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Pharmacy Automation: Technologies and Global Markets

  • September 2016
  • -
  • BCC Research
  • -
  • 212 pages

This BCC Research report provides a comprehensive analysis of the pharmacy automation market's current operations and equipment, current trends and detailed patent analysis. Structure and current market size of the pharmacy automation market are outlined with forecasts through 2021.

Use this report to:
- Gain analysis of the pharmacy automation market's current operations and equipment, current trends and detailed patent analysis.
- Determine in-depth market and competitive analyses of recent developments and current trends in the developed global pharmacy automation market.
- Analyze the operations of automated pharmacy processes.
- Discuss the major players in each of the regional markets and explain the global drivers, current trends, challenges and regional dynamics of the market.

Highlights
- The global inpatient and outpatient pharmacy automation market has grown to nearly $3.8 billion in 2016 from $3.5 billion in 2015. The market is expected to grow at a five-year compound annual growth rate (CAGR) of 7.9% from 2016 to 2021, increasing to $5.5 billion in 2021.
- The inpatient pharmacy automation market is the largest sector of the market. This market is expected to grow from $2.9 billion in 2016 to nearly $4.2 billion in 2021 at a CAGR of 7.3% for the period 2016-2021.
- The outpatient pharmacy automation market is expected to grow from $839 million in 2016 to more than $1.3 billion in 2021 at a CAGR of 9.8% for the period 2016-2021.

STUDY GOALS AND OBJECTIVES
This BCC Research report, Pharmacy Automation: Technologies and Global Markets (IAS026E), provides a comprehensive analysis of the pharmacy automation market’s current operations and equipment, current trends and detailed patent analysis. The study includes information regarding statistics for medication errors, costs associated with pharmacy activities, the pharmacist shortage and many other issues affecting the pharmacy automation market. Major pharmacy automation product segments include in-depth market and competitive analyses.

REASONS FOR DOING THE STUDY
Although pharmacy automation dates back to the 1970s with the introduction of pill-counting machines, the pharmacy automation market continues to advance and deliver impressive technology and improve efficiency. The increasing demand for accuracy, safety, industry standards and competency in the pharmacy environment by regulatory authorities, manufacturers, healthcare professionals and consumers has forced the growth of this market.

New opportunities in various settings will continue to surface—from small, private, family-owned pharmacies to large hospital and mail-order service facilities. Many small, private pharmacies are still conducting operations through manual and semi-manual methods, particularly in regions outside of the United States. The opportunity to fully automate these pharmacies surfaces more often each year, and with a growing compliance with bar-coding standards and new tracking capabilities with radio-frequency identification (RFID) technology, this trend will continue to increase at a rapid rate. A large portion of inpatient facilities are already highly automated; however, there are advancements in technology and performance improvements every year, and these pharmacies will continue to seek out the most efficient system to upgrade. In order to remain competitive in the pharmaceutical dispensing business, organizations will be highly dependent on efficient automation systems. Therefore, upgrades are likely to be an ongoing process.

SCOPE AND FORMAT
This BCC Research report is designed to be a helpful business tool that will provide a thorough evaluation of the global pharmacy automation market. The geographical scope is global with special emphasis on the United States and developed Europe, with supplemental data covering other geographical markets and trends. The report identifies pharmacy automation markets by inpatient and outpatient pharmacy settings, and by product type.

Within the global pharmacy automation market, there are two general pharmacy settings, each having other subsettings:
- Inpatient pharmacy automation.
- Acute-care settings.
- Long-term care settings.
- Outpatient pharmacy automation.
- Outpatient/fast-track clinical settings.
- Hospital retail settings.
- Pharmacy benefit management services and other mail-order settings.
- Retail pharmacy chains.

Each segment is further reviewed to provide detailed information of current and emerging products, current market estimates and market forecasts, and competitive analyses.

METHODOLOGY AND INFORMATION SOURCES
The information for this BCC Research report was obtained through primary and secondary data-collection methods. Primary methods included interviews with approximately 100 key executives, product managers, clinical specialists and purchasing agents involved in the pharmacy a included published literature in the area of pharmacy technology and services, investment reports, company literature, and various pharmacy-related business journals.
All market data pertain to the global market at the manufacturers’ level. Data are expressed in current U.S. dollars. The base year of the report is 2016, with historical data provided for 2014 and 2015, and forecast data provided for 2021. Historical base year and forecast data are provided for each market segment of the report. Competitor market share estimates are provided for each market segment for the 2016 base year. Although this study provides information on a variety of pharmacy automation equipment, it does not include a comprehensive list of products available.

Many companies offer products to a variety of industry types, including, but not limited to, the following industries:
- Appliance industry.
- Aircraft industry.
- Automotive industry.
- Electrical and electronics industry.
- Communications industry.
- Food production industry.

Some systems not covered in this study include those that are primarily used in other industry types but are, however, designed to accommodate other settings, including the medical and pharmacy industries.

