Pharmacy Automation: Technologies and Global Markets

Pharmacy Automation: Technologies and Global Markets

Although pharmacy automation dates back to the 1970s with the introduction of pill counting machines, the pharmacy automation market is anticipated to make generous strides in technology and efficiency through the forecast period outlined in this study. The continually 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, such as Medco Health Solutions, Inc. Many small, private pharmacies are still conducting operations through manual and semi-manual methods, particularly in regions outside the United States. The opportunity to fully automate these pharmacies surfaces more often each year, and with a growing compliance with bar coding standards, 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 to. 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. 
 

INTRODUCTION

STUDY GOALS AND OBJECTIVES

REASONS FOR DOING THE STUDY

SCOPE AND FORMAT

METHODOLOGY

ABOUT THE AUTHOR

RELATED BCC STUDIES

BCC ONLINE SERVICES

DISCLAIMER

SUMMARY

MAJOR WORLDWIDE PHARMACY AUTOMATION MARKETS

SUMMARY TABLE TOTAL ESTIMATED WORLDWIDE INPATIENT AND OUTPATIENT PHARMACY AUTOMATION MARKET BY SEGMENT, THROUGH 2012 ($ MILLIONS)

SUMMARY FIGURE TOTAL ESTIMATED WORLDWIDE INPATIENT AND OUTPATIENT PHARMACY AUTOMATION MARKET BY SEGMENT, 2005-2012 ($ MILLIONS)

LEADING MANUFACTURERS

INDUSTRY OVERVIEW

PHARMACY AUTOMATION INDUSTRY STRUCTURE

BACKGROUND, HISTORY, AND GROWTH OF THE PHARMACY

AUTOMATION MARKET

BACKGROUND, HISTORY, AND…(CONTINUED)

EMPLOYING AUTOMATION TO IMPROVE CURRENT

MEDICATION DELIVERY SYSTEMS

Areas for Improvement

ISSUES AFFECTING THE MARKET

REGULATORY AUTHORITIES

Joint Commission of Accredited Healthcare Organizations

(JCAHO)

Food and Drug Administration (FDA)

European Medicines Evaluation Agency (EMEA)

European Federation of Pharmaceutical Industries and

Associations (EFPIA)

Medicines and Healthcare Products Regulatory Agency

(MHRA)

Royal Pharmaceutical Society of Great Britain (RPSGB)

National Patient Safety Agency (NPSA)

Japanese Ministry of Health, Labor and Welfare (MHLW)

Central Drugs Standard Control Organization (CDSCO)

Therapeutic Goods Administration (TGA)

State Food and Drug Administration (SFDA)

Federal Trade Commission

Drug Enforcement Administration

National Association of Boards of Pharmacy

STANDARDIZATION OF BAR CODING

Standardization of Bar Coding (Continued)

Efficiency Solutions for Use Following Standardization

TRENDS IN RADIOFREQUENCY IDENTIFICATION

DEVICES (RFID)

E-Pedigree Systems and RFID

HEALTHCARE PERSONNEL TRENDS

Pharmacy Personnel

Pharmacists

Technicians

Direct Care Providers

CONSUMER ISSUES

Safety

Accuracy and Accountability

NATIONAL PHARMACIST SHORTAGE

RETAIL PHARMACY ISSUES

Retail Pharmacy Issues (Continued)

Retail Pharmacy Issues (Continued)

SAFETY ISSUES

FDA Reform Bill

Medication Administration Errors

TABLE 1 AVERAGE ANNUAL ADVERSE DRUG REACTIONS AND MEDICATION ADMINISTRATION ERRORS

TABLE 2 WIDELY REPORTED TYPES OF MEDICATION ERRORS

Organizational Structure and its Effect on Errors

COMPLIANCE ISSUES

IMPLEMENTATION ISSUES

COST-EFFECTIVENESS

BARRIERS TO IMPLEMENTATION

WORLD DEMOGRAPHICS AND AN AGING POPULATION

TABLE 3 ESTIMATED WORLD POPULATION BY AGE GROUP, 2005-2012 (MILLIONS)

FIGURE 1 ESTIMATED WORLD POPULATION BY AGE GROUP, 2005-2012

TABLE 4 ESTIMATED WORLD POPULATION BY LOCATION, 2005-2012 (MILLIONS)

FIGURE 2 ESTIMATED WORLD POPULATION BY REGION, 2005 AND 2012

TABLE 5 U.S. POPULATION ESTIMATES AND PROJECTIONS BY AGE GROUP, 1900-2050 (THOUSANDS)

FIGURE 3 U.S. POPULATION ESTIMATES AND PROJECTIONS BY AGE GROUP, 1900-2050 (THOUSANDS)

