sector is expected to grow 7.9% per year and reach the amount of BRL 107.7 billion in 2021. On the other hand, the health products sub-sector handled a smaller volume, BRL 14.9 billion
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