Table Of Contents

Pharmacy Automation: Technologies and Global Markets
CHAPTER 1
INTRODUCTION 2
STUDY GOALS AND OBJECTIVES 2
REASONS FOR DOING THE STUDY 2
INTENDED AUDIENCE 2
SCOPE AND FORMAT 3
METHODOLOGY AND INFORMATION SOURCES 3
GLOSSARY OF PHARMACY-RELATED TERMS[1] 4
LIST OF COMMON ACRONYMS 6
ANALYST'S CREDENTIALS 7
RELATED BCC RESEARCH REPORTS 7
BCC RESEARCH WEBSITE 8
DISCLAIMER 8
CHAPTER 2 SUMMARY 10
MAJOR GLOBAL PHARMACY AUTOMATION MARKETS 10
SUMMARY TABLE GLOBAL INPATIENT AND OUTPATIENT PHARMACY AUTOMATION
MARKET, BY SEGMENT, THROUGH 2021 ($ MILLIONS) 11
SUMMARY FIGURE GLOBAL INPATIENT AND OUTPATIENT PHARMACY AUTOMATION
MARKET, BY SEGMENT, 2014-2021 ($ MILLIONS) 11
KEY TRENDS 11
LEADING MANUFACTURERS 12
CHAPTER 3 INDUSTRY OVERVIEW 14
PHARMACY AUTOMATION INDUSTRY STRUCTURE 14
BACKGROUND, HISTORY AND GROWTH OF THE PHARMACY AUTOMATION
MARKET 14
EMPLOYING AUTOMATION TO IMPROVE CURRENT MEDICATION DELIVERY
SYSTEMS 16
Joint Commission Involvement 17
Common Prescribing Mistakes 18
TABLE 1 LIST OF ABBREVIATIONS USED IN MEDICAL PRESCRIPTIONS AND
POSSIBLE CONFUSION MEANINGS 18
REGULATORY AUTHORITIES 26
Joint Commission of Accredited Healthcare Organizations (JCAHO or
Joint Commission) 26
Food and Drug Administration (FDA) 27
European Medicines Agency (EMA) 28
European Federation of Pharmaceutical Industries and Associations (EFPIA) 28
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) 28
Royal Pharmaceutical Society (RPS) 28
National Patient Safety Agency (NPSA) 28
Japanese Ministry of Health, Labor and Welfare (MHLW) 29
Central Drugs Standard Control Organization (CDSCO) 29
Therapeutic Goods Administration (TGA) 29
China Food and Drug Administration (CFDA) 29
Federal Trade Commission 29Drug Enforcement Administration 30
National Association of Boards of Pharmacy (NABP) 30
ANVISA-Brazilian Health Surveillance Agency 30
CHAPTER 4 ISSUES AFFECTING THE MARKET 32
BAR CODING AND ELECTRONIC MEDICATION ADMINISTRATION 32
MEANINGFUL USE: AN OVERVIEW 33
TABLE 2 ELECTRONIC HEALTHCARE “MEANINGFUL USE” STAGES BY CMS, 2011-2016 33
STANDARDIZATION OF BAR CODING 33
TRENDS IN RADIOFREQUENCY IDENTIFICATION DEVICES (RFID) 35
E-Pedigree Systems and RFID 37
HEALTHCARE PERSONNEL TRENDS 37
PHARMACY PERSONNEL 37
PHARMACISTS 37
Advanced Practice Pharmacies 39
Does Pharmacist Medication Therapy Management Result in Better
Outcomes? 39
Pharmacist Occupational Outlook 39
Increasing Number of Pharmacists in Select Regions 39
PHARMACY TECHNICIANS 40
Pharmacy Technician Occupational Outlook 40
DIRECT CARE PROVIDERS 41
Nursing Occupational Outlook 42
CONSUMER ISSUES 42
Safety 42
Accuracy and Accountability 42
SAFETY ISSUES 43
FDA Reform Bill 43
Institute for Safe Medication Practices (ISMP) 44
Medication Administration Errors 44
TABLE 3 AVERAGE ANNUAL ADVERSE DRUG REACTIONS AND MEDICATION
ADMINISTRATION ERRORS 45
TABLE 4 WIDELY REPORTED TYPES OF MEDICATION ERRORS 46
Organizational Structure and Its Effect on Errors 46
Surgical or Invasive Procedure Events 48
Product or Device Events 48
Patient Protection Events 48
Care Management Events 48
Environmental Events 49
Radiologic Events 49
Criminal Events 49
SHORT CYCLE DISPENSING-REQUIREMENTS FOR LONG-TERM CARE
FACILITIES 50
IMPACT OF TELEPHARMACY 51
COMPLIANCE ISSUES 51
NARCOTICS MANAGEMENT AND TRACKING 52
FIGURE 1 OPIOID ANALGESIC OVERDOSE DEATHS, 1999 VS 2014 (NO. OF DEATHS) 52TABLE 5 BENEFITS OF PRESCRIPTION MONITORING PROGRAMS FOR MEDICAL
BOARDS 53
TABLE 6 STATES WITH ELECTRONIC PRESCRIPTION MONITORING PROGRAMS 54
FIGURE 2 NUMBER OF STATES WITH ELECTRONIC PRESCRIPTION MONITORING
PROGRAMS, BY YEAR OF ENACTMENT, 1990-2012 (NO. OF STATES) 55
EHR INTEGRATION 57
TABLE 7 PERCENTAGE OF OFFICE-BASED PHYSICIANS USING ANY ELECTRONIC