Gender and Age

TABLE 6 ESTIMATES OF U.S. LIFE EXPECTANCY AT BIRTH WITH PROJECTIONS BY SEX, 2000-2020 (YEARS)

FIGURE 4 ESTIMATES OF U.S. LIFE EXPECTANCY AT BIRTH WITH PROJECTIONS BY SEX, 2000-2020 (YEARS)

HEALTHCARE SYSTEM USAGE

TABLE 7 AVERAGE YEARLY ADMISSIONS AND CURRENT RESIDENTS BY TYPE OF HEALTHCARE FACILITY IN THE U.S

TABLE 8 HOSPITAL USAGE STATISTICS BY SELECTED REGION, 2007 (DAYS)

GLOBAL TRENDS

Mexico

Europe

Australia and New Zealand

Canada

Asia

INPATIENT PHARMACY AUTOMATION

OVERVIEW

ACUTE CARE SETTINGS

TABLE 9 ESTIMATED NUMBER OF REGISTERED HOSPITALS BY SELECTED COUNTRY, 2007

TABLE 10 TOTAL NUMBER OF REGISTERED U.S. HOSPITALS BY TYPE, 2007

FOR-PROFIT AND NOT-FOR-PROFIT HOSPITALS

TABLE 11 U.S. COMMUNITY HOSPITAL COMPARISONS BY PROFIT TYPE, 2007

TABLE 12 EXAMPLES OF LEADING FOR-PROFIT U.S. HOSPITAL CHAINS, 2006/2007 ($ BILLIONS)

LONG-TERM CARE SETTINGS

TABLE 13 EXAMPLES OF LEADING U.S. LONG-TERM CARE FACILITIES, 2006/2007 ($ BILLIONS)

CORRECTIONAL FACILITIES

TABLE 14 U.S. STATE AND FEDERAL CORRECTIONAL FACILITIES BY TYPE AND SIZE, 2004*

COST ANALYSIS OF PHARMACY AUTOMATION EQUIPMENT

TABLE 15 COST ANALYSES OF PHARMACY AUTOMATION EQUIPMENT USED IN INPATIENT APPLICATIONS ($ MILLIONS)

TABLE 15 (CONTINUED)

CASE STUDIES

EVERGREEN HOSPITAL MEDICAL CENTER (KIRKLAND, WA)

LEESBURG REGIONAL MEDICAL CENTER (LEESBURG, FL)

MIAMI CHILDREN’S HOSPITAL (MIAMI, FL)

MOUNTAIN VIEW HOSPITAL (LAS VEGAS, NV)

PRODUCT DESCRIPTIONS

AUTOMATED DISPENSING SYSTEMS

Automated Dispensing Systems (Continued)

AUTOMATED PACKAGING SYSTEMS

Automated Packaging Systems (Continued)

Automated Packaging Systems (Continued)

NARCOTICS MANAGEMENT SYSTEMS

OTHER AUTOMATED SYSTEMS

LEVEL OF AUTOMATION WITHIN INPATIENT PHARMACY

SETTINGS

TABLE 16 PERCENTAGE OF U.S. AND CANADIAN INPATIENT PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

FIGURE 5 PERCENTAGE OF U.S. AND CANADIAN INPATIENT PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

TABLE 17 PERCENTAGE OF EUROPEAN UNION INPATIENT PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007

FIGURE 6 PERCENTAGE OF EUROPEAN UNION INPATIENT PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

INPATIENT AUTOMATION COST BY EQUIPMENT TYPE

TABLE 18 SUMMARY OF INPATIENT PHARMACY AUTOMATION EQUIPMENT BY MANUFACTURER, EQUIPMENT TYPE AND COST ($)

TABLE 18 (CONTINUED)

MARKET SIZE AND GROWTH

OVERVIEW

MARKETS BY PRODUCT TYPE

TABLE 19 ESTIMATED WORLDWIDE INPATIENT PHARMACY AUTOMATION MARKET BY EQUIPMENT TYPE, THROUGH 2012 ($ MILLIONS)

FIGURE 7 ESTIMATED WORLDWIDE INPATIENT PHARMACY AUTOMATION MARKET BY EQUIPMENT TYPE, 2005-2012 ($ MILLIONS)

MARKETS BY WORLD REGION

TABLE 20 WORLDWIDE INPATIENT PHARMACY AUTOMATION SYSTEMS REVENUES BY WORLD REGION, 2007 ($ MILLIONS)

FIGURE 8 WORLDWIDE INPATIENT PHARMACY AUTOMATION SYSTEMS MARKET SHARES BY WORLD REGION, 2007 (%)