HEALTH RECORDS OR ELECTRONIC MEDICAL RECORDS, BY STATE, 2014* (%) 57
Aesynt AcuDose-Rx and Electronic Health Record Integration
Capabilities 59
RETAIL PHARMACY ISSUES 59
IMPLEMENTATION ISSUES 61
BARRIERS TO IMPLEMENTATION 62
COST-EFFECTIVENESS IN PHARMACY AUTOMATION 63
Eyecon System and Lakeview Pharmacy 64
Parata Systems and Tara Pharmacy Case Study 64
TCGRx and Premier Pharmacy Services 64
Ohio Department of Mental Health 65
London Drugs 65
Med-Fast Pharmacy 65
U.S. Navy and ScriptPro's Telepharmacy Solution 65
Evergreen Hospital Medical Center 65
Leesburg Regional Medical Center 66
Miami Children's Hospital 66
Mountain View Hospital 66
Madera Medical Pharmacy 66
Lucile Packard Children's Hospital 67
UCSF Medical Center 67
St. Joseph Hospital 67
GLOBAL FINANCIAL CONDITIONS 68
Rising Healthcare Costs 68
TABLE 8 HEALTHCARE EXPENDITURE AS A PERCENTAGE OF GDP, BY COUNTRY,
2008-2014 (%) 68
FIGURE 3 HEALTHCARE EXPENDITURE AS A PERCENTAGE OF GDP, BY COUNTRY,
2008-2014* (%) 69
Pharmaceutical Expenditures 70
TABLE 9 PHARMACEUTICAL EXPENDITURES AS A PERCENTAGE OF HEALTH
EXPENDITURES, BY COUNTRY, 2005-2013 (%) 70
TABLE 10 PHARMACEUTICAL EXPENDITURES PER CAPITA, BY COUNTRY, 2005-2013
($) 71
WORLDWIDE POPULATION GROWTH 71
TABLE 11 BIRTH RATES FOR SELECTED COUNTRIES, 2014 (%) 72
TABLE 12 LIFE EXPECTANCY DATA AND PROJECTIONS, 1970-2015 73
TABLE 13 TOP 10 COUNTRIES WITH HIGHEST LIFE EXPECTANCY AT AGE 65, 2015
(%) 73
TABLE 14 PERCENTAGE OF POPULATION AGE 65 AND OLDER IN SELECTED
COUNTRIES, 2014 (MILLIONS/%) 74
TRENDS IN HOSPITAL LENGTH OF STAY 74
TABLE 15 HOSPITAL UTILIZATION STATISTICS, 2003 AND 2013 (NO. OF DAYS) 75FIGURE 4 HOSPITAL UTILIZATION STATISTICS, 2003 AND 2013 (NO. OF DAYS) 75
PUBLIC HEALTHCARE SYSTEMS AROUND THE WORLD 76
CHAPTER 5 INPATIENT PHARMACY AUTOMATION 78
MARKET OVERVIEW 78
FIGURE 5 GLOBAL INPATIENT PHARMACY AUTOMATION MARKET, 2014-2021 ($
MILLIONS) 78
SETTING OVERVIEW 79
PRODUCT SALES BY END USER 79
FIGURE 6 GLOBAL INPATIENT PHARMACY AUTOMATION MARKET SHARE, BY END
USER, ESTIMATED 2016 (%) 80
ACUTE CARE SETTINGS 80
TABLE 16 ESTIMATED NUMBER OF HOSPITALS/INPATIENT ACUTE CARE CENTERS
AND BEDS AVAILABLE, BY SELECTED COUNTRY, 2015 81
FIGURE 7 ESTIMATED NUMBER OF INPATIENT CARE FACILITIES AND AVAILABLE
BEDS, BY SELECTED COUNTRY, 2015 81
LONG-TERM CARE SETTINGS 82
TABLE 17 LONG-TERM CARE AND NURSING HOMES BEDS AND RECIPIENTS, BY
SELECTED COUNTRY, 2015 (NUMBER) 82
TABLE 18 HOSPICE FACTS, 2011-2014 83
PRODUCT OVERVIEW 83
MARKETS BY PRODUCT TYPE 83
TABLE 19 GLOBAL INPATIENT PHARMACY AUTOMATION MARKET, BY EQUIPMENT
TYPE, THROUGH 2021 ($ MILLIONS) 84
FIGURE 8 GLOBAL INPATIENT PHARMACY AUTOMATION MARKET, BY EQUIPMENT
TYPE, 2014-2021 ($ MILLIONS) 84
AUTOMATED DISPENSING/STORAGE SYSTEMS 85
Narcotics and Anesthesia Management Systems 89
AUTOMATED PACKAGING SYSTEMS 90
OTHER AUTOMATED SYSTEMS 95
TABLE 20 SUMMARY OF INPATIENT PHARMACY AUTOMATION EQUIPMENT, BY
MANUFACTURER AND EQUIPMENT TYPE 97
INPATIENT AUTOMATION COST BY EQUIPMENT TYPE 99
TABLE 21 INPATIENT PHARMACY AUTOMATION EQUIPMENT ANALYSIS 101
MARKETS BY WORLD REGION 102
TABLE 22 GLOBAL INPATIENT PHARMACY AUTOMATION SYSTEMS MARKET, BY
REGION, ESTIMATED 2016 (%/$ MILLIONS) 104
FIGURE 9 GLOBAL INPATIENT PHARMACY AUTOMATION SYSTEMS MARKET SHARE,
BY REGION, ESTIMATED 2016 (%) 104
Level of Automation within Inpatient Pharmacy Settings 104
United States 105
TABLE 23 PERCENTAGE OF U.S. INPATIENT PHARMACIES AT ESTIMATED LEVELS OF
AUTOMATION, 2015 (%) 105
FIGURE 10 PERCENTAGE OF U.S. INPATIENT PHARMACIES AT ESTIMATED LEVELS
OF AUTOMATION, 2015 (%) 106
Developed Europe 106
TABLE 24 PERCENTAGE OF DEVELOPED EUROPEAN REGIONS—INPATIENT
PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2015 (%) 107
FIGURE 11 PERCENTAGE OF DEVELOPED EUROPEAN REGIONS—INPATIENT
PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2015 (%) 107COMPETITIVE STRUCTURE AND MARKET SHARE 107
TABLE 25 GLOBAL INPATIENT PHARMACY AUTOMATION EQUIPMENT
MANUFACTURER MARKET SHARE AND REVENUE, ESTIMATED 2016 (%/$ MILLIONS) 108
FIGURE 12 GLOBAL INPATIENT PHARMACY AUTOMATION EQUIPMENT
MANUFACTURER MARKET SHARE AND REVENUE, ESTIMATED 2016 (%/$ MILLIONS) 109
CHAPTER 6 OUTPATIENT PHARMACY AUTOMATION 111
MARKET OVERVIEW 111
FIGURE 13 GLOBAL OUTPATIENT PHARMACY AUTOMATION MARKET, 2014-2021 ($
MILLIONS) 111
SETTING OVERVIEW 112
FIGURE 14 GLOBAL DRUG SALES MARKET SHARE, BY SELECTED COUNTRY,
ESTIMATED 2015 (%) 112
Physician Office Visits 113
TABLE 26 UNITED STATES: MEDICATION THERAPY AND NUMBER OF MEDICATIONS
MENTIONED AT OFFICE VISITS, 2012* 113
TABLE 27 DOCTORS' CONSULTATIONS BY COUNTRY, 2015* 114
Hospital Retail Settings 114
Pharmacy Benefit Management Services and Other Mail-Order
Settings 115
TABLE 28 LEADING U.S. PHARMACY BENEFIT MANAGEMENT ORGANIZATIONS/
MAIL-ORDER GROUPS' SALES ACTIVITY, 2015/2016 ($ BILLIONS) 115
Private and Managed Care PBMS 115
TABLE 29 UNITED STATES: PRIVATE AND MANAGED CARE ORGANIZATION PBM
PARTICIPATION 116
PBM Acquisition and Merger Activity 116
Express Scripts and Medco Health Solutions 116
SXC Health Solutions and Catalyst Health Solutions 116
UnitedHealth Group and Catamaran Corp. 117
Walgreens and Drugstore.com 117
Retail Pharmacy Chains 117
TABLE 30 LEADING U.S. RETAIL PHARMACY CHAINS' SALES ACTIVITY (NUMBER/$ BILLIONS) 118
FIGURE 15 PHARMACY LOCATIONS BY PHARMACY CHAIN, 2008-2015 (NUMBER) 118
TABLE 31 U.S. RETAIL PHARMACY CHAINS: NUMBER OF LOCATIONS, BY STATE, 2015 119
MARKETS BY PRODUCT TYPE 120
TABLE 32 GLOBAL OUTPATIENT PHARMACY AUTOMATION MARKET, BY EQUIPMENT
TYPE, THROUGH 2021 ($ MILLIONS) 121
FIGURE 16 GLOBAL OUTPATIENT PHARMACY AUTOMATION MARKET, BY
EQUIPMENT TYPE, 2014-2021 ($ MILLIONS) 121
PRODUCT DESCRIPTIONS 122
Automated Dispensing Systems 122
Automated Packaging/Filling Systems 124
Other Automated Systems 127
TABLE 33 SUMMARY OF OUTPATIENT PHARMACY AUTOMATION EQUIPMENT BY
MANUFACTURER AND EQUIPMENT TYPE 128
OUTPATIENT AUTOMATION COST BY EQUIPMENT TYPE 129
TABLE 34 OUTPATIENT PHARMACY AUTOMATION EQUIPMENT ANALYSIS 130
ADVANTAGES OF PHARMACY AUTOMATION FOR RETAILERS 130MARKETS BY WORLD REGION 131
TABLE 35 GLOBAL OUTPATIENT PHARMACY AUTOMATION SYSTEMS MARKET, BY
REGION, ESTIMATED 2016 (%/$ MILLIONS) 132
FIGURE 17 GLOBAL OUTPATIENT PHARMACY AUTOMATION SYSTEMS MARKET
SHARE, BY REGION, ESTIMATED 2016 (%) 132
Level of Automation within Outpatient Pharmacy Settings 132
United States 132
TABLE 36 PERCENTAGE OF U.S. OUTPATIENT PHARMACIES AT ESTIMATED LEVELS
OF AUTOMATION, 2015 (%) 133
FIGURE 18 PERCENTAGE OF U.S. OUTPATIENT PHARMACIES AT ESTIMATED LEVELS
OF AUTOMATION, 2015 (%) 133
Developed Europe 134
TABLE 37 PERCENTAGE OF DEVELOPED EUROPEAN OUTPATIENT PHARMACIES AT
ESTIMATED LEVELS OF AUTOMATION, 2015 (%) 134
FIGURE 19 PERCENTAGE OF DEVELOPED EUROPEAN OUTPATIENT PHARMACIES AT
ESTIMATED LEVELS OF AUTOMATION, 2015 (%) 134
COMPETITIVE STRUCTURE AND MARKET SHARE 135
TABLE 38 GLOBAL OUTPATIENT PHARMACY AUTOMATION MANUFACTURER
MARKET, ESTIMATED 2016 (%/$ MILLIONS) 135
FIGURE 20 GLOBAL OUTPATIENT PHARMACY AUTOMATION MANUFACTURER
MARKET SHARE, ESTIMATED 2016 (%) 136
CHAPTER 7 GLOBAL PHARMACY AUTOMATION MARKET SUMMARY 138
GLOBAL MARKET BY SEGMENT 138
TABLE 39 GLOBAL INPATIENT AND OUTPATIENT PHARMACY AUTOMATION MARKET,
BY SEGMENT, THROUGH 2021 ($ MILLIONS) 138
FIGURE 21 GLOBAL INPATIENT AND OUTPATIENT PHARMACY AUTOMATION
MARKET, BY SEGMENT, 2014-2021 ($ MILLIONS) 139
GLOBAL MARKET BY EQUIPMENT TYPE 139
TABLE 40 GLOBAL PHARMACY AUTOMATION MARKET, BY EQUIPMENT TYPE,
THROUGH 2021 ($ MILLIONS) 139