COMPETITIVE STRUCTURE AND MARKET SHARE

TABLE 21 ESTIMATED WORLDWIDE INPATIENT PHARMACY AUTOMATION EQUIPMENT MANUFACTURER REVENUES, 2007 ($ MILLIONS)

FIGURE 9 ESTIMATED WORLDWIDE INPATIENT PHARMACY AUTOMATION EQUIPMENT MANUFACTURER MARKET SHARES, 2007 (%)

OUTPATIENT PHARMACY AUTOMATION

OVERVIEW

TABLE 22 U.S. RETAIL PRESCRIPTION DRUG SALES BY OUTLET, 1995-2006 (MILLION UNITS/$ BILLION)

OUTPATIENT/FAST-TRACK CLINIC SETTINGS

TABLE 23 U.S. OUTPATIENT/FAST-TRACK CLINICS BY SELECTED TYPE OF FACILITY, 2007 ($ MILLIONS)

HOSPITAL RETAIL SETTINGS

TABLE 24 ESTIAMTED U.S.HOSPITAL OUTPATIENT AND EMERGENCY ROOM VISITS BY PATIENT AGE, 2007 (MILLIONS)

PHARMACY BENEFIT MANAGEMENT SERVICES AND OTHER MAIL-ORDER SETTINGS

TABLE 25 EXAMPLES OF LEADING U.S. PHARMACY BENEFIT MANAGEMENT ORGANIZATIONS AND OTHER MAIL-ORDER GROUPS’ ESTIMATED SALES ACTIVITY*, 2007 ($ BILLIONS)

RETAIL PHARMACY CHAINS

TABLE 26 EXAMPLES OF LEADING U.S. RETAIL PHARMACY CHAINS’ ESTIMATED SALES ACTIVITY*, 2007 ($ BILLIONS)

TABLE 27 U.S. RETAIL PHARMACY CHAINS: NUMBER OF LOCATIONS AND PERCENTAGE, BY STATE BY STATE, 2006

TABLE 27 (CONTINUED)

FIGURE 10 U.S. RETAIL PHARMACY CHAINS: NUMBER OF LOCATIONS BY STATE, 2006

FIGURE 11 DISTRIBUTION OF WALGREEN PHARMACIES IN THE U.S. BY STATE, 2006 (%)

FIGURE 12 DISTRIBUTION OF CVS PHARMACIES IN THE U.S. BY STATE, 2006 (%)

FIGURE 13 DISTRIBUTION OF RITE AID PHARMACIES IN THE U.S. BY STATE, 2006 (%)

FIGURE 14 DISTRIBUTION OF LONGS DRUG STORE PHARMACIES IN THE U.S. BY STATE, 2006 (%)

COST ANALYSIS OF PHARMACY AUTOMATION EQUIPMENT

TABLE 28 EXAMPLE COST ANALYSES OF PHARMACY AUTOMATION EQUIPMENT USED IN OUTPATIENT APPLICATIONS

CASE STUDIES

OHIO DEPARTMENT OF MENTAL HEALTH (COLUMBUS, OH)

LONDON DRUGS (CANADA)

PRODUCT DESCRIPTIONS

AUTOMATED DISPENSING SYSTEMS

Automated Dispensing Systems (Continued)

AUTOMATED PACKAGING/FILLING SYSTEMS

Automated Packaging/Filling Systems (Continued)

Automated Packaging/Filling Systems (Continued)

SAMPLES MANAGEMENT SYSTEMS

OTHER AUTOMATED SYSTEMS

LEVEL OF AUTOMATION WITHIN OUTPATIENT PHARMACY

SETTINGS

TABLE 29 PERCENTAGE OF U.S. AND CANADIAN OUTPATIENT PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

FIGURE 15 PERCENTAGE OF U.S. AND CANADIAN OUTPATIENT PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

TABLE 30 PERCENTAGE OF EUROPEAN UNION OUTPATIENT PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007

FIGURE 16 PERCENTAGE OF EUROPEAN UNION OUTPATIENT PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

COST OF OUTPATIENT AUTOMATION BY EQUIPMENT TYPE

TABLE 31 SUMMARY OF OUTPATIENT PHARMACY AUTOMATION EQUIPMENT BY MANUFACTURER, EQUIPMENT TYPE, AND COST

TABLE 31 (CONTINUED)

MARKET SIZE AND GROWTH

OVERVIEW

MARKETS BY PRODUCT TYPE

TABLE 32 ESTIMATED WORLDWIDE OUTPATIENT PHARMACY AUTOMATION MARKET BY EQUIPMENT TYPE, THROUGH 2012 ($ MILLIONS)

FIGURE 17 ESTIMATED WORLDWIDE OUTPATIENT PHARMACY AUTOMATION MARKET BY EQUIPMENT TYPE, THROUGH 2012 ($ MILLIONS)

MARKETS BY WORLD REGION

TABLE 33 WORLDWIDE OUTPATIENT PHARMACY AUTOMATION SYSTEMS REVENUES BY REGION, 2007 ($ MILLIONS/PERCENT)

FIGURE 18 WORLDWIDE OUTPATIENT PHARMACY AUTOMATION SYSTEMS MARKET SHARES BY REGION, 2007 (%)

COMPETITIVE STRUCTURE AND MARKET SHARE

TABLE 34 ESTIMATED WORLDWIDE OUTPATIENT PHARMACY AUTOMATION MANUFACTURER REVENUES AND PERCENTAGE, 2007 ($ MILLIONS)

FIGURE 19 ESTIMATED WORLDWIDE OUTPATIENT PHARMACY AUTOMATION MANUFACTURER MARKET SHARES, 2007 (%)

WORLDWIDE PHARMACY AUTOMATION MARKET SUMMARY

WORLDWIDE MARKET BY SEGMENT

TABLE 35 ESTIMATED WORLDWIDE INPATIENT AND OUTPATIENT PHARMACY AUTOMATION MARKET BY SEGMENT, THROUGH 2012 ($ MILLIONS)

FIGURE 20 ESTIMATED WORLDWIDE INPATIENT AND OUTPATIENT PHARMACY AUTOMATION MARKET BY SEGMENT, 2005- 2012 ($ MILLIONS)

WORLDWIDE MARKET BY EQUIPMENT TYPE

TABLE 36 ESTIMATED WORLDWIDE PHARMACY AUTOMATION MARKET BY EQUIPMENT TYPE, THROUGH 2012 ($ MILLIONS)

FIGURE 21 ESTIMATED WORLDWIDE PHARMACY AUTOMATION MARKET BY EQUIPMENT TYPE, 2005-2012 ($ MILLIONS)

WORLDWIDE MARKET SHARES BY SEGMENT

TABLE 37 ESTIMATED WORLDWIDE PHARMACY AUTOMATION MARKET SHARES BY SEGMENT, 2005-2012 (%)

FIGURE 22 ESTIMATED WORLDWIDE PHARMACY AUTOMATION MARKET SHARES BY SEGMENT, 2005-2012 (%)

WORLDWIDE MARKET SHARES BY EQUIPMENT TYPE

TABLE 38 ESTIMATED WORLDWIDE PHARMACY AUTOMATION MARKET SHARES BY EQUIPMENT TYPE, THROUGH 2012 (%)

FIGURE 23 WORLDWIDE PHARMACY AUTOMATION MARKET SHARES BY EQUIPMENT TYPE, THROUGH 2012 (%)

WORLDWIDE MARKET BY GEOGRAPHIC REGION

TABLE 39 WORLDWIDE PHARMACY AUTOMATION SYSTEMS REVENUES BY REGION, 2007 ($ MILLIONS/PERCENT)

FIGURE 24 WORLDWIDE PHARMACY AUTOMATION SYSTEMS MARKET SHARES BY REGION, 2007 (%)

INDUSTRY PARTICIPANTS BY EQUIPMENT TYPE

TABLE 40 INDUSTRY PARTICIPANTS BY EQUIPMENT TYPE, 2007

TABLE 41 WORLDWIDE PHARMACY AUTOMATION EQUIPMENT PROVIDER PRODUCT LIST

TABLE 41 (CONTINUED)

TECHNOLOGY

OVERVIEW

CURRENT USES OF TECHNOLOGY

ROBOTICS

The Future of Robotics in Medicine

Robotic Configurations

Cartesian Robots

Biomek Pipetting Station

Cylindrical Robots

Articulating Robots

How Robots Mimic Human Movements

Robot Locomotion

Linear Tracks

Sensor Technology

Programming Languages

User Interfaces

Graphic Image Interfaces

Guidance Systems

Fluorescent Guidepaths

Solvent-Borne Guidepaths

Water-Borne Emulsion Guidepaths

Automated Parenteral Dispensers

U.S. PATENT ANALYSIS

TABLE 42 NUMBER OF U.S. PHARMACY AUTOMATION PATENTS FILED BY YEAR, 1992-2007

FIGURE 25 NUMBER OF U.S. PHARMACY AUTOMATION PATENTS FILED BY YEAR, 1992-2007

TABLE 43 U.S. PHARMACY AUTOMATION PATENTS, 1995-2007

TABLE 43 (CONTINUED)

WORLDWIDE PATENT ANALYSIS

TABLE 44 WORLDWIDE PHARMACY AUTOMATION PATENTS AND PATENT APPLICATIONS BY ASSIGNEE COMPANY, 1970-2007

TABLE 44 (CONTINUED)

TABLE 44 (CONTINUED)

TABLE 44 (CONTINUED)

FIGURE 26 NUMBER OF PATENTS HELD BY COMPANY

COMPANY PROFILES

AmerisourceBergen

Baxter International

Cardinal Health

Euclid Spiral Paper Tube Corp.