FIGURE 22 GLOBAL PHARMACY AUTOMATION MARKET, BY EQUIPMENT TYPE,
2014-2021 ($ MILLIONS) 140
GLOBAL MARKET SHARE BY SEGMENT 140
TABLE 41 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY SEGMENT,
2014-2021 (%) 140
FIGURE 23 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY SEGMENT, 2016
(%) 141
FIGURE 24 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY SEGMENT, 2021
(%) 141
GLOBAL MARKET SHARES BY EQUIPMENT TYPE 141
TABLE 42 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY EQUIPMENT TYPE,
2014-2021 ($ MILLIONS) 142
FIGURE 25 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY EQUIPMENT
TYPE, 2016 (%) 142
FIGURE 26 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY EQUIPMENT
TYPE, 2021 (%) 142
GLOBAL MARKET BY GEOGRAPHIC REGION 143
TABLE 43 GLOBAL PHARMACY AUTOMATION SYSTEMS MARKET SHARE AND
REVENUE, BY REGION, 2016 (%/$ MILLIONS) 144FIGURE 27 GLOBAL PHARMACY AUTOMATION SYSTEMS MARKET SHARE AND
REVENUE, BY REGION, 2016 (%/$ MILLIONS) 144
FIGURE 28 GLOBAL PHARMACY AUTOMATION SYSTEMS MARKET GROWTH, BY
REGION, 2016 AND 2021 ($ MILLIONS) 144
GLOBAL TRENDS 145
Mexico 146
Europe 146
Australia and New Zealand 146
Canada 146
Asia 147
Middle East 147
INDUSTRY PARTICIPANTS OVERVIEW 147
TABLE 44 GLOBAL PHARMACY AUTOMATION PARTICIPANT MARKET SHARE AND
REVENUE, ESTIMATED 2016 (%/$ MILLIONS) 148
FIGURE 29 GLOBAL PHARMACY AUTOMATION PARTICIPANT MARKET SHARE AND
REVENUE, ESTIMATED 2016 (%/$ MILLIONS) 148
FIGURE 30 MARKET PARTICIPATION BY VENDOR, CHANGE IN MARKET SHARE, 2016
VS 2021 (%) 148
TABLE 45 PHARMACY AUTOMATION MERGERS AND ACQUISITIONS* 150
INDUSTRY PARTICIPANTS BY EQUIPMENT TYPE 151
TABLE 46 INDUSTRY PARTICIPANTS BY EQUIPMENT TYPE, 2015/2016 151
TABLE 47 PHARMACY AUTOMATION EQUIPMENT PROVIDER PRODUCT LIST 153
CHAPTER 8 TECHNOLOGY 158
OVERVIEW 158
CURRENT USES OF TECHNOLOGY 158
MEDICATION INSPECTION 158
COMMUNICATION NETWORK TECHNOLOGY 158
BIOMETRIC-TYPE IDENTIFICATION TECHNOLOGY 159
INFRARED TECHNOLOGY 159
AUTOMATED PARENTERAL DISPENSERS 159
BAR-CODE TECHNOLOGY 159
RADIO FREQUENCY IDENTIFICATION (RFID) TECHNOLOGY 160
AUTOMATED PHARMACY INVENTORY MANAGEMENT (PIM) SYSTEMS 160
AUTOMATED DISPENSING CABINETS (ADCS) 160
ROBOTICS 161
Linear Tracks 161
Sensor Technology 161
Programming Languages 161
User Interfaces 162
Graphic Image Interfaces 162
Guidance Systems 162
Fluorescent Guidepaths 163
Solvent-Borne Guidepaths 163
Water-Borne Emulsion Guidepaths 163
PATENT EVALUATION 164
PHARMACY AUTOMATION AND PHARMACY ROBOT PATENTS 164
TABLE 48 NUMBER OF PHARMACY AUTOMATION AND ROBOT PATENTS ISSUED, BY
YEAR, 1995-2016 165FIGURE 31 NUMBER OF PHARMACY AUTOMATION AND ROBOT PATENTS ISSUED,
BY YEAR, 1995-2016* (NO.) 165
TABLE 49 PHARMACY AUTOMATION AND ROBOT PATENTS, BY ASSIGNEE, AS OF
JUNE 2016 167
TABLE 50 PHARMACY AUTOMATION AND ROBOT PATENTS, BY ASSIGNEE, AS OF
JUNE 2016 (NO. OF PATENTS) 173
PATENT HOLDER SUMMARY 174
Asteres 174
AutoMed Technologies 174
Intelligent Hospital Systems Ltd. 174
McKesson Automation 175
Medco Health Solutions/Express Scripts 175
Parata Systems 175
ScriptPro 175
Tech Pharmacy Services 176
CHAPTER 9 COMPANY PROFILES 178
ARXIUM 178
BAXTER INTERNATIONAL INC. 178
TABLE 51 BAXTER INTERNATIONAL'S SUMMARY FINANCIALS, 2013-2015 ($
MILLIONS) 179
FIGURE 32 BAXTER INTERNATIONAL'S SUMMARY FINANCIALS, 2013-2015 ($
MILLIONS) 179
CAPSA SOLUTIONS LLC 179
BECTON, DICKINSON AND COMPANY 181
TABLE 52 BECTON DICKINSON'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 181
FIGURE 33 BECTON DICKINSON'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 181
CERNER CORP. 182
TABLE 53 CERNER'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 183
FIGURE 34 CERNER'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 183
EUCLID MEDICAL PRODUCTS 183
INNOVATION ASSOCIATES 184