ForHealth Technologies

Innovation

Kirby Lester

Luciano Packaging

McKesson

MTS

Omnicell

Parata Systems

QEM, Inc.

ScriptPro

Swisslog

Talyst, Inc.

COMPANY PROFILES

AMERISOURCEBERGEN

BAXA CORP

BAXTER INTERNATIONAL, INC.

CARE FUSION

CERNER CORP.

EUCLID SPIRAL PAPER TUBE CORP

FORHEALTH TECHNOLOGIES, INC.

INNOVATION ASSOCIATES

KIRBY LESTER, INC

LIONVILLE SYSTEMS, INC

MCKESSON

MED-DISPENSE, LLC

MEDICAL PACKAGING, INC

MEDITECH PTY, LTD

MTS MEDICATION TECHNOLOGIES

OMNICELL, INC.

PARATA SYSTEMS

PYXIS CORP.

RX SYSTEMS, INC

SCRIPTPRO

SCRIPTPRO (CONTINUED)

APPENDICES

INTRODUCTION

APPENDIX I: LEADING DRUG MANUFACTURERS

AUTOMED TECHNOLOGIES

BAXA CORP.

BAXTER INTERNATIONAL, INC

BRIDGE MEDICAL, INC.

CARE FUSION

CERNER CORP

EUCLID SPIRAL PAPER TUBE CORP.

FORHEALTH TECHNOLOGIES, INC

GE HEALTHCARE

INNOVATION ASSOCIATES

INTEGRATED DISPENSING SYSTEMS

KIRBY LESTER, INC.

LIONVILLE SYSTEMS, INC.

M.E.D.S., INC

MCKESSON

MED-DISPENSE, LLC

MEDICAL PACKAGING, INC.

MEDITEC PTY, LTD.

MEDSELECT, INC.

MTS MEDICATION TECHNOLOGIES, INC.

OMNICELL, INC.

PARATA SYSTEMS

PYXIS CORP.

RX SYSTEMS, INC.

SCRIPTPRO, LLC

TELEPHARMACY SOLUTIONS, INC.

APPENDIX II: OTHER RELATED COMPANIES

ABBOTT LABORATORIES

ASTERES, INC

ASSOCIATED PHARMACIES, INC.

ASTRAZENECA, PLC

BAXTER HEALTHCARE CORP

BECKMAN COULTER, INC.

BRISTOL-MYERS SQUIBB CO

CARDINAL HEALTH, INC.

CYBERFLUOR, INC

DIEBOLD, INC.

FAULDING PHARMACEUTICAL CO.

FOREST LABORATORIES, INC.

GLAXOSMITHKLINE, PLC

KVM TECHNOLOGIES

LUCIANO PACKAGING TECHNOLOGIES, INC

MICROSOFT CORP

NEVOCA.COM, INC

NOVARTIS PHARMACEUTICAL CORP

NOVOPHARM, LTD.

PERKINELMER, INC

PERRIGO CO.

PFIZER, INC.

PHARMITAS, INC.

PROMEDICA, INC

PHARMACY AUTOMATION SYSTEMS, INC.

QEM, INC.

SWISSLOG HOLDING AG

TALYST, INC.

ZYMARK CORP.

APPENDIX III: HOSPITALS, RETAIL PHARMACIES, AND OTHERS

ALBERTSON’S, INC

BEVERLY ENTERPRISES, INC./GOLDEN LIVING

COMMUNITY HEALTH SYSTEMS, INC.

COSTCO WHOLESALE CORP

CVS CAREMARK

EVERGREEN HOSPITAL MEDICAL CENTER

EXPRESS SCRIPTS, INC

FLAGLER HOSPITAL

HCA, INC

HEALTH MANAGEMENT ASSOCIATES, INC.

IASIS HEALTHCARE CORP.

JACKSON HOSPITAL

THE JOHNS HOPKINS HOSPITAL

KINDRED HEALTHCARE, INC

KROGER COMPANY, THE

LEESBURG REGIONAL MEDICAL CENTER

LIFEBRIDGE HEALTH - SINAI HOSPITAL OF BALTIMORE

LIFEPOINT HOSPITALS, INC

LONDON DRUGS LTD.

LONGS DRUG STORES CORP.

MANOR CARE, INC.

MARINER HEALTH CARE, INC

MEDCO HEALTH SOLUTIONS, INC

MEDICINE SHOPPE INTERNATIONAL, THE

MIAMI CHILDREN’S HOSPITAL

MOUNTAIN VIEW HOSPITAL

NEW ORLEANS OCHSNER CLINIC

OHIO DEPARTMENT OF MENTAL HEALTH

RITE AID CORP

SAVASENIORCARE, LLC

TARGET CORP.

TENET HEALTHCARE CORP.

UNITED SUPERMARKETS, LTD

UNIVERSAL HEALTH SERVICES, INC

UNIVERSITY OF MARYLAND MEDICAL CENTER

VANGUARD HEALTH SYSTEMS, INC

WALGREEN CO.

WAL-MART STORES, INC.

APPENDIX IV: ASSOCIATIONS AND ORGANIZATIONS

AMERICAN ASSOCIATION OF COLLEGES OF PHARMACY

AMERICAN HOSPITAL ASSOCIATION

AUSTRALIAN DEPARTMENT OF HEALTH AND AGING

AUSTRALIAN INSTITUTE OF HEALTH AND WELFARE

CANADIAN INSTITUTE FOR HEALTH INFORMATION

CENTRAL DRUGS STANDARD CONTROL ORGANIZATION

CENTER FOR MEDICARE & MEDICAID SERVICES

CREIGHTON UNIVERSITY

DRUG ENFORCEMENT ADMINISTRATION

EUROPEAN FEDERATION OF PHARMACEUTICAL

INDUSTRIES AND ASSOCIATIONS

EUROPEAN MEDICINES EVALUATION AGENCY

EUROPEAN PATENT OFFICE

FEDERAL TRADE COMMISSION

FOOD & DRUG ADMINISTRATION

HEALTH CANADA

JAPANESE MINISTRY OF HEALTH, LABOR, AND

WELFARE

JOINT COMMISSION ON ACCREDITATION OF

HEALTHCARE ORGANIZATIONS

MEDICINES AND HEALTHCARE PRODUCTS REGULATORY

AGENCY

NATIONAL ASSOCIATION OF BOARDS OF PHARMACY

NATIONAL PATIENT SAFETY AGENCY

OREGON STATE BOARD OF PHARMACY

ROYAL PHARMACEUTICAL SOCIETY OF GREAT BRITAIN

STATE FOOD AND DRUG ADMINISTRATION

THERAPEUTIC GOODS ADMINISTRATION

U.S. BUREAU OF LABOR STATISTICS

U.S. CENSUS BUREAU

U.S. DEPARTMENT OF DEFENSE

U.S. PATENT AND TRADEMARK OFFICE

LIST OF TABLES

SUMMARY TABLE TOTAL ESTIMATED WORLDWIDE INPATIENT AND

OUTPATIENT PHARMACY AUTOMATION MARKET BY SEGMENT,

THROUGH 2012 ($ MILLIONS)

TABLE 1 AVERAGE ANNUAL ADVERSE DRUG REACTIONS AND

MEDICATION ADMINISTRATION ERRORS

TABLE 2 WIDELY REPORTED TYPES OF MEDICATION ERRORS

TABLE 3 ESTIMATED WORLD POPULATION BY AGE GROUP, 2005-

2012 (MILLIONS)

TABLE 4 ESTIMATED WORLD POPULATION BY LOCATION, 2005-2012

(MILLIONS)

TABLE 5 U.S. POPULATION ESTIMATES AND PROJECTIONS BY AGE

GROUP, 1900-2050 (THOUSANDS)

TABLE 6 ESTIMATES OF U.S. LIFE EXPECTANCY AT BIRTH WITH

PROJECTIONS BY SEX, 2000-2020 (YEARS)

TABLE 7 AVERAGE YEARLY ADMISSIONS AND CURRENT RESIDENTS

BY TYPE OF HEALTHCARE FACILITY IN THE U.S.

TABLE 8 HOSPITAL USAGE STATISTICS BY SELECTED REGION, 2007

(DAYS)

TABLE 9 ESTIMATED NUMBER OF REGISTERED HOSPITALS BY

SELECTED COUNTRY, 2007

TABLE 10 TOTAL NUMBER OF REGISTERED U.S. HOSPITALS BY

TYPE, 2007

TABLE 11 U.S. COMMUNITY HOSPITAL COMPARISONS BY PROFIT

TYPE, 2007

TABLE 12 EXAMPLES OF LEADING FOR-PROFIT U.S. HOSPITAL

CHAINS, 2006/2007 ($ BILLIONS)

TABLE 13 EXAMPLES OF LEADING U.S. LONG-TERM CARE

FACILITIES, 2006/2007 ($ BILLIONS)