MEDICAL PACKAGING INC. 185
OMNICELL INC. 185
TABLE 54 OMNICELL'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 187
FIGURE 35 OMNICELL'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 187
PARATA SYSTEMS LLC 187
SCRIPTPRO LLC 188
SWISSLOG AG 189
TABLE 55 SWISSLOG'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 189
FIGURE 36 SWISSLOG'S GROWTH SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 189
TALYST INC. 190
TCGRX 191
CHAPTER 10 APPENDICES 193
APPENDIX I: LEADING EQUIPMENT MANUFACTURERS 193
AESYNT INC. (OMNICELL) 193
APOSTORE GMBH 193ARXIUM CANADA 193
ASTERES INC. 194
BAXTER INTERNATIONAL INC. 194
BECTON, DICKINSON AND COMPANY 194
CAPSA SOLUTIONS LLC 194
CERNER CORP. 194
DIH TECHNOLOGIES CO. 194
DRUG PACKAGE INC. 195
ERGOTRON INC. 195
EUCLID MEDICAL 195
GLOBAL FACTORIES B.V. 195
HONEYWELL INTERNATIONAL INC. 195
INNOVATION ASSOCIATES 195
INTERMETRO INDUSTRIES CORP. 196
JONES PACKAGING INC. 196
KIRBY LESTER LLC. 196
KLS STEUERUNGTECHNIK GMBH 196
MANCHAC TECHNOLOGIES LLC 196
MANREX LTD. 196
MCKESSON PHARMACY SYSTEMS LLC 197
MEDICAL PACKAGING INC. 197
MEDITEC PTY LTD. 197
OMNICELL INC. 197
PARATA SYSTEMS 197
PEARSON MEDICAL TECHNOLOGIES LLC 197
ROBOPHARMA B.V. 198
RUBBERMAID HEALTHCARE 198
RXSAFE LLC 198
RX SYSTEMS INC. 198
SCRIPTPRO LLC 198
SUPPLY POINT SYSTEMS LTD. 198
SUZHOU IRON TECHNOLOGY CO. LTD. 199
SWISSLOG HOLDING AG 199
SYNERGY MEDICAL 199
TALYST INC. 199
TCGRX 199
TOSHO CO. INC. 199
WEBSTERCARE (MANREX) 200
YASKAWA ELECTRIC CORP. 200
YUYAMA CO. LTD. 200
APPENDIX II: OTHER RELATED COMPANIES 200
ALLERGAN PLC 200
AMERICAN ASSOCIATED PHARMACIES 200
AMERISOURCEBERGEN CORP. 201
ASTRAZENECA PLC 201
BECKMAN COULTER INC. 201
BRISTOL-MYERS SQUIBB CO. 201CARDINAL HEALTH INC. 201
DIEBOLD INC. 201
ENOVATE MEDICAL 202
FRESENIUS KABI AG 202
GLAXOSMITHKLINE PLC 202
IBM CORP. 202
IMPINJ INC. 202
INTERMEC 202
KIRO ROBOTICS S.L. 203
KUKA AG 203
LUCIANO PACKAGING TECHNOLOGIES INC. 203
MICROSOFT CORP. 203
NEW COMPOUNDING PHARMA GMBH 203
NOVARTIS INTERNATIONAL AG 203
PAR EXCELLENCE SYSTEMS INC. 204
PERRIGO CO. 204
PFIZER INC. 204
PHARMITAS INC. 204
SYSTECH CORP. 204
TAGSYS USA 204
WAVEMARK INC. 205
APPENDIX III: ASSOCIATIONS AND ORGANIZATIONS 205
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY 205
AMERICAN ASSOCIATION OF COLLEGES OF PHARMACY 205
AMERICAN HOSPITAL ASSOCIATION 205
AMERICAN PHARMACISTS ASSOCIATION 205
ANVISA-BRAZILIAN HEALTH SURVEILLANCE AGENCY 205
AUSTRALIAN DEPARTMENT OF HEALTH 206
AUSTRALIAN INSTITUTE OF HEALTH AND WELFARE 206
CANADIAN INSTITUTE FOR HEALTH INFORMATION 206
CENTERS FOR DISEASE CONTROL AND PREVENTION 206
CENTERS FOR MEDICARE AND MEDICAID SERVICES 206
CENTRAL DRUGS STANDARD CONTROL ORGANIZATION 206
CHINA FOOD AND DRUG ADMINISTRATION 207
DRUG ENFORCEMENT ADMINISTRATION 207
EUROPEAN CENTRE FOR DISEASE PREVENTION AND CONTROL (ECDC) 207
EUROPEAN FEDERATION OF PHARMACEUTICAL INDUSTRIES AND
ASSOCIATIONS 207
EUROPEAN MEDICINES AGENCY 207
EUROPEAN MONITORING CENTRE FOR DRUGS AND DRUG ADDICTION
(EMCDDA) 208
EUROPEAN PATENT OFFICE 208
FEDERAL TRADE COMMISSION 208
FOOD AND DRUG ADMINISTRATION 208
HEALTH CANADA 208
INSTITUTE FOR SAFE MEDICATION PRACTICES 208
JAPANESE MINISTRY OF HEALTH, LABOUR, AND WELFARE 209
THE JOINT COMMISSION 209NATIONAL ASSOCIATION OF BOARDS OF PHARMACY 209
NATIONAL PATIENT SAFETY AGENCY 209
OHIO DEPARTMENT OF MENTAL HEALTH 209
OREGON STATE BOARD OF PHARMACY 209
ROYAL PHARMACEUTICAL SOCIETY 210
THERAPEUTIC GOODS ADMINISTRATION (TGA) 210
U.S. BUREAU OF LABOR STATISTICS 210
U.S. CENSUS BUREAU 210
U.S. DEPARTMENT OF DEFENSE 210
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 210
U.S. PATENT AND TRADEMARK OFFICE 211
APPENDIX IV: STATE CONTROLLED SUBSTANCES SCHEDULING AUTHORITIES
AND OTHER CONTACT INFORMATION 211