TABLE 14 U.S. STATE AND FEDERAL CORRECTIONAL FACILITIES BY

TYPE AND SIZE, 2004*

TABLE 15 COST ANALYSES OF PHARMACY AUTOMATION

EQUIPMENT USED IN INPATIENT APPLICATIONS ($ MILLIONS)

TABLE 16 PERCENTAGE OF U.S. AND CANADIAN INPATIENT

PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

TABLE 17 PERCENTAGE OF EUROPEAN UNION INPATIENT

PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007

TABLE 18 SUMMARY OF INPATIENT PHARMACY AUTOMATION

EQUIPMENT BY MANUFACTURER, EQUIPMENT TYPE AND COST

($)

TABLE 19 ESTIMATED WORLDWIDE INPATIENT PHARMACY

AUTOMATION MARKET BY EQUIPMENT TYPE, THROUGH 2012

($ MILLIONS)

TABLE 20 WORLDWIDE INPATIENT PHARMACY AUTOMATION

SYSTEMS REVENUES BY WORLD REGION, 2007 ($ MILLIONS)

TABLE 21 ESTIMATED WORLDWIDE INPATIENT PHARMACY

AUTOMATION EQUIPMENT MANUFACTURER REVENUES, 2007

($ MILLIONS)

TABLE 22 U.S. RETAIL PRESCRIPTION DRUG SALES BY OUTLET,

1995-2006 (MILLION UNITS/$ BILLION)

TABLE 23 U.S. OUTPATIENT/FAST-TRACK CLINICS BY SELECTED

TYPE OF FACILITY, 2007 ($ MILLIONS)

TABLE 24 ESTIAMTED U.S.HOSPITAL OUTPATIENT AND

EMERGENCY ROOM VISITS BY PATIENT AGE, 2007 (MILLIONS)

TABLE 25 EXAMPLES OF LEADING U.S. PHARMACY BENEFIT

MANAGEMENT ORGANIZATIONS AND OTHER MAIL-ORDER

GROUPS’ ESTIMATED SALES ACTIVITY*, 2007 ($ BILLIONS)

TABLE 26 EXAMPLES OF LEADING U.S. RETAIL PHARMACY CHAINS’

ESTIMATED SALES ACTIVITY*, 2007 ($ BILLIONS)

TABLE 27 U.S. RETAIL PHARMACY CHAINS: NUMBER OF LOCATIONS

AND PERCENTAGE, BY STATE BY STATE, 2006

TABLE 28 EXAMPLE COST ANALYSES OF PHARMACY AUTOMATION

EQUIPMENT USED IN OUTPATIENT APPLICATIONS

TABLE 29 PERCENTAGE OF U.S. AND CANADIAN OUTPATIENT

PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

TABLE 30 PERCENTAGE OF EUROPEAN UNION OUTPATIENT

PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007

TABLE 31 SUMMARY OF OUTPATIENT PHARMACY AUTOMATION

EQUIPMENT BY MANUFACTURER, EQUIPMENT TYPE, AND COST

TABLE 32 ESTIMATED WORLDWIDE OUTPATIENT PHARMACY

AUTOMATION MARKET BY EQUIPMENT TYPE, THROUGH 2012

($ MILLIONS)

TABLE 33 WORLDWIDE OUTPATIENT PHARMACY AUTOMATION

SYSTEMS REVENUES BY REGION, 2007 ($ MILLIONS/PERCENT)

TABLE 34 ESTIMATED WORLDWIDE OUTPATIENT PHARMACY

AUTOMATION MANUFACTURER REVENUES AND PERCENTAGE,

2007 ($ MILLIONS)

TABLE 35 ESTIMATED WORLDWIDE INPATIENT AND OUTPATIENT

PHARMACY AUTOMATION MARKET BY SEGMENT, THROUGH 2012

($ MILLIONS)

TABLE 36 ESTIMATED WORLDWIDE PHARMACY AUTOMATION

MARKET BY EQUIPMENT TYPE, THROUGH 2012 ($ MILLIONS)

TABLE 37 ESTIMATED WORLDWIDE PHARMACY AUTOMATION

MARKET SHARES BY SEGMENT, 2005-2012 (%)

TABLE 38 ESTIMATED WORLDWIDE PHARMACY AUTOMATION

MARKET SHARES BY EQUIPMENT TYPE, THROUGH 2012 (%)

TABLE 39 WORLDWIDE PHARMACY AUTOMATION SYSTEMS

REVENUES BY REGION, 2007 ($ MILLIONS/PERCENT)