LIST OF TABLES

SUMMARY TABLE GLOBAL INPATIENT AND OUTPATIENT PHARMACY AUTOMATION
MARKET, BY SEGMENT, THROUGH 2021 ($ MILLIONS) 11
TABLE 1 LIST OF ABBREVIATIONS USED IN MEDICAL PRESCRIPTIONS AND POSSIBLE
CONFUSION MEANINGS 18
TABLE 2 ELECTRONIC HEALTHCARE “MEANINGFUL USE” STAGES BY CMS,
2011-2016 33
TABLE 3 AVERAGE ANNUAL ADVERSE DRUG REACTIONS AND MEDICATION
ADMINISTRATION ERRORS 45
TABLE 4 WIDELY REPORTED TYPES OF MEDICATION ERRORS 46
TABLE 5 BENEFITS OF PRESCRIPTION MONITORING PROGRAMS FOR MEDICAL
BOARDS 53
TABLE 6 STATES WITH ELECTRONIC PRESCRIPTION MONITORING PROGRAMS 54
TABLE 7 PERCENTAGE OF OFFICE-BASED PHYSICIANS USING ANY ELECTRONIC
HEALTH RECORDS OR ELECTRONIC MEDICAL RECORDS, BY STATE, 2014* (%) 57
TABLE 8 HEALTHCARE EXPENDITURE AS A PERCENTAGE OF GDP, BY COUNTRY,
2008-2014 (%) 68
TABLE 9 PHARMACEUTICAL EXPENDITURES AS A PERCENTAGE OF HEALTH
EXPENDITURES, BY COUNTRY, 2005-2013 (%) 70
TABLE 10 PHARMACEUTICAL EXPENDITURES PER CAPITA, BY COUNTRY, 2005-2013
($) 71
TABLE 11 BIRTH RATES FOR SELECTED COUNTRIES, 2014 (%) 72
TABLE 12 LIFE EXPECTANCY DATA AND PROJECTIONS, 1970-2015 73
TABLE 13 TOP 10 COUNTRIES WITH HIGHEST LIFE EXPECTANCY AT AGE 65, 2015 (%) 73
TABLE 14 PERCENTAGE OF POPULATION AGE 65 AND OLDER IN SELECTED
COUNTRIES, 2014 (MILLIONS/%) 74
TABLE 15 HOSPITAL UTILIZATION STATISTICS, 2003 AND 2013 (NO. OF DAYS) 75
TABLE 16 ESTIMATED NUMBER OF HOSPITALS/INPATIENT ACUTE CARE CENTERS
AND BEDS AVAILABLE, BY SELECTED COUNTRY, 2015 81
TABLE 17 LONG-TERM CARE AND NURSING HOMES BEDS AND RECIPIENTS, BY
SELECTED COUNTRY, 2015 (NUMBER) 82
TABLE 18 HOSPICE FACTS, 2011-2014 83
TABLE 19 GLOBAL INPATIENT PHARMACY AUTOMATION MARKET, BY EQUIPMENT
TYPE, THROUGH 2021 ($ MILLIONS) 84
TABLE 20 SUMMARY OF INPATIENT PHARMACY AUTOMATION EQUIPMENT, BY
MANUFACTURER AND EQUIPMENT TYPE 97
TABLE 21 INPATIENT PHARMACY AUTOMATION EQUIPMENT ANALYSIS 101
TABLE 22 GLOBAL INPATIENT PHARMACY AUTOMATION SYSTEMS MARKET, BY
REGION, ESTIMATED 2016 (%/$ MILLIONS) 104
TABLE 23 PERCENTAGE OF U.S. INPATIENT PHARMACIES AT ESTIMATED LEVELS OF
AUTOMATION, 2015 (%) 105
TABLE 24 PERCENTAGE OF DEVELOPED EUROPEAN REGIONS—INPATIENT
PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2015 (%) 107
TABLE 25 GLOBAL INPATIENT PHARMACY AUTOMATION EQUIPMENT
MANUFACTURER MARKET SHARE AND REVENUE, ESTIMATED 2016 (%/$ MILLIONS) 108
TABLE 26 UNITED STATES: MEDICATION THERAPY AND NUMBER OF MEDICATIONS
MENTIONED AT OFFICE VISITS, 2012* 113
TABLE 27 DOCTORS' CONSULTATIONS BY COUNTRY, 2015* 114
TABLE 28 LEADING U.S. PHARMACY BENEFIT MANAGEMENT ORGANIZATIONS/
MAIL-ORDER GROUPS' SALES ACTIVITY, 2015/2016 ($ BILLIONS) 115
TABLE 29 UNITED STATES: PRIVATE AND MANAGED CARE ORGANIZATION PBM
PARTICIPATION 116
TABLE 30 LEADING U.S. RETAIL PHARMACY CHAINS' SALES ACTIVITY (NUMBER/$
BILLIONS) 118
TABLE 31 U.S. RETAIL PHARMACY CHAINS: NUMBER OF LOCATIONS, BY STATE, 2015 119
TABLE 32 GLOBAL OUTPATIENT PHARMACY AUTOMATION MARKET, BY EQUIPMENT
TYPE, THROUGH 2021 ($ MILLIONS) 121
TABLE 33 SUMMARY OF OUTPATIENT PHARMACY AUTOMATION EQUIPMENT BY
MANUFACTURER AND EQUIPMENT TYPE 128
TABLE 34 OUTPATIENT PHARMACY AUTOMATION EQUIPMENT ANALYSIS 130
TABLE 35 GLOBAL OUTPATIENT PHARMACY AUTOMATION SYSTEMS MARKET, BY
REGION, ESTIMATED 2016 (%/$ MILLIONS) 132
TABLE 36 PERCENTAGE OF U.S. OUTPATIENT PHARMACIES AT ESTIMATED LEVELS
OF AUTOMATION, 2015 (%) 133
TABLE 37 PERCENTAGE OF DEVELOPED EUROPEAN OUTPATIENT PHARMACIES AT
ESTIMATED LEVELS OF AUTOMATION, 2015 (%) 134
TABLE 38 GLOBAL OUTPATIENT PHARMACY AUTOMATION MANUFACTURER MARKET,
ESTIMATED 2016 (%/$ MILLIONS) 135
TABLE 39 GLOBAL INPATIENT AND OUTPATIENT PHARMACY AUTOMATION MARKET,
BY SEGMENT, THROUGH 2021 ($ MILLIONS) 138
TABLE 40 GLOBAL PHARMACY AUTOMATION MARKET, BY EQUIPMENT TYPE,
THROUGH 2021 ($ MILLIONS) 139
TABLE 41 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY SEGMENT,
2014-2021 (%) 140
TABLE 42 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY EQUIPMENT TYPE,
2014-2021 ($ MILLIONS) 142
TABLE 43 GLOBAL PHARMACY AUTOMATION SYSTEMS MARKET SHARE AND
REVENUE, BY REGION, 2016 (%/$ MILLIONS) 144
TABLE 44 GLOBAL PHARMACY AUTOMATION PARTICIPANT MARKET SHARE AND
REVENUE, ESTIMATED 2016 (%/$ MILLIONS) 148
TABLE 45 PHARMACY AUTOMATION MERGERS AND ACQUISITIONS* 150
TABLE 46 INDUSTRY PARTICIPANTS BY EQUIPMENT TYPE, 2015/2016 151
TABLE 47 PHARMACY AUTOMATION EQUIPMENT PROVIDER PRODUCT LIST 153
TABLE 48 NUMBER OF PHARMACY AUTOMATION AND ROBOT PATENTS ISSUED, BY
YEAR, 1995-2016 165
TABLE 49 PHARMACY AUTOMATION AND ROBOT PATENTS, BY ASSIGNEE, AS OF
JUNE 2016 167
TABLE 50 PHARMACY AUTOMATION AND ROBOT PATENTS, BY ASSIGNEE, AS OF
JUNE 2016 (NO. OF PATENTS) 173
TABLE 51 BAXTER INTERNATIONAL'S SUMMARY FINANCIALS, 2013-2015 ($
MILLIONS) 179
TABLE 52 BECTON DICKINSON'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 181
TABLE 53 CERNER'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 183
TABLE 54 OMNICELL'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 187
TABLE 55 SWISSLOG'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 189

LIST OF FIGURES

SUMMARY FIGURE GLOBAL INPATIENT AND OUTPATIENT PHARMACY AUTOMATION
MARKET, BY SEGMENT, 2014-2021 ($ MILLIONS) 11
FIGURE 1 OPIOID ANALGESIC OVERDOSE DEATHS, 1999 VS 2014 (NO. OF DEATHS) 52
FIGURE 2 NUMBER OF STATES WITH ELECTRONIC PRESCRIPTION MONITORING
PROGRAMS, BY YEAR OF ENACTMENT, 1990-2012 (NO. OF STATES) 55
FIGURE 3 HEALTHCARE EXPENDITURE AS A PERCENTAGE OF GDP, BY COUNTRY,
2008-2014* (%) 69
FIGURE 4 HOSPITAL UTILIZATION STATISTICS, 2003 AND 2013 (NO. OF DAYS) 75
FIGURE 5 GLOBAL INPATIENT PHARMACY AUTOMATION MARKET, 2014-2021 ($
MILLIONS) 78
FIGURE 6 GLOBAL INPATIENT PHARMACY AUTOMATION MARKET SHARE, BY END
USER, ESTIMATED 2016 (%) 80
FIGURE 7 ESTIMATED NUMBER OF INPATIENT CARE FACILITIES AND AVAILABLE
BEDS, BY SELECTED COUNTRY, 2015 81
FIGURE 8 GLOBAL INPATIENT PHARMACY AUTOMATION MARKET, BY EQUIPMENT
TYPE, 2014-2021 ($ MILLIONS) 84
FIGURE 9 GLOBAL INPATIENT PHARMACY AUTOMATION SYSTEMS MARKET SHARE,
BY REGION, ESTIMATED 2016 (%) 104
FIGURE 10 PERCENTAGE OF U.S. INPATIENT PHARMACIES AT ESTIMATED LEVELS OF
AUTOMATION, 2015 (%) 106
FIGURE 11 PERCENTAGE OF DEVELOPED EUROPEAN REGIONS—INPATIENT
PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2015 (%) 107
FIGURE 12 GLOBAL INPATIENT PHARMACY AUTOMATION EQUIPMENT
MANUFACTURER MARKET SHARE AND REVENUE, ESTIMATED 2016 (%/$ MILLIONS) 109
FIGURE 13 GLOBAL OUTPATIENT PHARMACY AUTOMATION MARKET, 2014-2021 ($
MILLIONS) 111
FIGURE 14 GLOBAL DRUG SALES MARKET SHARE, BY SELECTED COUNTRY,
ESTIMATED 2015 (%) 112
FIGURE 15 PHARMACY LOCATIONS BY PHARMACY CHAIN, 2008-2015 (NUMBER) 118
FIGURE 16 GLOBAL OUTPATIENT PHARMACY AUTOMATION MARKET, BY EQUIPMENT
TYPE, 2014-2021 ($ MILLIONS) 121
FIGURE 17 GLOBAL OUTPATIENT PHARMACY AUTOMATION SYSTEMS MARKET SHARE,
BY REGION, ESTIMATED 2016 (%) 132
FIGURE 18 PERCENTAGE OF U.S. OUTPATIENT PHARMACIES AT ESTIMATED LEVELS
OF AUTOMATION, 2015 (%) 133
FIGURE 19 PERCENTAGE OF DEVELOPED EUROPEAN OUTPATIENT PHARMACIES AT
ESTIMATED LEVELS OF AUTOMATION, 2015 (%) 134
FIGURE 20 GLOBAL OUTPATIENT PHARMACY AUTOMATION MANUFACTURER MARKET
SHARE, ESTIMATED 2016 (%) 136
FIGURE 21 GLOBAL INPATIENT AND OUTPATIENT PHARMACY AUTOMATION MARKET,
BY SEGMENT, 2014-2021 ($ MILLIONS) 139
FIGURE 22 GLOBAL PHARMACY AUTOMATION MARKET, BY EQUIPMENT TYPE,
2014-2021 ($ MILLIONS) 140
FIGURE 23 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY SEGMENT, 2016
(%) 141
FIGURE 24 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY SEGMENT, 2021
(%) 141
FIGURE 25 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY EQUIPMENT TYPE,
2016 (%) 142
FIGURE 26 GLOBAL PHARMACY AUTOMATION MARKET SHARE, BY EQUIPMENT TYPE,
2021 (%) 142
FIGURE 27 GLOBAL PHARMACY AUTOMATION SYSTEMS MARKET SHARE AND
REVENUE, BY REGION, 2016 (%/$ MILLIONS) 144
FIGURE 28 GLOBAL PHARMACY AUTOMATION SYSTEMS MARKET GROWTH, BY
REGION, 2016 AND 2021 ($ MILLIONS) 144
FIGURE 29 GLOBAL PHARMACY AUTOMATION PARTICIPANT MARKET SHARE AND
REVENUE, ESTIMATED 2016 (%/$ MILLIONS) 148
FIGURE 30 MARKET PARTICIPATION BY VENDOR, CHANGE IN MARKET SHARE, 2016
VS 2021 (%) 148
FIGURE 31 NUMBER OF PHARMACY AUTOMATION AND ROBOT PATENTS ISSUED, BY
YEAR, 1995-2016* (NO.) 165
FIGURE 32 BAXTER INTERNATIONAL'S SUMMARY FINANCIALS, 2013-2015 ($
MILLIONS) 179
FIGURE 33 BECTON DICKINSON'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 181
FIGURE 34 CERNER'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 183
FIGURE 35 OMNICELL'S SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 187
FIGURE 36 SWISSLOG'S GROWTH SUMMARY FINANCIALS, 2011-2015 ($ MILLIONS) 189

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