TABLE 40 INDUSTRY PARTICIPANTS BY EQUIPMENT TYPE, 2007

TABLE 41 WORLDWIDE PHARMACY AUTOMATION EQUIPMENT

PROVIDER PRODUCT LIST

TABLE 42 NUMBER OF U.S. PHARMACY AUTOMATION PATENTS

FILED BY YEAR, 1992-2007

TABLE 43 U.S. PHARMACY AUTOMATION PATENTS, 1995-2007

TABLE 44 WORLDWIDE PHARMACY AUTOMATION PATENTS AND

PATENT APPLICATIONS BY ASSIGNEE COMPANY, 1970-2007

LIST OF FIGURES

SUMMARY FIGURE TOTAL ESTIMATED WORLDWIDE INPATIENT

AND OUTPATIENT PHARMACY AUTOMATION MARKET BY

SEGMENT, 2005-2012 ($ MILLIONS)

FIGURE 1 ESTIMATED WORLD POPULATION BY AGE GROUP, 2005-

2012

FIGURE 2 ESTIMATED WORLD POPULATION BY REGION, 2005 AND

2012

FIGURE 3 U.S. POPULATION ESTIMATES AND PROJECTIONS BY AGE

GROUP, 1900-2050 (THOUSANDS)

FIGURE 4 ESTIMATES OF U.S. LIFE EXPECTANCY AT BIRTH WITH

PROJECTIONS BY SEX, 2000-2020 (YEARS)

FIGURE 5 PERCENTAGE OF U.S. AND CANADIAN INPATIENT

PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

FIGURE 6 PERCENTAGE OF EUROPEAN UNION INPATIENT

PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

FIGURE 7 ESTIMATED WORLDWIDE INPATIENT PHARMACY

AUTOMATION MARKET BY EQUIPMENT TYPE, 2005-2012

($ MILLIONS)

FIGURE 8 WORLDWIDE INPATIENT PHARMACY AUTOMATION

SYSTEMS MARKET SHARES BY WORLD REGION, 2007 (%)

FIGURE 9 ESTIMATED WORLDWIDE INPATIENT PHARMACY

AUTOMATION EQUIPMENT MANUFACTURER MARKET SHARES,

2007 (%)

FIGURE 10 U.S. RETAIL PHARMACY CHAINS: NUMBER OF

LOCATIONS BY STATE, 2006

FIGURE 11 DISTRIBUTION OF WALGREEN PHARMACIES IN THE U.S.

BY STATE, 2006 (%)

FIGURE 12 DISTRIBUTION OF CVS PHARMACIES IN THE U.S. BY

STATE, 2006 (%)

FIGURE 13 DISTRIBUTION OF RITE AID PHARMACIES IN THE U.S. BY

STATE, 2006 (%)

FIGURE 14 DISTRIBUTION OF LONGS DRUG STORE PHARMACIES IN

THE U.S. BY STATE, 2006 (%)

FIGURE 15 PERCENTAGE OF U.S. AND CANADIAN OUTPATIENT

PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

FIGURE 16 PERCENTAGE OF EUROPEAN UNION OUTPATIENT

PHARMACIES AT ESTIMATED LEVELS OF AUTOMATION, 2007 (%)

FIGURE 17 ESTIMATED WORLDWIDE OUTPATIENT PHARMACY

AUTOMATION MARKET BY EQUIPMENT TYPE, THROUGH 2012

($ MILLIONS)

FIGURE 18 WORLDWIDE OUTPATIENT PHARMACY AUTOMATION

SYSTEMS MARKET SHARES BY REGION, 2007 (%)

FIGURE 19 ESTIMATED WORLDWIDE OUTPATIENT PHARMACY

AUTOMATION MANUFACTURER MARKET SHARES, 2007 (%)

FIGURE 20 ESTIMATED WORLDWIDE INPATIENT AND OUTPATIENT

PHARMACY AUTOMATION MARKET BY SEGMENT, 2005- 2012

($ MILLIONS)

FIGURE 21 ESTIMATED WORLDWIDE PHARMACY AUTOMATION

MARKET BY EQUIPMENT TYPE, 2005-2012 ($ MILLIONS)

FIGURE 22 ESTIMATED WORLDWIDE PHARMACY AUTOMATION

MARKET SHARES BY SEGMENT, 2005-2012 (%)

FIGURE 23 WORLDWIDE PHARMACY AUTOMATION MARKET

SHARES BY EQUIPMENT TYPE, THROUGH 2012 (%)

FIGURE 24 WORLDWIDE PHARMACY AUTOMATION SYSTEMS

MARKET SHARES BY REGION, 2007 (%)

FIGURE 25 NUMBER OF U.S. PHARMACY AUTOMATION PATENTS

FILED BY YEAR, 1992-2007

FIGURE 26 NUMBER OF PATENTS HELD BY COMPANY